title: Predictors of stage of adoption for colorectal cancer screening among African American primary care patients.
abstract: BACKGROUND
  Compared with other racial groups, African Americans have the highest colorectal cancer (CRC) incidence and mortality rates coupled with lower screening rates.
  
  
  OBJECTIVE
  Our study examined the predictors of stage of adoption for fecal occult blood testing (FOBT) and colonoscopy among African American primary care patients who were nonadherent to published screening guidelines.
  
  
  METHODS
  Baseline data (N = 815) in a randomized clinical trial were analyzed. Participants were categorized into precontemplation, contemplation, and preparation stages for FOBT and colonoscopy. Predictor variables were demographics, clinical variables, CRC health beliefs and knowledge, and social support. Hierarchical modeling was to identify significant predictors of stage of adoption.
  
  
  RESULTS
  Older, male, Veterans Affairs participants and those with higher perceived self-efficacy, family/friend encouragement, and a provider recommendation had higher odds of being at a more advanced stage of adoption for FOBT. Patients with a history of cancer and higher perceived barriers had higher odds of being at an earlier stage of adoption for FOBT. Predictors of more advanced stage of adoption for colonoscopy included higher perceived benefits, higher perceived self-efficacy, family/friend encouragement, and a provider recommendation for colonoscopy. Higher income (>30 000 vs <15 000) was predictive of earlier stage of adoption for colonoscopy.
  
  
  CONCLUSIONS
  Enhancing self-efficacy, encouragement from family and friends, and provider recommendations are important components of interventions to promote CRC screening.
  
  
  CONCLUSIONS
  Nurses can use knowledge of the characteristics associated with stage of adoption to educate and motivate their African American primary care patients to complete CRC screening tests.
authors.affiliation: Author Affiliations: University of South Florida College of Nursing, Tampa (Dr Wang); Department of Psychology, Purdue University School of Science, Indiana University-Purdue University, Indianapolis (Ms Christy); University of Texas Southwestern Medical Center, Harold C. Simmons Cancer Center, Dallas (Dr Skinner); Indiana University School of Nursing, Indianapolis (Drs Champion and Rawl and Ms Krier); Indiana University Simon Cancer Center, Indianapolis (Drs Champion, Perkins, and Rawl); Grady College of Journalism and Mass Communication, University of Georgia, Athens (Dr Springston); Indiana University School of Medicine, Indianapolis (Drs Perkins and Tong and Ms Gebregziabher).
authors.forename: Hsiao-Lan
authors.initials: HL
authors.lastname: Wang
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Christy
authors.forename: Celette S
authors.initials: CS
authors.lastname: Skinner
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Champion
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Springston
authors.forename: Susan M
authors.initials: SM
authors.lastname: Perkins
authors.forename: Yan
authors.initials: Y
authors.lastname: Tong
authors.forename: Connie
authors.initials: C
authors.lastname: Krier
authors.forename: Netsanet
authors.initials: N
authors.lastname: Gebregziabher
authors.forename: Susan M
authors.initials: SM
authors.lastname: Rawl
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000451:nursing*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000451:nursing*; D055088:Early Detection of Cancer / Q000451:nursing*; D005260:Female; D019983:Guideline Adherence; D017408:Guidelines as Topic; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015399:Nursing Research; D009780:Occult Blood; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D010349:Patient Compliance / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020377:Self Efficacy; D012680:Sensitivity and Specificity; D012944:Social Support; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data