Abstract
This study assessed barriers to testicular self-examination (TSE) performance in a population of US Modern Orthodox Jewish undergraduate students. Participants answered questionnaires that measured their TSE performance and their attitudes toward TSEs. Out of 541 participants, 301 (55.6%) had heard of TSEs, 177 (32.7%) had ever performed a TSE, and 21 (3.9%) performed TSEs once per month in the past year. Significant positive associations of TSE awareness and practice included self-efficacy and engagement with medical professionals vis-à-vis testicular health. Shame and adherence to certain religious beliefs negatively correlated with awareness and performance of TSEs. The results demonstrate medical professionals’ integral role in educating young individuals about TSEs.
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Notes
To calculate these means, Strongly Disagree = 1, Somewhat Disagree = 2, Somewhat Agree = 3, and Strongly Agree = 4. Therefore, a higher mean reflects a greater concurrence with a given statement.
References
Allen, S. H., & Golojuch, L. A. (2019). “She still doesn’t want me to tell my next-door neighbor:” The familial experiences of Modern Orthodox Jewish gay men. Journal of GLBT Family Studies, 15(4), 373–394. https://doi.org/10.1080/1550428X.2018.1487811
Bachner-Melman, R., & Zohar, A. H. (2019). Potential risk and protective factors for eating disorders in Haredi (ultra-Orthodox) Jewish women. Journal of Religion and Health, 58, 2161–2174. https://doi.org/10.1007/s10943-019-00854-2
Besterman-Dahan, K. (2008). Cultural factors and concepts of pollution: Colorectal cancer and health behaviors among Ashkenazi Jewish women. [Doctoral dissertation, University of South Florida]. USF Tampa Graduate Theses and Dissertations. http://scholarcommons.usf.edu/etd/142/.
Bowen, D. J., Singal, R., Eng, E., Crystal, S., & Burke, W. (2003). Jewish identity and intentions to obtain breast cancer screening. Cultural Diversity and Ethnic Minority Psychology, 9(1), 79–87. https://doi.org/10.1037/1099-9809.9.1.79
Brenner, J., Hergenroeder, A., Kozinetz, C. A., & Kelder, S. H. (2003). Teaching testicular self-examination: education and practices in pediatric residents. Pediatrics. https://doi.org/10.1542/peds.111.3.e239
Brewer, G., Roy, M., & Watters, J. (2011). Testicular self-examination in an adult community sample. American Journal of Men’s Health, 5(1), 57–64. https://doi.org/10.1177/1557988310361520
Brown-Kramer, C. R., & Kiviniemi, M. T. (2015). Affective associations and cognitive beliefs relate to individuals’ decisions to perform testicular or breast self-exams. Journal of Behavioral Medicine, 38(4), 664–672. https://doi.org/10.1007/s10865-015-9641-6
Bursac, Z., Gauss, C. H., Williams, D. K., & Hosmer, D. W. (2008). Purposeful selection of variables in logistic regression. Source Code for Biology and Medicine. https://doi.org/10.1186/1751-0473-3-17
Chowdhury, M. Z. I., & Turin, T. C. (2020). Variable selection strategies and its importance in clinical prediction modelling. Family Medicine and Community Health, 8(1), e000262. https://doi.org/10.1136/fmch-2019-000262
Cronholm, P. F., Mao, J. J., Nguyen, G. T., & Paris, R. T. (2009). A dilemma in male engagement in preventive services: Adolescent males’ knowledge and attitudes toward testicular cancer and testicular self-exam. American Journal of Men’s Health, 3(2), 134–140. https://doi.org/10.1177/1557988308315071
Fadich, A., Giorgianni, S. J., Rovito, M. J., Pecchia, G. A., Bonhomme, J. J., Adams, W. B., & Sparkes, J. S. (2018). USPSTF testicular examination nomination-self-examinations and examinations in a clinical setting. American Journal of Men’s Health, 12(5), 1510–1516. https://doi.org/10.1177/1557988318768597
Freund, A., Cohen, M., & Azaiza, F. (2014). The doctor is just a messenger: Beliefs of Ultraorthodox Jewish women in regard to breast cancer and screening. Journal of Religion & Health, 53(4), 1075–1090. https://doi.org/10.1007/s10943-013-9695-0
Freund, A., Cohen, M., & Azaiza, F. (2019). Factors associated with routine screening for the early detection of breast cancer in cultural-ethnic and faith-based communities. Ethnicity & Health, 24(5), 527–543. https://doi.org/10.1080/13557858.2017.1346176
Garner, I. D. (2011). A Q-methodological study of male attitudes towards testicular cancer and testicular self-examination. Inquiries Journal, 3(11) www.inquiriesjournal.com/articles/592/a-q-methodological-study-of-male-attitudes-towards-testicular-cancer-and-testicular-self-examination.
Hachfeld, L., MacWilliams, B., & Schmidt, B. (2016). Physical awareness a key to improving adolescent male health: a grounded theory study of the perception of testicular self-examination in male student athletes. The Journal for Nurse Practitioners, 12(4), 243–249. https://doi.org/10.1016/j.nurpra.2015.10.024
Harris, B. (2008). Jewish Year Abroad. The Wall Street Journal. https://www.wsj.com/articles/SB120425090627701855.
Itzhaky, H., & Kissil, K. (2015). “It’s a horrible sin. If they find out I will not be able to stay”: Orthodox Jewish gay men’s experiences living in secrecy. Journal of Homosexuality, 62(5), 621–643. https://doi.org/10.1080/00918369.2014.988532
Lodyga, M. G. (2013). The relationship between health belief model constructs and factors influencing cancer self-examinations in college students. (Doctoral dissertation, Southern Illinois University Carbondale]. ProQuest Dissertations and Theses Global.
