1
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Cabral DN, Tsai MH, Gishe J, Dagne GA. Colorectal Cancer Risk Perceptions Among Black Men in Florida. J Racial Ethn Health Disparities 2024; 11:1984-1993. [PMID: 37311885 DOI: 10.1007/s40615-023-01667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE We examined colorectal cancer (CRC) risk perceptions among Black men in relation to socio-demographic characteristics, disease prevention factors, and personal/family history of CRC. METHODS A self-administered cross-sectional survey was conducted in five major cities in Florida between April 2008 and October 2009. Descriptive statistics and multivariable logistic regression were performed. RESULTS Among 331 eligible men, we found a higher proportion of CRC risk perceptions were exhibited among those aged ≥ 60 years (70.5%) and American nativity (59.1%). Multivariable analyses found men aged ≥ 60 had three times greater odds of having higher CRC risk perceptions compared to those ≤ 49 years (95% CI = 1.51-9.19). The odds of higher CRC risk perception for obese participants were more than four times (95% CI = 1.66-10.00) and overweight were more than twice the odds (95% CI = 1.03-6.31) as compared to healthy weight/underweight participants. Men using the Internet to search for health information also had greater odds of having higher CRC risk perceptions (95% CI = 1.02-4.00). Finally, men with a personal/family history of CRC were ninefold more likely to have higher CRC risk perceptions (95% CI = 2.02-41.79). CONCLUSION Higher CRC risk perceptions were associated with older age, being obese/overweight, using the Internet as a health information source, and having a personal/family history of CRC. Culturally resonate health promotion interventions are sorely needed to elevate CRC risk perceptions for increasing intention to screen among Black men.
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Affiliation(s)
- Daramola N Cabral
- Department of Health, Human Services, and Public Policy, College of Health Sciences and Human Services, California State University, Monterey Bay, Seaside, CA, USA
- African Caribbean Cancer Consortium, Philadelphia, PA, USA
| | - Meng-Han Tsai
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Augusta University, 1410 Laney Walker Boulevard, Suite CN-2154, Augusta, GA, USA.
- Georgia Prevention Institute, Augusta University, Augusta, GA, USA.
| | - Jemal Gishe
- Department of Public Health, Health Administration, and Health Sciences, College of Health Sciences, Tennessee State University, Nashville, TN, USA
| | - Getachew A Dagne
- College of Public Health, University of South Florida, Tampa, FL, USA
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2
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Korous KM, Ogbonnaya UC, De Vera MA, Brooks E, Moore JX, Rogers CR. Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45-75). Cancer Causes Control 2023; 34:737-747. [PMID: 37243849 PMCID: PMC10961139 DOI: 10.1007/s10552-023-01713-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 05/04/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE To examine whether a greater perception of economic pressure would be associated with more-negative attitudes, greater perceived barriers, and lower subjective norms regarding colorectal cancer (CRC) and CRC screening among males aged 45-75 years. METHODS We recruited 492 self-identified males aged 45-75 years living in the United States. We operationalized perceived economic pressure as a latent factor with three subscales: can't make ends meet, unmet material needs, and financial cutbacks. Our dependent variables were attitudes toward CRC and CRC screening, perceived barriers to completing a CRC screening exam, and subjective norms regarding CRC screening (e.g., how others value CRC screening). We tested a hypothesized model using structural equation modeling with maximum-likelihood estimation, adjusting for covariates, and made post-hoc modifications to improve model fit. RESULTS Greater perceived economic pressure was associated with more-negative attitudes toward CRC and CRC screening (β = 0.47, 95% CI: 0.37,0.57) and with greater perceived barriers to CRC screening (β = 0.22, 95% CI: 0.11, 0.34), but was not significantly associated with subjective norms (β = 0.07, 95% CI: - 0.05, 0.19). Perceived economic pressure was an indirect pathway by which lower-income and younger age were associated with more-negative attitudes and greater perceived barriers. CONCLUSIONS Our study is one of the first to show that, among males, perceived economic pressure is associated with two social-cognitive mechanisms (i.e., negative attitudes, greater perceived barriers) that are known to influence CRC screening intent and, ultimately, CRC screening completion. Future research on this topic should employ longitudinal study designs.
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Affiliation(s)
- Kevin M Korous
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA.
| | - Uchenna C Ogbonnaya
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Ellen Brooks
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Justin X Moore
- Medical College of Georgia, Georgia Cancer Center, Cancer Prevention, Control & Population Health, Augusta University, Augusta, GA, 30912, USA
| | - Charles R Rogers
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA
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3
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Webber-Ritchey KJ, Taylor-Piliae RE, Loescher LJ. Recruiting African American parents of school-aged children in a physical activity study: Lessons learned. Chronic Illn 2022; 18:181-192. [PMID: 32483997 DOI: 10.1177/1742395320928389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To describe the recruitment strategies and lessons learned when enrolling African American parents/caregivers of school-aged children (ages 6-12 years) in an online survey of physical activity. With physical activity serving as a modifiable behavioral risk factor for several chronic diseases (obesity and cardiovascular diseases), little is understood regarding the influences on African Americans' physical activity participation to develop culturally appropriate physical activity interventions. Gaining a better understanding of physical activity influences is possible through research, yet recruiting and enrolling African Americans in health research is a challenge. METHODS Over a three-month period, a multidimensional approach (distribution of flyers, community partnerships, network sampling, African American researcher, effective communication, and data collection procedures) was used for study recruitment. RESULTS We exceeded our recruitment goal of 105 participants. A total of 127 African American parent/caregivers of school-aged children enrolled, which included both females/mothers (n = 87, 69%) and males/fathers (n = 40, 31%). Network sampling was the single most effective recruitment strategy for reaching this population. Lessons learned in this study includes considering participant burden and their comfort with technology, as well as gaining community trust. DISCUSSION Lessons learned in recruiting African American parents provides a guide for future research. Efforts are needed to further increase the representation of African American males in health research.
