Development of a Culturally Tailored Educational Tool to Increase Somatic Testing Participation Among Black Men With Metastatic Prostate Cancer

PURPOSE Black patients with metastatic prostate cancer (mPCa) are less likely to receive somatic testing than their White counterparts. Our objective was to develop a culturally tailored educational tool intended to increase somatic testing participation. METHODS We conducted a multisite qualitative study to develop the tool, informed by the human-centered design (HCD) principles Inspiration and Ideation, and the capability-opportunity-motivation-behavior (COM-B) framework. We approached stakeholders to codesign a prototype, iteratively refined the tool through semistructured interviews with Black patients with mPCa, and identified likes , wishes , questions , and ideas until data saturation. We analyzed interviews via COM-B into barriers/facilitators of two behaviors: (1) tool engagement and (2) somatic testing participation. RESULTS Four physicians, one genetic counselor, and two patients codesigned an electronic tool, consisting of an 8-minute video of a non-Hispanic Black physician and animations followed by a text-based decision aid. We reached data saturation after interviewing 11 patients (61% of 18 approached). Participants liked the tool's cultural tailoring, wished for more information on somatic testing benefits, and questioned content gaps. Their ideas reflected cost concerns. Ten participants expressed a desire to obtain and/or speak with their oncologist about somatic testing. We identified barriers/facilitators of tool engagement and somatic testing participation, which led to changing the text-based decision aid into a Q&A format and tailoring the content to address race, cost, and biopsy-related concerns. CONCLUSION HCD and COM-B frameworks enabled the development of a culturally tailored educational tool for Black patients with mPCa. This educational tool was well received and might have contributed to increased interest in somatic testing participation. Further research to evaluate the feasibility, acceptability, and efficacy of the tool in clinical workflows is needed.