Amitai Miller, BA
Harvard Medical School
Amitai S. Miller, Silke M. Aisenbrey, Daniel Kimmel,
Silke M. Aisenbrey, PhD and Daniel Kimmel, PhD
Objectives: The study assessed awareness and performance of testicular self-examinations (TSEs) in a population of Modern Orthodox Jewish college-aged men attending a Jewish university. In addition, it explored cultural, social-cognitive, and gender-related barriers and facilitators to performance of TSEs.
Methods: Participants answered questionnaires assessing their demographic and medical characteristics, religious self-identification, knowledge about testicular cancer, knowledge about TSEs, and previous performance behavior of TSEs. Participants shared attitudes and beliefs towards testicular cancer, TSEs, and health generally. Regression models were created to examine correlates of TSE knowledge and practice.
Results: 541 men (52.5% of all male undergraduates) participated in the study. Though most participants (90.3%) had heard of testicular cancer, only 301 participants (55.6%) had heard of TSEs. 177 participants (32.7%) had performed at least one TSE in their lifetime, 68 (12.6%) performed one TSE in the past 3 months, and 21 (3.9%) performed TSEs at least as often as once per month in the past year. 134 participants (30.1%) would delay seeking care, if at all, upon noticing a change in their testicular shape or feeling until they experienced pain or discomfort. Significant positive predictors of TSE awareness and practice included self-efficacy, engagement with medical professionals vis-à-vis testicular wellness, and external encouragement to perform TSEs. Adherence to religious beliefs that attribute control over health to God and potential embarrassment of a testicular cancer diagnosis negatively predicted awareness and performance of TSEs. Participants indicated they would feel more comfortable discussing TSEs with a male health professional than they would with a female health professional (88.7% with male versus 58.6% with female)
Conclusions: This was the first study to evaluate TSE awareness, performance, attitudes, and beliefs in an Orthodox Jewish community. Health professionals and religious community leaders should create culturally-specific education materials to increase awareness and practice of TSEs in this community.