This study used a mixed methods design. Fourteen African American men (≥18 years of age) in rural central Virginia, who had been diagnosed and treated for prostate cancer, were individually interviewed. Semi-structured interviews were used to explore health status, demographics, prostate knowledge, literacy and mathematic skills, relationship issues with health professionals and family, prostate myths and religious beliefs.  Data were analyzed using both qualitative and quantitative methods. 

Three main themes were revealed from study findings: “spiritual needs are important to health,” “trust in healthcare providers is necessary,” and “how men decide on what to believe.”  Prayer was used by all 14 participants as a coping mechanism during cancer treatment.  Each of the participants expressed the belief that God works through healthcare providers to provide appropriate healthcare treatments, and that spirituality is an important part of their lives.  However, participants emphasized that they would not forego medical treatment and trust only in God to treat their prostate cancer.  The participants' way of thinking about health, treatment decision-making, and the healthcare system was determined largely by their faith in God and previous healthcare experiences.

This study provides understanding on how African Americans decide what to believe or who to trust to improve their health. Research results may guide development of future culturally sensitive educational decision aids or programs to be used during patient and healthcare provider interaction.  Communication and infrastructural improvements within the healthcare system, particularly between the patient and healthcare provider, have potential to improve minority health through direct patient care as well as organized managed care.

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