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Affiliation(s)
| | - Ruth E Taylor-Piliae
- Biobehavioral Health Sciences, College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Lois J Loescher
- College of Nursing, University of Arizona, Tucson, AZ, USA.,Biobehavioral Health Sciences, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
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4
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Earl V, Beasley D, Ye C, Halpin SN, Gauthreaux N, Escoffery C, Chawla S. Barriers and Facilitators to Colorectal Cancer Screening in African-American Men. Dig Dis Sci 2022; 67:463-472. [PMID: 33811563 DOI: 10.1007/s10620-021-06960-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/04/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND African-Americans rank last among all racial groups for age-adjusted colorectal cancer mortality, 5-year survival rates, and rates of screening. Access to care does not fully explain racial disparities in rates of CRC and mortality. Sociocultural attitudes can predict probabilities of CRC screening. AIMS The objective of this study is to identify factors that influence colorectal cancer screening behavior in African-American men. METHODS Semi-structured interviews were conducted among 32 African-American men. Transcripts were analyzed using MAXQDA software. We then conducted a cross-sectional survey of 103 African-American men, using previously validated scales related to colorectal cancer screening and determinants. Data were analyzed with SPSS. RESULTS In the interview phase, beliefs relating to masculinity emerged as factors that hindered participation in screening. Overwhelmingly, participants felt that having an in-depth discussion about colorectal cancer with their provider was critical to enabling them to get screened. The survey phase demonstrated that most participants had poor colorectal cancer knowledge, as only 16% passed the knowledge test. Forty-eight percentage agreed that their provider did not recommend getting screened. Those who had been previously screened for colorectal cancer scored higher in total and on all subsets of the masculinity index than those who had not (p < .01). The most persuasive messages were those related to themes of masculinity. CONCLUSION This study provides a novel sociocultural perspective about colorectal cancer screening in African-American men. Our findings highlight the importance of family, masculinity, and community when promoting colorectal cancer screening to this population.
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Affiliation(s)
- Victoria Earl
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
| | - Derrick Beasley
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Chengcheng Ye
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Sean N Halpin
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Nicole Gauthreaux
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Cam Escoffery
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Saurabh Chawla
- Department of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA
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5
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Rogers CR, Figueroa R, Brooks E, Petersen EM, Kennedy CD, Gray II DM, Sapienza M, Hung M. Factors associated with colorectal cancer screening intent and uptake among adult Non-Hispanic Black men. Am J Cancer Res 2021; 11:6200-6213. [PMID: 35018252 PMCID: PMC8727804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/24/2021] [Indexed: 06/14/2023] Open
Abstract
Non-Hispanic (NH) Black men in the United States have the lowest five-year colorectal cancer (CRC) survival rate across all racial/ethnic and sex subgroups and are less likely than their NH White counterparts to complete CRC screening. We hypothesized that greater masculinity barriers to medical care (MBMC) would be negatively associated with CRC screening uptake. Employing a survey design, we examined the MBMC scale and other psychosocial factors influencing CRC screening intent and uptake in a sample of 319 NH Black men aged 45 to 75 years residing in Minnesota, Ohio, and Utah. A series of ordinary least squares and logistic regression models were run with intention and uptake as the outcome variable while controlling for various demographic characteristics. Independent variables in all models included average score on the MBMC; CRC screening knowledge, beliefs and values; and barriers to and social support for CRC screening. Social support, marital status, and age were positively associated with CRC screening intention. Increased CRC screening knowledge and older age were associated with a greater likelihood of completing a stool-based screening test for CRC. Fewer masculinity-related and CRC screening barriers were associated with a greater likelihood of undergoing a sigmoidoscopy or colonoscopy. Contrary to our primary hypothesis, lesser MBMC-related perceptions were associated with increased CRC screening uptake among NH Black men. Our findings inform future CRC promotion programs and emphasize the need for multilevel interventions tailored toward this marginalized population to reduce disparities in screening and survival.
