From Availability to Access: A Mixed-Methods Study of Digital Prostate Cancer Survivorship Support for Black Men

Introduction: Black men experience persistent disparities across the prostate cancer continuum, including inequities in access to survivorship support. This study examined the perceived value, acceptability, and experiences of accessing a multicomponent digital survivorship program among Black men with prostate cancer. Methods: This exploratory mixed-methods study was embedded within the ongoing international Phase 4 implementation trial of the Prostate Cancer Patient Empowerment Program (PC-PEP), a six-month digital intervention integrating exercise, pelvic floor muscle training, nutrition, stress management, psychosocial support, and peer connection. Fourteen self-identified Black participants contributed six-month program evaluation and qualitative data collected through open-ended responses and conference-based focus group discussions. Nine participants (64%) had undergone surgery with or without radiation and/or hormone therapy, four (29%) had received radiation with or without hormone therapy, and one (7%) was on active surveillance or had received no treatment. Quantitative data were summarized descriptively, and qualitative data were analyzed using inductive thematic analysis. Results: PC-PEP was highly valued, with median ratings of 10 (IQR 8-10) for likelihood of recommending the program and 9 (IQR 8-10) for overall usefulness. Among participants with available item-level data, 11/13 (85%) reported lifestyle improvement and 12/13 (92%) endorsed offering PC-PEP as standard care. Qualitative findings identified the value of holistic survivorship support, peer connection, normalization of vulnerability, and support for physical and psychological self-management. Participants also described limited awareness of PC-PEP at diagnosis and reliance on individual clinicians or incidental opportunities to learn about the program. Participants emphasized the need for earlier referral, greater representation, and culturally relevant community outreach. Conclusions: Black men who accessed PC-PEP reported high perceived value and identified benefits across multiple dimensions of survivorship. Their experiences, however, highlighted an important distinction between program availability and meaningful access: participants' experiences suggest that availability alone may not ensure timely connection to survivorship support. Earlier referral, culturally responsive outreach, and integration of survivorship support into routine prostate cancer care may help close this gap.