Design and Implementation of a Community-Based Educational Program to Enhance Prostate Cancer Screening in Southeastern Puerto Rico.

Abstract

BACKGROUND/OBJECTIVES: Prostate cancer (PCa) has the highest incidence and mortality rates among men in Puerto Rico. However, screening and early detection programs remain limited and fragmented. This study presents the design and implementation of a community-based educational program to increase PCa screening and knowledge in three southeastern rural communities with high African ancestry and elevated PCa mortality. METHODS: Conducted between 2021 and 2025, this mixed-method study followed Community Engagement principles and was guided by the Intervention Mapping framework. A Community Advisory Committee informed each step of the intervention, which included PSA and digital rectal examination (DRE) testing via a mobile clinic staffed by urologists. Pre- and post-tests measured knowledge gains and willingness to screen, while satisfaction surveys evaluated the program's impact. RESULTS: After the intervention, knowledge scores increased significantly (t = -5.5, p < 0.001), and 76% of participants reported greater confidence in making health decisions. In total, 95 men accessed screening services through a mobile clinic, 33 were referred for follow-up, and 4 PCa cases were detected. CONCLUSIONS: Combining culturally tailored education with accessible screening helped overcome sociocultural and structural barriers, showing promise for reducing PCa disparities in underserved Puerto Rican populations.