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Affiliation(s)
- Charles R Rogers
- University of Utah School of Medicine, Department of Family & Preventive Medicine375 Chipeta Way, Suite A, Salt Lake, UT 84108, USA
| | - Roger Figueroa
- Cornell University, College of Human Ecology, Division of Nutritional Sciences244 Garden Avenue, Ithaca, NY 14853, USA
| | - Ellen Brooks
- University of Utah School of Medicine, Department of Family & Preventive Medicine375 Chipeta Way, Suite A, Salt Lake, UT 84108, USA
| | - Ethan M Petersen
- University of Utah School of Medicine, Department of Family & Preventive Medicine375 Chipeta Way, Suite A, Salt Lake, UT 84108, USA
| | - Carson D Kennedy
- University of Utah School of Medicine, Department of Family & Preventive Medicine375 Chipeta Way, Suite A, Salt Lake, UT 84108, USA
| | - Darrell M Gray II
- The Ohio State University, College of Medicine1590 N High St. Suite 525, Columbus, OH 43201, USA
| | - Michael Sapienza
- Colorectal Cancer Alliance1025 Vermont Ave. NW, Suite 1066, Washington, DC 20005, USA
| | - Man Hung
- College of Dental Medicine, Roseman University of Health Sciences10894 South River Front Pkwy, South Jordan, UT 84095, USA
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6
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Rogers CR, Brooks E, Petersen E, Campanelli P, Figueroa R, Kennedy C, Thorpe RJ, Levant RF. Psychometric Properties and Analysis of the Masculinity Barriers to Medical Care Scale Among Black, Indigenous, and White Men. Am J Mens Health 2021; 15:15579883211049033. [PMID: 34636686 PMCID: PMC8516392 DOI: 10.1177/15579883211049033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Non-Hispanic (NH) Black, American Indian/Alaska Native (Indigenous), and NH-White men have the highest colorectal cancer (CRC) mortality rates among all other racial/ethnic groups. Contributing factors are multifaceted, yet no studies have examined the psychometric properties of a comprehensive survey examining potential masculinity barriers to CRC screening behaviors among these populations. This study assessed the psychometric properties of our Masculinity Barriers to Medical Care (MBMC) Scale among NH-Black, Indigenous, and NH-White men who completed our web-based MBMC, Psychosocial Factors, and CRC Screening Uptake & Intention Survey. We conducted exploratory factor analysis on a sample of 254 men and multivariate analysis of variance (MANOVA) on a separate sample of 637 men nationally representative by age and state of residence. After psychometric assessment, the MBMC scale was reduced from 24 to 18 items and from six to four subscales. NH-Black men’s mean scores were lowest on three of four subscales (Being Strong, Negative and Positive Attitudes) and highest on the Acknowledging Emotions subscale. Compared with both Indigenous and NH-White men, NH-Black men had significantly lower Negative Attitudes subscale scores and significantly higher scores on the Acknowledging Emotions subscale. Compared with both Indigenous and NH-Black men, NH-White men had significantly higher Being Strong and Positive Attitudes subscales scores. This study expands on previous research indicating that, among racialized populations of men, endorsement of traditional masculine ideologies influences engagement in preventive health behaviors. Our scale can be tailored to assess attitudes to screening for other cancers and diseases that disproportionately burden medically underserved populations.
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Affiliation(s)
- Charles R Rogers
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ellen Brooks
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Ethan Petersen
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Pamela Campanelli
- UK Survey Methods Consultant, Chartered Statistician, Colchester, UK
| | - Roger Figueroa
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Carson Kennedy
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Roland J Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ronald F Levant
- Department of Psychology (Professor Emeritus), The University of Akron, Akron, OH, USA
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7
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Wilson-Howard D, Vilaro MJ, Neil JM, Cooks EJ, Griffin LN, Ashley TT, Tavassoli F, Zalake MS, Lok BC, Odedina FG, Modave F, Carek PJ, George TJ, Krieger JL. The development of a Credible Virtual Clinician Promoting Colorectal Cancer Screening via Telehealth Applications for and by Black Men: A Qualitative Study. JMIR Form Res 2021; 5:e28709. [PMID: 34780346 PMCID: PMC8751682 DOI: 10.2196/28709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/21/2021] [Accepted: 10/06/2021] [Indexed: 01/06/2023] Open
Abstract
Background Traditionally, promotion of colorectal cancer (CRC) screening among Black men was delivered by community health workers, patient navigators, and decision aids (printed text or video media) at clinics and in the community setting. A novel approach to increase CRC screening of Black men includes developing and utilizing a patient-centered, tailored message delivered via virtual human technology in the privacy of one’s home. Objective The objective of this study was to incorporate the perceptions of Black men in the development of a virtual clinician (VC) designed to deliver precision messages promoting the fecal immunochemical test (FIT) kit for CRC screening among Black men in a future clinical trial. Methods Focus groups of Black men were recruited to understand their perceptions of a Black male VC. Specifically, these men identified source characteristics that would enhance the credibility of the VC. The modality, agency, interactivity, and navigability (MAIN) model, which examines how interface features affect the user’s psychology through four affordances (modality, agency, interactivity, and navigability), was used to assess the presumed credibility of the VC and likability of the app from the focus group transcripts. Each affordance triggers heuristic cues that stimulate a positive or a negative perception of trustworthiness, believability, and understandability, thereby increasing source credibility. Results In total, 25 Black men were recruited from the community and contributed to the development of 3 iterations of a Black male VC over an 18-month time span. Feedback from the men enhanced the visual appearance of the VC, including its movement, clothing, facial expressions, and environmental surroundings. Heuristics, including social presence, novelty, and authority, were all recognized by the final version of the VC, and creditably was established. The VC was named Agent Leveraging Empathy for eXams (ALEX) and referred to as “brother-doctor,” and participants stated “wanting to interact with ALEX over their regular doctor.” Conclusions Involving Black men in the development of a digital health care intervention is critical. This population is burdened by cancer health disparities, and incorporating their perceptions in telehealth interventions will create awareness of the need to develop targeted messages for Black men.
