Thesis:

The role of female partner led initiative on promoting prostate cancer screening intentions among men aged 40-69 years in rural kiambu county, kenya

Prostate cancer (PC) is a significant global health concern, particularly in Africa, where late diagnosis often leads to poor outcomes. This study aimed to evaluate the role of female partner-led initiatives in promoting the intention to screen for cancer of the prostate among men in rural Kiambu County, Kenya. A randomized controlled trial was conducted among men aged 40-69 years. Participants were randomly assigned to receive either gain-framed, loss-framed, or control brochures. Data were collected using structured questionnaires and analyzed using structural equation modeling and difference-in-difference analysis. Quantitative data was analyzed using STATA version 15 Structural equation modeling was used to assess the difference in the influence of independent variables on PCS intention between the control and intervention groups at baseline and at the end line. The difference in-difference analysis was used to assess the magnitude effect of the interventions on PCS intention, knowledge of PC, attitude, perception, and culture toward PCS. The study found that partner-led loss-framed and gain-framed interventions had a significant influence on PCS intention among men, with the loss-framed group having considerably higher rates (54.9%) of intention than those in the gain-framed group (48.4%) post-intervention. The intervention groups had a significantly higher mean difference in knowledge about cancer of the prostate than the control group, with the group treated using gain-framed and loss-framed brochures having a mean DID of 4.989 (3.561 – 6.418) and 5.264(3.804 – 6.724), respectively. Attitudes towards prostate cancer screening differed significantly among respondents in the control and intervention groups (p<0.05). Slightly above half of the respondents (52.7%) in the group intervened using gain-framed brochures had a positive attitude towards cancer of the prostate screening, and close to half (46.2%) of respondents in the group treated with loss-framed brochures had a positive attitude towards cancer of the prostate screening. Fatalism belief decreased significantly in the intervention groups that were treated with gain-framed and loss-framed brochures compared to the control group, as indicated by a mean DID of -2.376 (-2.988 to -1.765) and -2.774(-3.385 to -2.163), respectively. The study concluded that the use of loss-framed messages on brochures is more effective in promoting PCS screening, the partner-led loss-framed brochure intervention had slightly more influence on general knowledge of cancer of the prostate and knowledge on early signs of PC while the gain-framed brochure method had a more influence on knowledge on PC screening methods. The results suggest that Gain-framed messages seem to be particularly effective in addressing psychological barriers like fatalism, which can be deeply ingrained and difficult to change. These findings highlight the potential of female partner led interventions in promoting PC screening among men. The study suggests that a combination of gain-framed and loss-framed messaging, coupled with increased awareness and education, could be effective in improving PC screening rates and outcomes. This highlights the need for a multifaceted approach by concerned stakeholders to enhance the uptake of PC screening Further research is needed to explore the long-term impact of these interventions and to identify other strategies for addressing barriers to PC screening in diverse populations.