title: Addressing Low Colorectal Cancer Screening in African Americans: Using Focus Groups to Inform the Development of Effective Interventions.
abstract: African Americans have the highest burden of colorectal cancer (CRC) in the United States of America (USA) yet lower CRC screening rates than whites. Although poor screening has prompted efforts to increase screening uptake, there is a persistent need to develop public health interventions in partnership with the African American community. The aim of this study was to conduct focus groups with African Americans to determine preferences for the content and mode of dissemination of culturally tailored CRC screening interventions. In June 2013, 45-75-year-old African Americans were recruited through online advertisements and from an urban Veterans Affairs system to create four focus groups. A semi-structured interview script employing open-ended elicitation was used, and transcripts were analyzed using ATLAS.ti software to code and group data into a concept network. A total of 38 participants (mean age = 54) were enrolled, and 59 ATLAS.ti codes were generated. Commonly reported barriers to screening included perceived invasiveness of colonoscopy, fear of pain, and financial concerns. Facilitators included poor diet/health and desire to prevent CRC. Common sources of health information included media and medical providers. CRC screening information was commonly obtained from medical personnel or media. Participants suggested dissemination of CRC screening education through commercials, billboards, influential African American public figures, Internet, and radio. Participants suggested future interventions include culturally specific information, including details about increased risk, accessing care, and dispelling of myths. Public health interventions to improve CRC screening among African Americans should employ media outlets, emphasize increased risk among African Americans, and address race-specific barriers. Specific recommendations are presented for developing future interventions.
authors.affiliation: Division of Gastroenterology, Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. fmay@mednet.ucla.edu.|Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. fmay@mednet.ucla.edu.|Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA. fmay@mednet.ucla.edu.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. fmay@mednet.ucla.edu.
authors.forename: Folasade P
authors.initials: FP
authors.lastname: May
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Cynthia B
authors.initials: CB
authors.lastname: Whitman
authors.affiliation: Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Ksenia
authors.initials: K
authors.lastname: Varlyguina
authors.affiliation: Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Erica G
authors.initials: EG
authors.lastname: Bromley
authors.affiliation: Division of Gastroenterology, Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.|Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.|Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.|Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Brennan M R
authors.initials: BM
authors.lastname: Spiegel
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data*; D061345:Early Medical Intervention / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care
keywords: African American; Colorectal cancer; Disparities; Qualitative; Screening