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Affiliation(s)
- Danyell Wilson-Howard
- Department of Natural Sciences, Bethune Cookman University, 640 Mary McLeod Blvd., Daytona, US.,STEM Translational Communication Center, College of Journalism, University of Florida, Gainesville, US
| | - Melissa J Vilaro
- STEM Translational Communication Center, College of Journalism, University of Florida, Gainesville, US
| | - Jordan M Neil
- Harvard Medical School, Haarvard University, Boston, US.,Mongan Institute's Health Policy Research Center, Massachusetts General Hospital, Boston, US
| | - Eric J Cooks
- STEM Translational Communication Center, College of Journalism, University of Florida, Gainesville, US.,Health Cancer Center, University of Florida, Gainesville, US
| | - Lauren N Griffin
- STEM Translational Communication Center, College of Journalism, University of Florida, Gainesville, US
| | - Taylor T Ashley
- Department of Natural Sciences, Bethune Cookman University, 640 Mary McLeod Blvd., Daytona, US
| | - Fatemeh Tavassoli
- Computer and Information Science and Engineering, University of Florida, Gainesville, US
| | - Mohan S Zalake
- Computer and Information Science and Engineering, University of Florida, Gainesville, US
| | - Benjamin C Lok
- Computer and Information Science and Engineering, University of Florida, Gainesville, US
| | - Folakemi G Odedina
- College of Pharmacy, University of Florida, Gainesville, US.,College of Medicine, University of Florida, Gainesville, US
| | - Francois Modave
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Floridal, Gainesville, US
| | - Peter J Carek
- Familly Medicine, University of Florida, Gainesville, US
| | - Thomas J George
- Gastrointestinal (GI) Oncology Center, University of Florida, Gainesville, US.,UF Health Medical Oncology - Davis Cancer, University of Florida, Gainesville, US
| | - Janice L Krieger
- STEM Translational Communication Center, College of Journalism, University of Florida, Gainesville, US.,UF Health Cancer Center, University of Florida, Gainesville, US
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8
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Roy S, Dickey S, Wang HL, Washington A, Polo R, Gwede CK, Luque JS. Systematic Review of Interventions to Increase Stool Blood Colorectal Cancer Screening in African Americans. J Community Health 2021; 46:232-244. [PMID: 32583358 PMCID: PMC7313439 DOI: 10.1007/s10900-020-00867-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
African Americans experience colorectal cancer (CRC) related disparities compared to other racial groups in the United States. African Americans are frequently diagnosed with CRC at a later stage, screening is underutilized, and mortality rates are highest in this group. This systematic review focused on intervention studies using stool blood CRC screening among African Americans in primary care and community settings. Given wide accessibility, low cost, and ease of dissemination of stool-based CRC screening tests, this review aims to determine effective interventions to improve participation rates. This systematic review included intervention studies published between January 1, 2000 and March 16, 2019. After reviewing an initial search of 650 studies, 11 studies were eventually included in this review. The included studies were studies conducted in community and clinical settings, using both inreach and outreach strategies to increase CRC screening. For each study, an unadjusted odds ratio (OR) for the CRC screening intervention compared to the control arm was calculated based on the data in each study to report effectiveness. The eleven studies together recruited a total of 3334 participants. The five studies using two-arm experimental designs ranged in effectiveness with ORs ranging from 1.1 to 13.0 using interventions such as mailed reminders, patient navigation, and tailored educational materials. Effective strategies to increase stool blood testing included mailed stool blood tests augmented by patient navigation, tailored educational materials, and follow-up calls or mailings to increase trust in the patient-provider relationship. More studies are needed on stool blood testing interventions to determine effectiveness in this population.
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Affiliation(s)
- Siddhartha Roy
- Department of Family and Community Medicine, Pennsylvania State University Health Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Cancer Control, Penn State Cancer Institute, Hershey, PA, USA
| | - Sabrina Dickey
- College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Hsiao-Lan Wang
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Alexandria Washington
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida A&M University, 1415 South Martin Luther King, Jr. Blvd, Tallahassee, FL, 32307, USA
| | - Randy Polo
- University Libraries, University of South Florida, Tampa, FL, USA
| | - Clement K Gwede
- Division of Population Sciences, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - John S Luque
- College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida A&M University, 1415 South Martin Luther King, Jr. Blvd, Tallahassee, FL, 32307, USA.
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Echeverri M, Anderson D, Haas JM, Johnson ME, Serrano FSA, Nápoles AM. Testing the Preliminary Validity of a Multidimensional Framework for Studying the Effects of Cancer Health Literacy on Cancer Screening Behaviors among Diverse Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2987. [PMID: 32344860 PMCID: PMC7246920 DOI: 10.3390/ijerph17092987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/18/2020] [Accepted: 04/24/2020] [Indexed: 12/15/2022]
Abstract
The objective of this study was to evaluate the applicability of a multidimensional framework to explore factors associated with cancer literacy and its effects on receiving cancer screenings among diverse populations. Based on the conceptual framework, we developed and pilot-tested the Multidimensional Cancer Literacy Questionnaire (MCLQ) among 1500 individuals (African Americans, Latinos and Whites) in Louisiana. Exploratory factor analysis was used to identify the MCLQ underlying structure and predominant factors explaining each of the dimensions in the model. A total of 82 items (explaining 67% of the total variance) in the MCLQ were grouped into 20 factors associated with three key dimensions related to cancer literacy. Preliminary validity of the MCLQ was supported: Cronbach alpha for the scale score was 0.89 and internal consistency reliability coefficients for each factor were all above 0.67. The Facilitators Domain included five factors (28 items) that may positively influence individuals to have early-detection cancer screenings. The Barriers Domain included seven factors (26 items) explaining aspects that may negatively influence individuals to have cancer screenings. The Cultural Domain included eight factors (28 items) related to aspects that influence positively or negatively individuals' perceptions regarding cancer as a disease, screenings and treatments. A multidimensional framework to study cancer literacy, including cultural attitudes, beliefs and practices, as well as facilitators and barriers, among diverse populations, will increase understanding of factors influencing individuals' approach to cancer prevention and screening. Results will inform further testing of the multidimensional framework and questionnaire.
