title: Social and cultural factors are related to perceived colorectal cancer screening benefits and intentions in African Americans.
abstract: Models that explain preventive behaviors, such as colorectal cancer (CRC) screening, do not account for social and cultural factors relevant to African Americans. This exploratory study examined the relationship between socio-cultural factors (e.g., traditional acculturative strategy, group-based medical mistrust, physician ethnicity, and group-level perceptions of susceptibility) and perceived benefits, perceived barriers, and CRC screening intentions among African Americans (N = 198; Age: M = 59.7, SD = 9.9; 65% female; 44% household income $50,000+). Hierarchical multiple regression was used to test the following models with perceived benefits, perceived barriers, and screening intentions as the outcomes: (a) traditional acculturative strategy x medical mistrust; (b) physician's ethnicity x medical mistrust; (c) group susceptibility x medical mistrust; and (d) group susceptibility x traditional acculturative strategy. Results revealed that perceiving high group susceptibility while being both more culturally traditional and less mistrustful was associated with more perception of screening benefits. Greater intention to be screened was associated with perceiving high group susceptibility while having a more traditional cultural orientation and low levels of mistrust in those with African American physicians. These results suggest that it may be beneficial to include these social and cultural factors in behavioral interventions to increase CRC screening among African Americans.
authors.affiliation: Health Communication Research Laboratory, Washington University in St. Louis, 700 Rosedale Ave., Campus Box 1009, St. Louis, MO 63112-1408, USA. jpurnell@gwbmail.wustl.edu
authors.forename: Jason Q
authors.initials: JQ
authors.lastname: Purnell
authors.forename: Mira L
authors.initials: ML
authors.lastname: Katz
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Andersen
authors.forename: Oxana
authors.initials: O
authors.lastname: Palesh
authors.forename: Colmar
authors.initials: C
authors.lastname: Figueroa-Moseley
authors.forename: Pascal
authors.initials: P
authors.lastname: Jean-Pierre
authors.forename: Nancy
authors.initials: N
authors.lastname: Bennett
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health / Q000208:ethnology*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003469:Culture; D055088:Early Detection of Cancer / Q000523:psychology*; D005006:Ethnicity; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010820:Physicians; D012044:Regression Analysis; D012959:Socioeconomic Factors; D014481:United States