Moore, R., & Topping, A. (1999). Young men’s knowledge of testicular cancer and testicular self-examination: a lost opportunity? European Journal of Cancer Care, 8(3), 137–142. https://doi.org/10.1046/j.1365-2354.1999.00151.x
Nishma Research. (2017). The Nishma research profile of American Modern Orthodox Jews. https://www.jewishdatabank.org/content/upload/bjdb/2017_Complete_Report_Profile_of_American_Modern_Orthodox_Jews_09-27-17.pdf.
Pew Research Center. (2015). A portrait of American Orthodox Jews: A further analysis of the 2013 survey of U.S. Jews. https://www.pewresearch.org/religion/2015/08/26/a-portrait-of-american-orthodox-jews/.
Pour, H. A., Kunter, D., Norouzzadeh, R., & Heidari, M. R. (2018). The effect of testicular self-examination education on knowledge, performance, and health beliefs of Turkish men. Journal of Cancer Education, 33(2), 398–403. https://doi.org/10.1007/s13187-016-1132-0
Powe, B. D., Ross, L., Wilkerson, D., Brooks, P., & Cooper, D. (2007). Testicular cancer among African American college men: knowledge, perceived risk, and perceptions of cancer fatalism. American Journal of Men’s Health, 1(1), 73–80. https://doi.org/10.1177/1557988306295305
Reece, M., Herbenick, D., Sanders, S. A., Dodge, B., Ghassemi, A., & Fortenberry, J. D. (2010). Prevalence and predictors of testicular self-exam among a nationally representative sample of men in the United States. International Journal of Sexual Health, 22(1), 1–4. https://doi.org/10.1080/19317610903392953
Rockman, H. (1995). Sexual behavior among Ultra-Orthodox Jews. In J. Magonet (Ed.), Jewish Explorations of Sexuality (pp. 191–204). Berghahn Books.
Rovito, M. J., Gordon, T. F., Bass, S. B., & DuCette, J. (2011). Perceptions of testicular cancer and testicular self-examination among college men: A report on intention, vulnerability, and promotional material preferences. American Journal of Men’s Health, 5(6), 500–507. https://doi.org/10.1177/1557988311409023
Roy, R. K., & Casson, K. (2017). Attitudes toward testicular cancer and self-examination among Northern Irish males. American Journal of Men’s Health, 11(2), 253–261. https://doi.org/10.1177/1557988316668131
Saab, M. M., Landers, M., & Hegarty, J. (2016). Testicular cancer awareness and screening practices: a systematic review. Oncology Nursing Forum, 43(1), E8–E23. https://doi.org/10.1188/16.ONF.E8-E23
Shepherd, L., Watt, C., & Lovell, B. (2017). The role of social-cognitive and emotional factors on testicular self-examination. Psycho-Oncology, 26(1), 53–59. https://doi.org/10.1002/pon.4097
Shulchan Arukh, (2016). SA HaBahir (Original work published in 1565).
Singleton, A. (2008). “It’s because of the invincibility thing”: young men, masculinity, and testicular cancer. International Journal of Men’s Health, 7(1), 40–58. https://doi.org/10.3149/jmh.0701.40
Slider, C. L. (2009). Encouraging testicular self-examination behaviors in college males: Examining the role of fear appeals in protection motivation theory. [Master of Science in Journalism thesis, West Virginia University]. ProQuest Dissertations and Theses Global.
Tani, C. R. (2002). Increasing the frequency of testicular self-examination behavior in college men. [Doctoral Dissertation, Colorado State University]. ProQuest Dissertations and Theses Global.
Tkatch, R., Hudson, J., Katz, A., Berry-Bobovski, L., Vichich, J., Eggly, S., Penner, L. A., & Albrecht, T. (2014). Barriers to cancer screening among Orthodox Jewish Women. Journal of Community Health, 39(6), 1200–1208. https://doi.org/10.1007/s10900-014-9879-x
Tsuria, R. (2016). Jewish Q&A online and the regulation of sexuality: using foucault to read technology. Social Media + Society, 2(3), 1–10. https://doi.org/10.1177/2056305116662176
Ugurlu, Z., Akkuzu, G., Karahan, A., Beder, A., Dogan, N., Okdem, S., & Kav, S. (2011). Testicular cancer awareness and testicular self-examination among university students. Asian Pacific Journal of Cancer Prevention, 12, 695–698. http://journal.waocp.org/?sid=Entrez:PubMed&id=pmid:21627366&key=2011.12.3.695.
U.S. Preventive Services Task Force. (2011). Screening for testicular cancer: US Preventive Services Task Force reaffirmation recommendation statement. Annals of Internal Medicine. https://doi.org/10.7326/0003-4819-154-7-201104050-00006
Webb, C. R., Kronheim, L., Williams, J. E., & Hartman, T. J. (2006). An evaluation of the knowledge, attitudes, and beliefs of African-American men and their female significant others regarding prostate cancer screening. Ethnicity & Disease, 16(1), 234–238. https://pubmed.ncbi.nlm.nih.gov/16599376/
Woo, J. S. T., Brotto, L. A., & Gorzalka, B. (2010). Sex guilt and culture-linked barriers to testicular examinations. International Journal of Sexual Health, 22(3), 144–154. https://doi.org/10.1080/19317611003656644
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This study received funding from Yeshiva University’s Jay and Jeanie Schottenstein Honors Program.
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Miller, A.S., Aisenbrey, S. & Kimmel, D.M. Awareness and Performance of Testicular Self-Examinations: An Analysis of Social and Cultural Barriers to Cancer Screenings in a US Orthodox Jewish Community. J Relig Health 61, 4398–4419 (2022). https://doi.org/10.1007/s10943-022-01623-4
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DOI: https://doi.org/10.1007/s10943-022-01623-4