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Affiliation(s)
- Margarita Echeverri
- College of Pharmacy, Xavier University of Louisiana, New Orleans, LA 70125, USA
| | - David Anderson
- Department of Mathematics, Xavier University of Louisiana, New Orleans, LA 70125, USA
| | | | - Marc E Johnson
- African American Cancer Community Advisory Board, Kenner, LA 70063, USA
| | | | - Anna María Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892, USA
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10
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Abuadas FH, Abuadas MH. An Interventional Study to Improve Colorectal Cancer Screening Knowledge and Health Perceptions among Jordanians' Average Risk Population. Open Nurs J 2019. [DOI: 10.2174/1874434601913010237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Context:
Globally, Colorectal Cancer (CRC) is the second most commonly occurring cancer in women and the third most commonly occurring cancer in men.
Aims:
This study was conducted to investigate the current levels of Jordanians' CRC knowledge and health perceptions; and to test the effects of a health education intervention on them.
Settings and Design:
A descriptive quasi-experimental design was used to recruit a convenience sample of 197 Jordanian adult participants from two governmental hospitals in Amman.
Methods and Material:
A rolling enrolment strategy was used to randomly assign participants into intervention (n=98) and control (n=99) groups. An education intervention included a 1-hour Power Point presentation about CRC.
Results:
The mean knowledge scores were (6.51±1.60) and (6.91± 1.83) for females and males, respectively. The mean of the knowledge level in the intervention group subsequent to the intervention was significantly higher than that for the control group. More than half of the study participants (53.8%) did not believe they were susceptible to CRC, while about one third (37.4%) of the participants believed that CRC is a severe disease. 42.2% of study participants believed there were barriers preventing them from participating in CRC screening. The most frequently perceived barrier among them was the cost of screening tests. The means of the perceived susceptibility and severity subscales of the intervention group was significantly higher than that of the control group.
Conclusion:
Correcting the knowledge gap and improper health perceptions toward CRC could play an important role in facilitating early detection as a primary prevention measure. Findings may enhance health strategies to better address the needs of the average-risk population.
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11
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Rogers CR, Okuyemi K, Paskett ED, Thorpe RJ, Rogers TN, Hung M, Zickmund S, Riley C, Fetters MD. Study protocol for developing #CuttingCRC: a barbershop-based trial on masculinity barriers to care and colorectal cancer screening uptake among African-American men using an exploratory sequential mixed-methods design. BMJ Open 2019; 9:e030000. [PMID: 31345981 PMCID: PMC6661686 DOI: 10.1136/bmjopen-2019-030000] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/26/2019] [Accepted: 06/28/2019] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) is preventable, as screening leads to the identification and removal of precancerous polyps. African-American men consistently have the highest CRC mortality rates, and their CRC-screening uptake remains low for complex reasons. Culture-specific masculinity barriers to care may contribute to the low uptake among African-American men. Examining these barriers to care is vital as CRC screening may challenge cultural role expectations of African-American men, whose tendency is to delay help-seeking medical care. Barbershops provide a pathway for reaching African-American men with masculinity barriers to care who are not regularly receiving healthcare services and CRC screening. This study aims to develop and pilot test a theory-driven, culture-specific, barbershop-based intervention targeting masculinity barriers to care and CRC-screening uptake among African-American men ages 45-75. METHODS AND ANALYSIS Guided by the theory of planned behaviour and the behaviour change wheel, we will use a multistage mixed-methods study design, beginning with an exploratory sequential approach to validate items for subsequent use in a pilot mixed-methods intervention. First, we will collect and analyse qualitative data from focus groups, cognitive interviews and expert item review to validate and test a culture-specific Masculinity Barriers to Care Scale (MBCS) among African-American men. Next, we will administer the MBCS to our target population as an online quantitative survey and evaluate the association between scores and CRC-screening uptake. Then, we will consider existing evidence-based approaches, our integrated results (qualitative +quantitative), and community input to design a culture-specific, behavioural intervention aimed at increasing CRC-screening uptake among African-American men and feasible for barbershop delivery. We will test the peer intervention in a pilot study with a two-arm cluster randomised design (six barbershops, randomised by site) to reduce contamination and account for barbershop culture differences. Our primary outcomes for the pilot are recruitment, sample size estimation, preliminary efficacy and acceptability. ETHICS AND DISSEMINATION Ethics approval was obtained from the University of Utah Institutional Review Board (00113679), who will also be responsible for receiving communication updates regarding important protocol modifications. To ensure confidentiality, data dispersed to project team members will be blinded of any identifying participant information. Study results will be disseminated through publications in peer-reviewed journals, community dialogue sessions, and presentations at conferences. TRIAL REGISTRATION NUMBER ClinicalTrials.gov identifier: NCT03733197 (Pre-results);https://clinicaltrials.gov/ct2/show/NCT03733197.
