Factors affecting African American men's use of online colorectal cancer education.

Colorectal cancer (CRC) incidence rates have decreased due to the increased use of CRC screenings that permit the detection and removal of polyps. However, CRC is still the second most common cause of cancer death among men ages 40 to 79 years; incidence and mortality rates for CRC are higher among African American (AA) men than among white men and AA women. CRC screening rates for AA men are comparable to their counterparts of other racial groups, but adherence to the screening guidelines is less, contributing to disparities in CRC mortality. Internet use is widespread and could be a channel to reach and disseminate health information to AA men; however, there are disparities in Internet use, and limited literature exists on how to best address this divide. This pilot project sought to understand African American male attitudes on colorectal cancer screening (CRCS), receipt of CRCS information, and the best strategy to provide African American men online CRCS education. Three focus groups and a feasibility trial were completed with African American men, ages of 45 to 75. Data suggest that disseminating information online is not a very effective way to reach older African American men with limited education. Although we do not recommend using websites among this population, email was more effective in getting participants to the website even though participants expressed a preference for phone messages. Recommendations for future research are provided.

Selected sociocultural correlates of physical activity among African-American adults.

OBJECTIVE: Previous studies have identified several factors to be associated with physical activity (PA) among African-Americans, e.g., demographic and health-related characteristics. Formative studies suggest a link between sociocultural factors and PA among ethnic minorities; yet, it is unclear whether these factors play a role in PA among African-Americans. This paper explores the association of selected sociocultural characteristics with self-reported PA by gender among African-American adults, taking into account demographic and health-related characteristics. DESIGN: Data from the baseline survey of a colorectal cancer communication intervention trial were used. Participants included 446 African-American men and women, aged 45-75 years. Self-report data were collected on demographics, health-related characteristics, selected sociocultural constructs (e.g., ethnic identity, religiosity, collectivism, and medical mistrust), and PA. PA was categorized as meeting or not meeting recommended levels; recommended levels were defined as participating in vigorous PA for 20 minutes/day for at least three days/week or moderate PA for 30 minutes/day for at least five days/week or a minimum of 600 MET-minutes/week in at least five days. Chi-square and multivariate logistic regression models were used to characterize the association between the selected sociocultural constructs and PA among men and women, after adjusting for demographic and health-related characteristics. RESULTS: Most participants reported some PA but only 59% were found to be meeting recommended levels. Univariate analyses revealed that high collectivist attitudes were associated with meeting recommended PA (OR = 1.74), particularly for women (OR = 1.81). In multivariate analyses, high collectivist attitudes were significantly associated with meeting PA recommendations among men (OR = 1.87); while high religiosity and high collectivism were significant among women (OR = 1.87 and 1.85, respectively). CONCLUSIONS: Few of the selected sociocultural characteristics were found to be associated with meeting recommended PA levels. Further study is needed to understand the association of these characteristics with PA among African-Americans.

African American's self-report patterns using the National Cancer Institute Colorectal Cancer Screening questionnaire.

Studies that examine colorectal cancer screening (CRCS) behaviors and correlates rely on self-reports of screening status. Self-reports of CRCS may be more biased than other self-reported cancer screening because of multiple screening options, tests may be offered in combination, and screening schedules differ for each test. The National Cancer Institute (NCI) sponsored the development of a core set of questions to measure self-reported CRCS that are consistent with current guidelines, the NCI Colorectal Cancer Screening questionnaire (NCI CRCS). Several studies support the validity and reliability of this measure; however, none of the existing studies have described African American (AA) responses to items that might be important to clinical decision making and research related to screening adherence. This paper addresses the limited descriptions of AA response patterns to items that comprise the NCI CRCS. The NCI CRCS was administered to 439 AAs 50 to 75 years, participating in the baseline survey of a Center for Excellence in Cancer Communication CRC study. The survey measured self-reported CRCS, factors associated with screening, and response patterns to items that might affect estimates of screening and screening adherence. AA participants reported on CRCS, the test used, and time interval since last screening. Except for queries related to month and year of screening, few participants reported uncertainty in response to items. Two thirds of participants reported receiving CRCS; however, less than half of participants were adherent to guidelines. Less than half reported healthcare provider recommendations to screen. AA participants responded to items on the NCI CRCS as developed. Until new strategies or items are available, interval since last screening appears to be the most appropriate item to estimate AA self-reported CRCS adherence. Strategies are needed to increase physician recommendation to screen.