A Qualitative Study of Barriers and Facilitators for Health Behavior Change in Low-Income Men with Prostate Cancer

Abstract

Abstract Purpose Low-income prostate cancer survivors, who typically have worse outcomes and greater all-cause mortality, often have poor health-promoting behaviors. Our objective was to assess perceived facilitators of and barriers to healthy behavior change by interviewing low-income men with prostate cancer who received no-cost treatment through a state-funded program. Methods Between September 2021 and April 2022, we conducted semi-structured interviews with 19 men (ages 60–75). Purposive sampling was utilized from participants of a cohort of men with prostate cancer from low-income backgrounds. Interviews were recorded, transcribed, and then coded by the authors to generate salient themes via thematic analysis. Results We found internal factors and structural factors that functioned independently and in concert to promote and/or hinder healthy behavior change. Internal factors such as motivations (prostate cancer diagnosis, self-perceptions, support system, and preferences) and determination, defined as level of motivation, drove behavior actualization. Structural factors that influenced behavior change included resources (access to food and opportunities for exercise) and social support. Conclusions These outcomes suggest that motivation and determination can serve as protective factors encouraging healthy behaviors despite structural barriers low-income prostate cancer survivors may face. However, motivations challenged by financial constraints were not sufficient to guide healthy behavior change. With this in mind, we recommend that interventions promoting healthy behavior change among this population should focus on identifying and strengthening internal assets such as motivations, self-perceptions, preferences, and support systems.