title: African Americans with a family history of colorectal cancer: barriers and facilitators to screening.
abstract: OBJECTIVE
  To explore barriers and facilitators of screening for colorectal cancer (CRC), as well as suggestions for improving screening among African Americans with first-degree relatives with CRC.
  
  
  METHODS
  A qualitative, descriptive approach involving focus groups.
  
  
  METHODS
  A community healthcare clinic in Baltimore, MD.
  
  
  METHODS
  14 African American men and women aged 40 or older with at least one first-degree family member affected by CRC.
  
  
  METHODS
  In-depth focus groups were conducted until thematic saturation was achieved. Thematic analysis and data reduction were conducted using ATLAS.ti, version 5.0.
  
  
  METHODS
  CRC screening barriers and facilitators.
  
  
  RESULTS
  The participants were mostly male, insured, and had a parent with CRC. Commonly reported barriers to CRC screening included fear of serious illness, mistrust of the medical establishment, potential screening discomfort, lack of information on CRC risk factors, lack of healthcare access, absence of symptoms, no knowledge of CRC screening benefits, community reticence about cancer, and CRC myths. Facilitating factors for CRC screening included a belief of personal risk for CRC, physician recommendations, and acknowledgment of age as a risk factor. Suggestions to increase screening rates included distribution of culturally appropriate and community-based efforts (e.g., mobile units, church-based interventions). Participants also suggested ways to increase motivation and provide social support for screening patients.
  
  
  CONCLUSIONS
  Additional research is needed to identify and test effective screening approaches for this underserved group at increased risk for CRC. Study results suggest that cancer risk and screening education, coupled with screening opportunities in the community, may yield increased screening rates.
  
  
  CONCLUSIONS
  Lack of knowledge about CRC and CRC screening exists in the study population. Promoting screening across generations, developing and disseminating culturally appropriate educational materials within the community, and encouraging older individuals to screen to take care of their family may be appropriate interventions.
authors.affiliation: School of Nursing, University of Maryland, Baltimore, MD, USA. griffith@son.umaryland.edu
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Griffith
authors.forename: Susan R
authors.initials: SR
authors.lastname: Passmore
authors.forename: Domanic
authors.initials: D
authors.lastname: Smith
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wenzel
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology* / Q000523:psychology; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000451:nursing; D003469:Culture; D005192:Family Health / Q000208:ethnology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000451:nursing / Q000523:psychology*; D008507:Medically Underserved Area; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology; D012307:Risk Factors