title: Barriers to oral cancer screening: a focus group study of rural Black American adults.
abstract: OBJECTIVE
  Mortality from mouth and throat cancer (MTC) is higher among Black Americans than White Americans partially because of late stage detection through screening. The disparity in mortality is particularly problematic among Black Americans living in rural areas who have limited access to preventative resources. Our study explored barriers to screening for MTC among Black Americans.
  
  
  METHODS
  We conducted nine focus groups among rural Black Americans age 40 years and older (N = 80).
  
  
  RESULTS
  Content coding of the transcripts of the focus groups revealed three primary barriers to screening. Lack of knowledge (e.g., not knowing about MTC and not knowing MTC symptoms) accounted for 31.8% of all barriers mentioned, lack of resources (e.g., lack of money and health insurance) accounted for 25.0% of all barriers mentioned, and fear (e.g., fear of screening and diagnosis) accounted for 22.9% of all barriers mentioned.
  
  
  CONCLUSIONS
  We placed these barriers within the Theory of Planned Behavior and conclude that interventions aimed at increasing MTC screening among rural Black Americans should first focus on changing people's attitudes about screening by increasing knowledge about MTC and reducing fear.
authors.affiliation: Department of Psychology, University of Florida, Gainesville, FL 32611-2250, USA. jenny.howell@ufl.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Howell
authors.forename: James A
authors.initials: JA
authors.lastname: Shepperd
authors.forename: Henrietta
authors.initials: H
authors.lastname: Logan
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D055088:Early Detection of Cancer / Q000379:methods; D005239:Fear; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States