Background:
Prostate cancer is the most common cancer in men in the UK with incidence rates projected to rise (1). Black men are at least twice as likely to develop prostate cancer as white men and the mortality rate is twice as high (1–3), evidencing substantial cancer inequalities. Although there currently is no national screening programme for prostate cancer, it is vital that black men are aware of prostate cancer and their elevated risk as this can encourage help-seeking behaviour, and in turn early diagnosis. Early diagnosis can save lives, yet black men tend to present at later stages (4,5). Without action, these rates will increase further and importantly, exacerbate prostate cancer inequalities (1). Participatory and community-centred approaches are an important strategy to tackle health inequalities (6,7). Furthermore, culturally tailored approaches in cancer communication that are aligned with the values of the target population, are more effective than non-targeted interventions (8,9). Therefore, working in partnership with the local black population, we aim to co-design a culturally appropriate intervention to tackle barriers to early diagnosis of prostate cancer for black men in Scotland and the North-East of England using a community-centred participatory approach.

PPIE:
We aim to recruit a Patient and Public Involvement and Engagement (PPIE) group (n=10) who will be involved at every step of the research. Two community leads will be part of the research team.

Methods:
This mixed methods study will run in two socioeconomically deprived areas with poor cancer outcomes: Scotland and the North-East of England, which lack inclusion in UK research. Drawing on the principles of the Integrated Screening Action model (I-SAM)(10), the study has 8 objectives: 1) to explore barriers to early diagnosis of prostate cancer among black men (45+) in Scotland and the North-East of England through two focus groups with the PPIE group (n=10); 2) to co-design with the PPIE group a culturally acceptable peer-led intervention to tackle barriers to early diagnosis of prostate cancer in black men; 3) to train members of the black community as ‘peer-educators’; 4) to deliver the intervention face-to-face in each location, facilitated by peer-educators, with a purposive sample (n=20) of black men (45+); 5) to qualitatively evaluate the intervention through focus groups and interviews; 6) to refine the intervention based on the qualitative feedback; 7) to pilot the refined intervention with another purposive sample (n=40) through a cross-sectional survey pre- and post-intervention; 8) to qualitatively evaluate the refined intervention through focus groups and interviews to further refine the intervention.

Outcome:
This project aims to co-design a culturally appropriate intervention to tackle inequalities in prostate cancer outcomes by increasing black men’s awareness and understanding of the risks of prostate cancer, and improve attitudes to help-seeking behaviours. Community-centred and culturally tailored interventions have the potential to be effective in addressing barriers to early diagnosis of prostate cancer, and thus ultimately reduce morbidity and mortality rates through earlier diagnosis in black communities.

Funding:
This study is funded by Prostate Cancer Research for 24 months.