This blog is the first entry of a three-part series focusing on nurse-led education programs located in faith-based community settings. This series aims to motivate parishioners to engage in personal healthcare practices.

Introduction

In February 2020, we witnessed a global retreat of patients from health care settings due to facility closures and fears of contracting the COVID-19 virus.

Consequently, during the past 18 months, men’s health screenings have been less available for those in need of annual screenings, as well as those experiencing early symptoms of potential prostate disease.

Nurses are amongst the most trusted health leaders (Godde 2021), and as we emerge from this crisis, now is the time for us to engage in out-of-the-box thinking that will address this critical need.

Faith-based communities provide ideal locations to host educational programs about men’s health screenings that will effectively reach members who are reluctant to return to healthcare settings.

The Unintended Consequences of the COVID-19 Pandemic

Breast and prostate cancer screening rates declined rapidly in the early months of the COVID-19 pandemic compared to rates from the same time period a year earlier, according to a study by the University of Massachusetts (Spencer 2021).

While these rates rebounded in June 2020, prostate testing stayed well below pre-pandemic levels through the study’s end in October 2020.

“We do know that it’s possible that when people miss a screening test, they could be diagnosed with cancer down the line, but it might be at a more advanced stage than if it had been detected earlier by screening,” Mara Meyer Epstein, assistant professor of medicine in the Division of Geriatric Medicine and the Meyers Primary Care Institute, said in response to these results (Spencer 2021).

Faith-Based Health Promotion

Local parishes offer an ideal setting for nurses to position themselves amongst their family, friends and coworkers in order to create teachable moments within the walls of faith-based communities.

The United States has evidenced data from a variety of surveys indicating that Black Americans, on average, demonstrate a high degree of religious involvement (Taylor, Chatters, & Levin 2004). The ‘Black Church’ provides its members with a place to worship and serve their spiritual beliefs by addressing the unmet needs of members who are disenfranchised, despondent or experiencing devastating personal or professional losses.

These faith-based institutions are also ideally suited to be the epicentre for nurse-led health promotion programs that provide parishioners with information and education on personal health care needs.

A Focus on Men’s Health

It’s been recognised that the concept of men’s health ‘extends beyond male-specific conditions of the reproductive organs, such as prostate problems, testicular concerns and erectile dysfunction’ (Smith 2007).

For example, men’s health has been linked to perceptions of masculinity, which vary across cultures and racial ethnicities.

Parsons (2009) proposes that men are enculturated with masculine values such as stoicism, suppression of emotion, independence and self-reliance, which adds to the complex issues involved in structuring education for men’s health.

Another factor that nurse educators should consider when planning educational programs is the potential barrier of health literacy.

According to researchers, higher health literacy directly correlates to higher rates of prostate cancer screening (2020). Struggles with health literacy are associated with a loss of self-worth and shame that may prevent men from seeking information about prostate health and the importance of prostate screenings. Therefore, nurse educators should assess the health literacy amongst parishioners and then create educational materials that will clearly and concisely meet their learning needs.

Designing Your Men’s Prostate Awareness Church Training (M-PACT) Program

Step One: Recruiting Your Program Team

Nursing has been considered the most honest and ethical profession for 19 consecutive years (Oakland University 2021).

This is a critical point to consider when designing education focused on topics that may be difficult to discuss in public forums. Nurses are ideally positioned to recruit public health specialists, physicians, nursing colleagues, social workers, community volunteers and health educators within your local church community to assist with this education initiative.

Step Two: Establishing an Advisory Panel

In order to meet the unique health needs of the parishioners, your next step will be to recruit volunteer members of an advisory panel. This group should include a diverse group of stakeholders from within your local church group and community, for example:

• Clergy members
• Health professionals
• Local business leaders
• Cancer survivors
• Those with an interest in prostate cancer.

Consider the possibility of finding a business leader or local company that may be willing to provide funding for small honorariums for members of the panel.

