Determining Barriers to Dietary Change Among Medically Underserved Men With Prostate Cancer.

Abstract

Prostate cancer (PCa) disproportionately affects Black men and men of low socioeconomic status, who are more likely to experience higher incidence, disease progression, and mortality. Despite this, cardiovascular disease remains a leading cause of death among men with localized disease. Therefore, lifestyle interventions, particularly diet-based, provide an opportunity to drastically improve outcomes. Little is known about how underserved men with PCa and their families perceive barriers to dietary change, including adaptation of the cardioprotective Mediterranean diet (MD). This qualitative study explored dietary knowledge, cultural influences, and willingness to participate in dietary interventions among Black and Hispanic men with localized PCa at a county hospital. Six focus groups were conducted in English or Spanish with 31 total participants (men and their partners) recruited from a safety-net county hospital. Thematic analysis was guided by the health belief model and theory of planned behavior. Four themes emerged: First, the attitudes toward healthy diet and physician advice; second, the positive and negative influence of family, friends, and culture; third, the emotional and spiritual influences on dietary behavior; and finally, structural barriers and their impact on self-efficacy. Findings underscore the critical role of buy-in from family, the importance of education and instruction, and the value of maintaining space for emotion and spirituality. These results support the development of partner-engaged, culturally tailored dietary interventions for medically underserved populations with PCa.