Three years ago, when I was working as a full time prostate cancer Research Nurse, I asked myself why there didn’t seem to be any, or very few, black men in the prostate cancer clinics. Having an enquiring mind I conducted a review of the literature on ethnicity and prostate cancer and was surprised to find that men of African and African Caribbean origin have twice the risk for prostate cancer than white men. I quickly realised that this was something I wanted to research, and applied for PhD funding from RCBC Wales to explore what was known by men in the African and African Caribbean community in South Wales about their risk for prostate cancer. From the very beginning I was faced with a number of obstacles. My initial application for funding for this PhD topic was declined; the panel’s main concern being that I would “not be able to get a black man to talk to me about his prostate”. By my second round of funding they could see that I was not going to let this stand in my way and I secured the funding on the basis that I would find novel ways to recruit to my study.
I started my PhD on a part-time basis, keeping my toe in clinical waters, and decided to conduct a qualitative study using interviews and field work to find out how men living in black and white populated areas construct their beliefs about risks for prostate cancer. The aim of this being to find similarities and differences between these men to devise ways of targeting those most at risk in a meaningful and effective way.
The area in which I’m conducting my research is a suburb which is densely populated by people of African and African Caribbean origin. Of course the majority are now second generation but they have worked hard to hold onto their roots and this meant some were suspicious of ‘outsiders’ and at times just rude. Knowing I had to earn the trust of people in this community, doing something with not to them and not solely for myself, I learnt about a historic 1-mile running event which used to take place along a stretch of road going through their community. Most people spoke about it with fond memories; talking about the crowds it brought to their area, and expressing sadness at how they now feel they are isolated and separated from the city by new developments. So, why not re-launch this event? I saw this as a great opportunity to work with the community and soon set-up a small committee of myself and two key men who had been involved with the run in the past; one of Caribbean origin and one of Somali origin. The local council was thrilled. They had been trying to work with this community for years and so agreed to close the roads for free.
We decided, for the first year, to do the run for a large charity that I have connections with to help with administration. This seemed simple enough. The course is a straight line which generated interest in the past, and it now quickly became popular with club runners who started making noises about entry. Here we had two distinct social groups coming together. As a keen runner myself I am safe in the knowledge that most club runners are white professionals largely worried about how fast they run. The community I was working with, and particularly the men on the committee, were not used to the demands of the running group and bringing the two communities together has been almost impossible. The charity taking responsibility for administration has also seemed inflexible on accommodating to the cultural pace of the local community and I have started to see why the community might feel left behind. It is a matter of cultural competence; a concept which has become an extremely important thread in my PhD.
Last year, after months of stress and two weeks of sleepless nights, our first event was a success. The outcome was worth it; we had 65 runners pounding the streets on what turned out to be a great event. The club runners won and kept themselves separate from the local community but I feel sure that integration will come with time. Integration does not happen with one event. The fastest child was from the local community and had never run before – so I feel we have something to build on. This year we have sponsorship and more engagement promises from the community, although I have learnt about pace and try not to get frustrated.
You may ask what this has this told me about the men in the community and how they think about their risk for prostate cancer. Firstly, it has allowed me access to this community and a depth of knowledge that will be invaluable, but it has also opened my eyes to what is important to these men. Surprisingly – it’s not what we as healthcare professionals think it should be.
Enter the Butetown Mile at –