Step Three: Scheduling Community Conversation Groups

Community conversation groups will require organisation, planning and support from local parish leaders. These groups should be scheduled at convenient times for members to attend and include time for prayer, fellowship and socialisation. Attendees should be expressly informed that the information shared amongst participants is private and personal and is not to be shared outside of the group, including on social media platforms.

Often, a period of 90 minutes is sufficient to allow members to discuss three basic areas of concern:

1. Knowledge and risk factors associated with prostate cancer
2. Use of technology to access information about prostate health
3. Strategies to optimise communication about prostate health that focus on facts versus misinformation.

The nurse leader of these groups will need to assess how many focus groups will be required to ascertain the educational needs of the parish community.

Once the groups have concluded, members of the program team should meet to discuss the common themes and issues that arose in each of the focus groups. Then, recommendations should be presented to the advisory panel for structuring and evaluating educational opportunities that will address these needs.

Summary

This blog is designed to focus on the power you possess as a nurse educator to address educational needs for community members within faith-based settings that already provide comfort, spirituality and a safe haven for members.

The next entry in this series will focus on specific education strategies that can be used to design programs that address prostate health, enhance health literacy and empower men to take charge of their health.

Judith Paré, PhD, RN

Clinical Professor
ABSN Program Director
College of Nursing and Health Science, University of Massachusetts-Boston

References

• Australian Health Ministers’ Advisory Council 2014, Prostate Cancer Screening in Australia: Position Statement, Australian Health Ministers’ Advisory Council, https://www.health.gov.au/sites/default/files/documents/2019/09/prostate-cancer-screening-position-statement.pdf
• Cancer.Net 2020, Prostate Cancer: Diagnosis, American Society of Clinical Oncology, https://www.cancer.net/cancer-types/prostate-cancer/diagnosis
• Godde, C 2021, ‘Australia’s Most and Least Trusted Professions’, 7 News, 28 April, https://7news.com.au/lifestyle/poll-finds-doctors-most-trusted-profession-c-2704423
• Meryn, S & Shabsigh, R 2009, ‘Men's Health: Past, Present and Future’, Journal of Men's Health, vol. 6, no. 3, pp. 143-146, https://www.liebertpub.com/doi/abs/10.1016/j.jomh.2009.08.191
• Oakland University 2021, ‘Gallup Poll Finds Nursing is Most Honest, Ethical Profession’, Oakland University News, viewed 19 July 2021, https://oakland.edu/oumagazine/news/nursing/2021/gallup-poll-finds-nursing-is-most-honest-ethical-profession
• Parsons, J 2009, ‘Not Mission Impossible’, Australian Family Physician, vol. 38, no. 3, https://www.racgp.org.au/download/Documents/AFP/2009/March/200903parsons.pdf
• Peters, D 2020, ‘Study Examines Health Literacy and Shared Decision-Making in Prostate Cancer Screening’, EurekAlert!, 9 November, https://www.eurekalert.org/pub_releases/2020-11/w-seh110420.php
• Saad, L 2020, ‘U.S. Ethics Ratings Rise for Medical Workers and Teachers’, Gallup, 22 December, https://news.gallup.com/poll/328136/ethics-ratings-rise-medical-workers-teachers.aspx
• Smith, J A 2007, ‘Addressing Men's Health Policy Concerns in Australia: What Can Be Done?’, Australia and New Zealand Health Policy, no. 20, viewed 23 July 2021, https://anzhealthpolicy.biomedcentral.com/articles/10.1186/1743-8462-4-20
• Spencer, E W S 2021, ‘Breast and Prostate Cancer Screenings Dropped During COVID-19 Pandemic, UMMS Study Finds’, UMass Medical School Communications, 10 February, https://www.umassmed.edu/news/news-archives/2021/02/breast-and-prostate-cancer-screenings-dropped-during-covid-19-pandemic-umms-study-finds/
• Taylor, R J, Chatters, L M & Levin, J S 2004, Religion in the Lives of African Americans: Social, Psychological and Health Perspectives, Sage Publications, Thousand Oaks, CA.