Physical Activity, Trust, and Research Participation Among Men From Minority Ethnic Backgrounds Living With Prostate Cancer: A Qualitative Study.

Men from minority ethnic backgrounds described physical activity as psychologically meaningful, supporting coping, identity, and continuity following prostate cancer.

• Semi-structured interviews were conducted with ten men from African, Caribbean, Asian, and Middle Eastern backgrounds living with prostate cancer.
• PA was characterised as supporting mental renewal, identity, and social connection.
• PA engagement was described as a mechanism for psychological coping and maintaining a sense of continuity amid illness.
• Sampling continued until thematic saturation was achieved, consistent with qualitative methodological guidance.

Physical activity participation was frequently disrupted by inconsistent guidance and structural barriers following prostate cancer diagnosis.

• A theme of 'Cancer-Related Disruption and Fragmented PA Support' was identified across participants.
• Participants described receiving inconsistent guidance regarding PA after their prostate cancer diagnosis.
• Structural barriers to PA participation were identified as a distinct theme ('Barriers to Participation in PA and Research').
• The absence of culturally tailored or consistent PA support contributed to fragmented engagement.

Trust, representation, and relational communication were identified as central factors influencing research engagement among minority ethnic men with prostate cancer.

• A theme of 'Trust, Representation, and Inclusive Research Practices' was one of six interconnected themes identified.
• Participants indicated that mistrust and lack of representation acted as barriers to research participation.
• Relational communication was highlighted as important for building the trust necessary for research engagement.
• A patient-informed topic guide and culturally reflexive approach were used to ensure contextual sensitivity and psychological safety during data collection.

Cultural stigma and silence around prostate cancer were identified as barriers, alongside evidence of shifting perspectives among participants.

• The theme 'Cultural Stigma, Silence, and Shifting Perspectives' was identified through reflexive thematic analysis.
• Cultural norms around discussing illness and cancer appeared to discourage open engagement with both PA support and research.
• Participants also described evolving or shifting perspectives on their condition and engagement over time.
• Data was analysed using Braun and Clarke's reflexive thematic analysis framework.

Altruism and the desire to leave a legacy were identified as motivating factors for minority ethnic men's engagement with prostate cancer research.

• The theme 'Altruism, Legacy, and Motivation to Engage' was one of six themes identified.
• Participants expressed motivation to participate in research in order to benefit future generations or community members.
• This altruistic motivation was identified as a potential facilitator for research recruitment in this underrepresented population.
• Participants were ten men from African, Caribbean, Asian, and Middle Eastern backgrounds.

The study findings informed the development of a Culturally Sensitive Recruitment Framework for engaging minority ethnic men in prostate cancer research.

• The framework was developed in response to the intersecting psychological, cultural, and structural factors identified across the six themes.
• The framework is intended to support more equitable research participation among minority ethnic men with prostate cancer.
• Culturally sensitive, relationship-centred approaches were recommended to strengthen integrated psycho-oncology care.
• A patient-informed topic guide was used during data collection, reflecting involvement of this population in study design.

Men from minority ethnic backgrounds are underrepresented in physical activity-related and psycho-oncology research despite experiencing a disproportionate burden of prostate cancer.

• The study explicitly identified this disparity as a motivation for the research.
• Underrepresentation in research was identified as both a background concern and a theme within participants' experiences ('Trust, Representation, and Inclusive Research Practices').
• The study recruited specifically from African, Caribbean, Asian, and Middle Eastern backgrounds to address this gap.
• Ten participants were recruited, with sampling continuing until thematic saturation was achieved.