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Approximately one in every seven American men will be diagnosed with prostate cancer during his lifetime. Men of African descent have higher incidence and mortality rates than others. Prostate cancer screening is important because the five-year survival rate is only 31% post-metastasis. The purpose of this study was to assess the likelihood of action for and factors influencing choice regarding prostate screenings. It was also to determine if a relationship existed between ethnicity (African American and Afro-Caribbean American men) and knowledge of prostate health, self-efficacy, perceived barriers to and belief regarding prostate screening. Data collection methods included a focus group (n = 8) among African American and Afro-Caribbean American men (M = 53.8, 10.3) and self-administered surveys (n = 113) among African American (n = 49, 45.4%) and Afro-Caribbean American (n = 38, 35.2%) men (M = 59.5, 16.4) from churches in South Florida using convenience sampling and the Health Belief Model (HBM) as a framework. Knowledge was assessed using a combined version of the Knowledge and Practice of Prostate Health Questionnaire and Prostate Cancer Screening Education (PROCASE) Knowledge Index. Self-efficacy was measured as decisional conflict reported from the Low Literacy Decisional Conflict Scale. Barriers were identified from a Perceived Barriers Survey. Beliefs were measured as spiritual well-being and evaluated using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, a modified version for non-illness (FACIT-Sp Non-Illness). Almost half of African American (47.9%) and nearly a third (29%) of Afro-Caribbean American participants were unaware of participation or did not participate in prostate-specific antigen (PSA) testing. Findings indicated prostate screening concerns, inadequate knowledge, past negative experiences, and cost may contribute to low prostate screening rates. Both ethnicities did not differ in knowledge of prostate health or self-efficacy for making an informed decision regarding prostate screening. Potential targets for outreach efforts among these ethnic groups could include faith-based medical partnerships to diminish health disparities. Future intervention studies would benefit from a focus on diverse cultures and ethnicities in different settings and culturally appropriate strategies for nurses and other health professionals to use when assisting patients with informed decision making regarding prostate cancer screening.