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Affiliation(s)
- Charles R Rogers
- Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Kola Okuyemi
- Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Electra D Paskett
- Internal Medicine, College of Medicine, Ohio State University, Columbus, Ohio, USA
| | - Roland J Thorpe
- Program for Research on Men's Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tiana N Rogers
- Sorenson Impact Center, University of Utah Eccles School of Business, Salt Lake City, Utah, USA
| | - Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA
| | - Susan Zickmund
- Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Colin Riley
- Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Michael D Fetters
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Obidike OJ, Rogers CR, Caspi CE. Examining Colorectal Cancer Risk Awareness and Food Shelf Use Among Health Center Patients. J Racial Ethn Health Disparities 2019; 6:1021-1029. [PMID: 31168698 DOI: 10.1007/s40615-019-00603-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/21/2019] [Accepted: 05/26/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To employ the Colorectal Cancer Risk Awareness for Public Health Prevention (CRC-PHP) survey to examine how food shelf use and other covariates predict awareness of colorectal cancer (CRC) risk factors among patients of a Federally Qualified Health Center in Minneapolis, Minnesota. Secondary aims included describing the demographic and chronic-disease characteristics of the patient population and assessing their general knowledge of additional CRC risk factors and intent to make healthy food selections in the near future. METHODS Measures included CRC risk awareness, food shelf use, chronic-disease status, and intent to select healthy food options. Regression models and chi-square tests of independence were employed to examine differences among food shelf users and non-users. RESULTS Among the 103 patients surveyed, 29% reported using a food shelf in the last 12 months. Forty-seven percent of food shelf users and 38% of non-users reported having at least 1 diet-related condition (e.g., type 2 diabetes mellitus). Food shelf users scored 1.2 points higher than non-users, on average, on the CRC risk-factor awareness scale. They also answered more survey questions correctly regarding fruit and vegetable intake and its effect on CRC risk (p = 0.035). Most participants reported being likely to purchase health-promoting foods in the future. In addition, participants reported being likely to select foods that were labeled as protective against CRC. CONCLUSIONS Behavioral interventions exist that are focused on preventing and managing type II diabetes among food shelf users. Building off such interventions and incorporating behavioral economics components (such as nudges and product labels) has the potential to reduce food shelf customers' heightened risk and management of CRC.
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Affiliation(s)
- Ogechi J Obidike
- Public Health Administration and Policy, University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Charles R Rogers
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Caitlin E Caspi
- Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
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Measuring Factors Associated with Colorectal Cancer Screening among Young Adult African American Men: A Psychometric Study. J Immigr Minor Health 2019; 20:101-106. [PMID: 27815663 DOI: 10.1007/s10903-016-0523-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The Male Role Norms, Knowledge, Attitudes, and Perceptions associated with Colorectal Cancer Screening (MKAP-CRCS) survey was developed to assess the attitudes, knowledge, male role norms, perceived barriers, and perceived subjective norms associated with screening for colorectal cancer (CRC) among young adult African American men. There is a critical need for exploring the complex factors that may shape attitudes towards CRC screening among men who are younger (i.e., ages 19-45) than those traditionally assessed by clinicians and health promotion researchers (age 50 and older). Psychometrically sound measures are crucial for eliciting valid and reliable data on these factors. The current study, therefore, assessed the psychometric properties of the MKAP-CRCS instrument using an online sample of young adult African American men (N = 157) across the United States. Exploratory principal component factor analyses revealed that the MKAP-CRCS measure yielded construct valid and reliable scores, suggesting that the scale holds promise as an appropriate tool for assessing factors associated with CRC screening among younger African American men. Strengths and limitations of this study, along with directions for future research are discussed, including the need for more research examining the relationship between masculinity and CRC screening among African American men.
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Gholampour Y, Jaderipour A, Khani Jeihooni A, Kashfi SM, Afzali Harsini P. The Effect of Educational Intervention Based on Health Belief Model and Social Support on the Rate of Participation of Individuals in Performing Fecal Occult Blood Test for Colorectal Cancer Screening. ASIAN PACIFIC JOURNAL OF CANCER PREVENTION : APJCP 2018; 19:2777-2787. [PMID: 30360606 PMCID: PMC6291048 DOI: 10.22034/apjcp.2018.19.10.2777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background and Aim: Among the screening tests for colorectal cancer, fecal occult blood test (FOBT) is important in comparison other methods due to its ease of use and low cost.The aim of this study is to survey the effect of educational intervention based on health belief model and social support on the rate of participation of individuals in performing fecal occult blood test for colorectal cancer screening among men who referred to the health centers in FasaCity, Fars province, Iran. Materials and Methods: In this quasi-experimental study, 200 men (100 in experimental group and 100 in control group) in FasaCity, Fars province, Iranwere selected in 2017. A questionnaire consisting of demographic information, knowledge, HBM constructs (perceived susceptibility, severity, benefits, barriers, self- efficacy and cues to action) and social support was used to measure the rate of participation of individuals in performing Fecal Occult Blood Test for colorectal cancer screening before and three months after the intervention. Data were analyzed using SPSS22 viadescriptive and inferential statistics, paired t-test, Mann-Whitney, Chi-square, and independent t-test at a significance level of 0.5. Results: The mean age of the men was 63.18 ± 8.25 years in the experimental group and 65.11 ± 7.66 years in the control group. Three months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, Self-efficacy, cues to action, social support and the level of referrals (participation) of subjects for FOBTcompared to the control group. Conclusion: This study showed the effectiveness of HBM constructs and social support in adoption of the level of participation of subjects for FOBTin men. Hence, these models can act as a framework for designing and implementing educational interventions for undergoing FOBT.
