That gap between awareness and action sits at the heart of research led by Dr. Linda Mermelstein, Associate Director for Community Outreach and Engagement at Stony Brook Cancer Center and colleagues in Suffolk County, New York. Rather than assuming what Black men needed to hear, the team asked them directly. Eighteen Black men aged 40 years and older took part in one of three virtual focus groups, discussing what they knew about prostate cancer, where they looked for health information, what encouraged them to seek screening, and what made health care feel trustworthy or untrustworthy.

The study was small, but the conversations revealed an important distinction. Rather than being simply uninformed, many participants already knew a fair amount about prostate cancer, and nearly three quarters had previously been screened. Yet significant gaps remained. On a ten-question knowledge survey, the average participant answered six questions correctly. Some were uncertain about symptoms, screening methods, insurance coverage, and the benefits of early detection. Most strikingly, a portion of the men who had not been screened said they had not known screening was something they needed to consider.

This matters because prostate cancer does not affect every group equally. In Suffolk County, the disparity, or difference is stark: both incidence and mortality rates are much higher among non-Hispanic Black residents than among non-Hispanic White residents. The problem, then, is larger than simply handing out more facts. It is to understand how information becomes meaningful enough to influence behavior.

The men’s reasons for caring about screening were often intensely personal. Family experiences with cancer stood out. Participants spoke about relatives who had suffered and about the fear that cancer could bring serious illness or death into their own lives. Fear, often treated only as a roadblock to health care, could also act as a powerful reason to act. Worry prompted some men to seek information, undergo tests, and think more carefully about prevention.

But fear alone is a fragile foundation for good health decisions. People also need information they can trust and opportunities to ask questions. Here, the study offers a more hopeful picture. Most participants reported trusting their own health care providers, and nearly all considered discussing screening with a provider important. The United States Preventive Services Task Force recommends that before deciding whether to be screened, men should have a chance to discuss the potential benefits and harms of screening with their doctor or provider and to include what matters to them and their preferences in the decision. This shared-decision-making conversation is recommended when considering prostate cancer options. Many were confident that they could have those conversations.

At the same time, trust in an individual clinician was not necessarily the same as trust in the wider health care system. Some participants described negative experiences, discomfort, or concerns about bias. The difficulty the research team faced in recruiting volunteers also hinted at a broader challenge: meaningful engagement cannot be created by simply sending out invitations. The researchers contacted 109 community organizations to recruit just 18 participants. The most effective connections came through trusted community “champions,” showing that relationships may be as important as information itself.

That lesson extends to the way health education is delivered. When participants needed medical advice, health care professionals were their preferred source. They were also interested in receiving information electronically, but enthusiasm for digital communication did not translate into unquestioning trust in social media. Some saw social platforms primarily as entertainment, where misinformation could easily spread. Others were willing to follow a social media post if it led them to a source they recognized as trustworthy, such as a hospital, university, or public health organization.

This suggests the need for a mix of methods. Social media may be good at attracting attention, while trusted medical sources provide the substance. The presentation matters too. Participants said educational material could be more engaging when it featured people they could relate to. Some preferred receiving information from Black health care professionals, although this was far from universal. For many, the decisive qualities were competence, compassion, cultural understanding, respect, and a willingness to answer questions.

The findings challenge simplistic assumptions about what improving cancer screening requires. A leaflet packed with accurate facts may achieve little if it never reaches the people who need it, feels disconnected from their lives, or comes from an institution they barely know. Effective communication is more than what is said. It is also about who says it, where the conversation happens, and whether people feel respected enough to listen and respond.

The participants themselves wanted greater engagement. They welcomed the Cancer Center’s decision to hold the focus groups and asked for more opportunities for hospitals, physicians, and community organizations to connect. This is particularly significant because family and friends already played an important role in health decisions. Men described talking to relatives and peers about their experiences before turning to medical professionals. Health education, therefore, does not have to travel only from doctor to patient. It can move through families, friendships, and community networks.

There are important reasons not to assume this study applies to everyone. Only 18 men participated, most were relatively well educated, all could attend online meetings, and many had already undergone prostate cancer screening. Men who were harder to reach may have different levels of knowledge, different attitudes toward medicine, less internet access, or greater practical roadblocks to care. Indeed, the enormous recruitment effort required for this modest group is itself a reminder of whose voices research can struggle to capture.

Yet that limitation also points toward one of the study’s most valuable insights. Better prostate cancer education needs to be built with communities, shaped by their questions, experiences, fears, preferences, and existing networks of trust.

For Dr. Linda Mermelstein and her colleagues in the office of Community Outreach and Engagement, whose mission is to reduce the cancer burden and disparities in the local community, the focus groups offered practical directions for doing exactly that: involve family and community members, use trusted health professionals, make reliable online information accessible, represent people audiences can identify with, and use social media strategically rather than treating it as the final authority.

The larger message reaches beyond prostate cancer. Health information becomes powerful when people can recognize its relevance, trust its source, discuss it openly, and use it to make informed choices. Closing a health disparity therefore requires more than telling people what they should know. It requires listening closely enough to understand how knowledge becomes trust, and how trust can become action.