African American Patients’ Intent to Screen for Colorectal Cancer: Do Cultural Factors, Health Literacy, Knowledge, Age and Gender Matter?

Abstract

African Americans have higher colorectal cancer (CRC) mortality rates compared with all racial/ethnic groups. Research suggests that CRC screening interventions for African Americans target cultural variables. Secondary analysis of data from 817 African-Americans who had not been screened for CRC was conducted to examine: 1) relationships among cultural variables (provider trust, cancer fatalism, health temporal orientation [HTO]), health literacy, and CRC knowledge; 2) age and gender differences; and 3) relationships among cultural variables, health literacy, CRC knowledge, and CRC screening intention. Provider trust, fatalism, HTO, health literacy, and CRC knowledge demonstrated significant relationships among study variables. Stool blood test intention model explained 43% of the variance, with age and gender being significant predictors. Colonoscopy intention model explained 41% of the variance with gender a significant predictor. Results suggest when developing CRC interventions for African Americans, addressing cultural variables is important, but particular attention should be given to age and gender.