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Affiliation(s)
- Yousef Gholampour
- Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.
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15
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Khashij S, Jalilian F, Vaezi M, Jalilian M, Gharibnavaz H, Ahmadi-Jouybari T, Naghibifar Z, Karami H. Measuring Beliefs Related to Colorectal Cancer Screening Behavior among Iranian Middle-Aged and Elderly: a Psychometric Study. Asian Pac J Cancer Prev 2018; 19:2211-2216. [PMID: 30139227 PMCID: PMC6171398 DOI: 10.22034/apjcp.2018.19.8.2211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The annual fecal occult blood test is a very important method for colorectal cancer early detection through screening.
Our aim was to assess psychometrics of instrument measuring beliefs related to fecal occult blood test uptake among
Iranian middle-aged and elderly, based on the theory of planned behavior. This cross-sectional study was performed on
150 middle-aged and elderly who were randomly selected to participate voluntarily in Kermanshah, in the west of Iran.
The studied constructs included attitude, subjective norms, perceived behavior control, and behavior intention. Data
were analyzed with SPSS software (ver. 21.0). The mean age of the respondents was 59.1 years [SD: 6.73], in the range
from 50 to 73. All of the loads of the exploratory factorial analysis were larger than 0.4. KMO was calculated as 0.756.
Overall, four factors under investigation accounted for 82% of the variance in the hypothesized model. Cronbach’s
alpha for the measured constructs of attitude, subjective norms, perceived behavior control, and behavior intention
were 0.92, 0.88, 0.70 and 0.88, respectively. Our findings indicated the final scale to be adequately reliable and valid for
measurement of these constructs for prediction of fecal occult blood test uptake among Iranian middle-aged and elderly.
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Affiliation(s)
- Shiva Khashij
- Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Rogers CR, Goodson P, Dietz LR, Okuyemi KS. Predictors of Intention to Obtain Colorectal Cancer Screening Among African American Men in a State Fair Setting. Am J Mens Health 2018; 12:851-862. [PMID: 27161985 PMCID: PMC5101175 DOI: 10.1177/1557988316647942] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Racial disparities in health among African American men in the United States are appalling. African American men have the highest mortality and incidence rates from colorectal cancer compared with all other ethnic, racial, and gender groups. Juxtaposed to their white counterparts, African American men have colorectal cancer incidence and mortality rates 27% and 52% higher, respectively. Colorectal cancer is a treatable and preventable condition when detected early, yet the intricate factors influencing African American men's intention to screen remain understudied. Employing a nonexperimental, online survey research design at the Minnesota State Fair, the purpose of this study was to explore whether male role norms, knowledge, attitudes, and perceptions influence intention to screen for colorectal cancer among 297 African American men. As hypothesized, these Minnesota men (ages 18 to 65) lacked appropriate colorectal cancer knowledge: only 33% of the sample received a "passing" knowledge score (85% or better). In a logistic regression model, the three factors significantly associated with a higher probability of obtaining colorectal cancer screening were age, perceived barriers, and perceived subjective norms. Findings from this study provide a solid basis for informing health policy and designing health promotion and early-intervention colorectal cancer prevention programs that are responsive to the needs of African American men in Minnesota and beyond.
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Affiliation(s)
| | | | | | - Kola S. Okuyemi
- University of Minnesota Medical School,
Minneapolis, MN, USA
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17
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Rogers CR, Mitchell JA, Franta GJ, Foster MJ, Shires D. Masculinity, Racism, Social Support, and Colorectal Cancer Screening Uptake Among African American Men: A Systematic Review. Am J Mens Health 2017; 11:1486-1500. [PMID: 26483293 PMCID: PMC4835264 DOI: 10.1177/1557988315611227] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Colorectal cancer (CRC) is highly preventable when CRC screening is utilized, yet CRC screening completion among African American men is relatively low and their mortality rates remain 50% higher juxtaposed to their White counterparts. Since a growing body of literature indicates masculinity, racism, and social support each have strong influences on CRC screening uptake, this systematic review examined the connections between these three sociocultural factors and CRC screening uptake among African American men. Potential studies were retrieved from MEDLINE, CINAHL, EMBASE, and PsycINFO. Cited reference searching for the final sample was employed to identify and assess additional studies for inclusion using Scopus. The methodological quality of the reviewed evidence was also evaluated. Nineteen studies met inclusion/exclusion criteria. Thirteen studies employed nonexperimental research designs; a quasi-experimental design was present in four, and two utilized experimental designs. Studies were published between 2000 and 2014; the majority between 2009 and 2013. Social support was most frequently addressed (84%) while masculinity and racism were equally studied with paucity (11%) for their influence on CRC screening. After evaluating conceptual and methodological characteristics of the studies, 42% fell below average in quality and rigor. The need for increased attention to the sociocultural correlates of CRC screening for African American men are highlighted in this systematic review, and important recommendations for research and practice are provided. Alongside a call for more rigorous research, further research examining the influence of masculinity and racism on CRC screening completion among African American men is warranted.
