title: Cultural, economic, and psychological predictors of colonoscopy in a national sample.
abstract: BACKGROUND
  Although colorectal cancer (CRC) is the second leading cause of cancer death among adults in the US and colonoscopy is efficacious in reducing morbidity and mortality from CRC, screening rates are sub-optimal. Understanding the socioeconomic, cultural, and health care context within which decisions about colonoscopy are made allows physicians to address patients' most salient beliefs and values and other constraints when making screening recommendations.
  
  
  OBJECTIVE
  To evaluate the direct and interactive effects of socioeconomics, health care variables, psychological characteristics, and cultural values on colonoscopy use.
  
  
  METHODS
  National survey completed between January-August 2009 in a random sample of African American, white, and Hispanic adults ages 50-75 without cancer (n = 582).
  
  
  METHODS
  Self-reported colonoscopy use.
  
  
  RESULTS
  Only 59% of respondents reported having a colonoscopy. The likelihood of colonoscopy increased with having health insurance (OR = 2.82, 95% CI = 1.24, 6.43, p = 0.004), and increasing age (OR = 1.40, 95% CI = 1.11, 1.77, p = 0.001). In addition, respondents with greater self-efficacy were more likely to have a colonoscopy (OR = 2.41, 95% CI = 1.35, 4.29, p = 0.003).
  
  
  CONCLUSIONS
  Programs that help patients to overcome access and psychological barriers to screening are needed.
authors: Department of Psychiatry, Center for Community-Based Research, University of Pennsylvania, Philadelphia, PA, USA. chanita@mail.med.upenn.edu
authors: Chanita Hughes
authors: CH
authors: Halbert
authors: Frances K
authors: FK
authors: Barg
authors: Carmen E
authors: CE
authors: Guerra
authors: Judy A
authors: JA
authors: Shea
authors: Katrina
authors: K
authors: Armstrong
authors: Monica
authors: M
authors: Ferguson
authors: Benita
authors: B
authors: Weathers
authors: James
authors: J
authors: Coyne
authors: Andrea B
authors: AB
authors: Troxel
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000191:economics* / Q000523:psychology / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000523:psychology; D016001:Confidence Intervals; D003469:Culture; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017060:Patient Satisfaction; D012307:Risk Factors; D020377:Self Efficacy; D014481:United States