For Black patients, 'representation matters' in evaluating prostate cancer websites

For Black men with prostate cancer, racial representation is a key factor affecting trust in websites offering information on prostate cancer, reports a study in the March issue of The Journal of Urology, an official journal of the American Urological Association (AUA).

"Our study shows that representation matters to Black patients seeking prostate cancer information online," comments lead author Stacy Loeb, MD, MSc, Ph.D. (Hon), of New York University Langone Health. "Not only does it impact trust in the information, but a lack of Black representation in prostate cancer content gave the impression that Black men are at lower risk for prostate cancer."

In fact, national statistics show that Black men have higher rates of prostate cancer compared to White or Hispanic men. "Thus lack of representation could have dangerous consequences such as discouraging screening among Black men," Dr. Loeb adds.

'I don't see any melanin': Representation affects trust in patient information

The researchers conducted a series of focus groups with Black patients to assess factors affecting the perceived trustworthiness of online sources of information regarding prostate cancer. Most participants said they used the internet to seek information on their diagnosis and its treatment.

Patients viewed "Black representation [as] an important factor affecting trust in online information," Dr. Loeb and colleagues write. As one focus group participant commented when viewing a website that depicted only White patients, "Yeah, I don't see any melanin...This is exactly where they would lose me."

Participants also noticed a lack of Black faces among the professionals pictured in health care organizations and advocacy groups. As one patient commented, "As soon as I didn't see an African American doctor represented in any of the studies, it would kind of turn me off." Not seeing Black people pictured in online sites led some patients to give up on searching for information.

Findings point to recommendations for online prostate cancer information

Other factors also affected patients' trust in online information sources. All participants mentioned choosing reputable sources of content, such as leading health care institutions and national organizations. The AUA's Urology Care Foundation offers expert information on prostate cancer, along with other urologic conditions.

Participants preferred websites with a "simple professional appearance," avoiding sites that appeared "amateur, disorganized, [or] overly flashy." They also distrusted sources with any apparent financial conflict—particularly those selling alternative or herbal therapies. Even for major nonprofit organizations, patients were wary of sites with fundraising or donation buttons.

"Underrepresentation of Black adults in prostate cancer content has the potential to worsen prostate cancer health disparities," Dr. Loeb and colleagues conclude. "Optimal online communications should include racially diverse representation, and evidence-based information in a professional format from reputable sources without financial conflict."