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Khani Jeihooni A, Kashfi SM, Shokri A, Kashfi SH, Karimi S. Investigating Factors Associated with FOBT Screening for Colorectal Cancer Based on the Components of Health Belief
Model and Social Support. Asian Pac J Cancer Prev 2017; 18:2163-2169. [PMID: 28843251 PMCID: PMC5697476 DOI: 10.22034/apjcp.2017.18.8.2163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction: This study aimed to investigate the factors associated with FOBT screening for colorectal cancer based on the components of Health Belief Model and social support in Fasa City, Fars Province, Iran. Materials and Methods: This was a cross-sectional study carried out on 240 subjects in people of Fasa city who had 50 years old and above. The subjects in this study were assigned to two groups of 120 patients. The first group included people over 50 years, who referred to the diagnostic laboratories for doing FOBT, but the second group included people aged 50 years and above who did not refer to a laboratory for doing FOBT and were assessed by questionnaires at home. Data were collected through a questionnaire based on health belief model and perceived social support. Results: The referring group included 61.3 percent women and 38.7 percent men, with a mean age of 65.24 ± 8.01. The non-referring group included 59.7 percent women and 40.3 percent men, with a mean age of 64.21 ±7.53 (p=0.24). In the referring group, 64.2 percent had undergone FOBT in the past year, while in the non-referring group only 12.72percent had done so (p=0.001). The results showed that the referring group obtained higher scores on awareness about CRC and ways to prevent it, and on HBM Model constructs, and social support compared to the non-referring group (p<0.001). In addition, the referring group reported significantly lower Perceived Barriers compared to the non-referring group (p<0.001). Conclusion: The results showed significant differences between the two groups in terms of HBM components and perceived social support for doing FOBT. Therefore, theory-based educational interventions can be used to increase individuals’ Perceived Severity, Perceived Susceptibility, and Perceived Benefits and reduce their Perceived Barriers in order to empower and encourage people to perform FOBT.
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Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa.
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Gabriel E, Ostapoff K, Attwood K, Al-Sukhni E, Boland P, Nurkin S. Disparities in the Age-Related Rates of Colorectal Cancer in the United States. Am Surg 2017. [DOI: 10.1177/000313481708300631] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The incidence of colorectal cancer (CRC) among Americans under the age of 50 years is increasing. The purpose of this study was to identify racial and socioeconomic disparities associated with this trend. The National Cancer Data Base was used to identify patients with CRC from 1998 to 2011. Patients were stratified by age (<50 versus >60 years), with ages 50 to 60 years omitted from the analysis to minimize overlapping trends between the two age groups. Relative frequencies (RFs) by year were plotted against demographic variables. Changes in RF over time and intervals from diagnosis to treatment (including surgery and chemotherapy) were compared. A total of 1,213,192 patients were studied; 885,510 patients with colon cancer and 327,682 with rectal or rectosigmoid cancer. Patients <50 years had higher RF for stage III/IV CRC compared with >60 years, with the highest rate of increase in stage III colon cancer (0.198% per year). Patients <50 years had higher RF for CRC if they were African-American or Hispanic. Hispanic patients <50 years had the highest rates of increase for both colon (RF = 0.300% per year) and rectal cancer (RF = 0.248% per year). Compared with race, other variables including education and income were not found to have as strong an association on age-related rates of CRC. No clinically significant differences were observed for time from diagnosis to treatment in either age group. Important racial disparities are associated with differences in age-related CRC rates, warranting further investigation to develop improved strategies for the earlier detection of CRC in these populations.
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Affiliation(s)
| | | | | | | | - Patrick Boland
- Medical Oncology, Roswell Park Cancer Institute, Buffalo, New York
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Lumpkins CY, Vanchy P, Baker TA, Daley C, Ndikum-Moffer F, Greiner KA. Marketing a Healthy Mind, Body, and Soul: An Analysis of How African American Men View the Church as a Social Marketer and Health Promoter of Colorectal Cancer Risk and Prevention. HEALTH EDUCATION & BEHAVIOR 2015; 43:452-60. [PMID: 26424748 DOI: 10.1177/1090198115604615] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Centers for Disease Control and Prevention ranks colorectal cancer (CRC) as the third most commonly diagnosed cancer among men in the United States; African American (AA) men are at even greater risk. The present study was from a larger study that investigates the church's role as a social marketer of CRC risk and prevention messages, and whether religiously targeted and tailored health promotion materials will influence screening outcome. We used an integrated theoretical approach to explore participants' perceptions of CRC risk and prevention and how promotion messages should be developed and socially marketed by the church. Six focus groups were conducted with men from predominately AA churches in the Midwest. Themes from focus group discussions showed participants lacked knowledge about CRC, feared cancer diagnosis, and feared the procedure for screening. Roles of masculinity and the mistrust of physicians were also emergent themes. Participants did perceive the church as a trusted marketer of CRC but believed that promotional materials should be cosponsored and codeveloped by reputable health organizations. Employing the church as a social marketer of CRC screening promotion materials may be useful in guiding health promotions and addressing barriers that are distinct among African American men.
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Affiliation(s)
- Crystal Y Lumpkins
- University of Kansas Medical Center, Kansas City, KS, USA University of Kansas, Lawrence, KS, USA
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