American Indian (AI) men are disproportionately impacted by prostate cancer (PC) compared to White men and experience the worst PC outcomes of any racial/ethnic group. To address these disparities, it is important to better understand AI men's preferences regarding PC screening.
(1) Conduct a literature review, followed by qualitative, culturally responsive formative research with AI men, (2) develop and field a discrete choice experiment (DCE) survey to elicit the preferences of AI men toward prostate cancer screening, and (3) identify feasible, culturally appropriate, preference-concordant screening strategies that are targeted for AI men.
We have created a scoping literature review to identify previous PC DCEs. We will follow that review by conducting rigorous, theoretically grounded qualitative work to identify plausible DCE attributes and attribute levels among men from the Lumbee Tribe in North Carolina. We will pilot the DCE among Lumbee men to assess cultural responsiveness and comprehension of the choice context and choice tasks. Finally, we will use the DCE methodology to elicit the PC screening preferences among 100 Lumbee men between the ages of 40 and 69 years. Choice data will be analyzed using mixed logit models; trade-offs will be described using marginal rates of substitution.
The study was funded in 2024. Formative qualitative research is still ongoing. DCE data is expected to start in April 2026 and end in June 2026.
This will be the first study to use a culturally-responsive approach to DCE development in an indigenous population. The findings from this study can be used to educate providers regarding culturally-responsive PC screening and to inform the design of interventions to increase preference-concordant PC screening in AI men.
This study has been pre-registered on the OpenScienceFramework (OSF) study protocol registry (osf.io/4gnr2).
JMIR research protocols. 2026 Feb 18 [Epub ahead of print]
Chris Gillette, Ronny Bell, Tony Locklear, Jan Ostermann, Delaney Provenza, Daniel Reuland, Beata Debinski, Kristie Foley, Robert Wooten, Laiton Steele, Quazi Minhaz Tabassum
Department of PA Studies, School of Medicine, Wake Forest University, Medical Center Blvd, Winston-Salem, US., Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, US., Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, US., Health Services Policy and Management, University of South Carolina, Columbia, US., Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, US., Department of Family and Community Medicine, School of Medicine, Wake Forest University, Winston-Salem, US., Department of Implementation Science, School of Medicine, Wake Forest University, Winston-Salem, US., Department of Epidemiology and Community Health, University of North Carolina at Charlotte, Charlotte, US.