Discussing cancer: communication with African Americans.

Regular screening for colorectal cancer (CRC) facilitates earlier detection, lowers mortality, and may reduce incidence through detection and removal of pre-cancerous polyps. Optimizing health professional delivery of CRC screening information and recommendations can assist in reducing CRC disparity in the African-American community. This article presents qualitative data on African Americans' attitudes about health professional CRC communications based on the analysis of focus groups (N = 79). Using a social-ecological framework, colorectal cancer and professional communication themes are examined to offer four general and nine cancer-specific theoretically based and culturally appropriate strategies for improving health professional cancer communication with African Americans.

Use of cancer control referrals by 2-1-1 callers: a randomized trial.

BACKGROUND: Callers to 2-1-1 have greater need for and lesser use of cancer control services than other Americans. Integrating cancer risk assessment and referrals to preventive services into 2-1-1 systems is both feasible and acceptable to callers. PURPOSE: To determine whether callers will act on these referrals. METHODS: In a randomized trial, 2-1-1 callers (n=1200) received standard service and those with at least one cancer risk factor or need for screening were assigned to receive verbal referrals only, verbal referrals + a tailored reminder mailed to their home, or verbal referrals + a telephone health coach/navigator. All data were collected from June 2010 to March 2012 and analyzed in March and April 2012. RESULTS: At 1-month follow-up, callers in the navigator condition were more likely to report having contacted a cancer control referral than those receiving tailored reminders or verbal referrals only (34% vs 24% vs 18%, respectively; n=772, p<0.0001). Compared to verbal referrals only, navigators were particularly effective in getting 2-1-1 callers to contact providers for mammograms (OR=2.10, 95% CI=1.04, 4.22); Paps (OR=2.98, 95% CI=1.18, 7.54); and smoking cessation (OR=2.07, 95% CI=1.14, 3.74). CONCLUSIONS: Given the extensive reach of 2-1-1s and the elevated risk profile of their callers, even modest response rates could have meaningful impact on population health if proactive health referrals were implemented nationally.

Comparing narrative and informational videos to increase mammography in low-income African American women.

OBJECTIVE: Compare effects of narrative and informational videos on use of mammography, cancer-related beliefs, recall of core content and a range of reactions to the videos. METHOD: African American women (n=489) ages 40 and older were recruited from low-income neighborhoods in St. Louis, MO and randomly assigned to watch a narrative video comprised of stories from African American breast cancer survivors (Living Proof) or a content-equivalent informational video using a more expository and didactic approach (Facts for Life). Effects were measured immediately post-exposure and at 3- and 6-month follow-up. RESULTS: The narrative video was better liked, enhanced recall, reduced counterarguing, increased breast cancer discussions with family members and was perceived as more novel. Women who watched the narrative video also reported fewer barriers to mammography, more confidence that mammograms work, and were more likely to perceive cancer as an important problem affecting African Americans. Use of mammography at 6-month follow-up did not differ for the narrative vs. informational groups overall (49% vs. 40%, p=.20), but did among women with less than a high school education (65% vs. 32%, p<.01), and trended in the same direction for those who had no close friends or family with breast cancer (49% vs. 31%, p=.06) and those who were less trusting of traditional cancer information sources (48% vs. 30%, p=.06). CONCLUSIONS: Narrative forms of communication may increase the effectiveness of interventions to reduce cancer health disparities. PRACTICE IMPLICATIONS: Narratives appear to have particular value in certain population sub-groups; identifying these groups and matching them to specific communication approaches may increase effectiveness.

African American men's perceptions of factors influencing health-information seeking.

The lack of health information is one of several factors implicated in the poor health status of African American men. Although a growing body of research delineates the obstacles to African Americans' engagement in preventive health behaviors, relatively little is known about the barriers that adversely affect men's involvement in health-information seeking. This article presents qualitative data on African American men's information seeking through an analysis of focus group data. Three research questions are addressed: (a) What health-information concerns and needs do African American men have? (b) How do African American men describe their efforts to obtain health information? and (c) What factors facilitate or inhibit health-information seeking by African American men? The implications of the data and suggestions for future research are provided.