Colorectal Cancer Screening

African Americans have the highest colorectal cancer (CRC) incidence and mortality of any ethnic/racial group. This study aims to increase our understanding of factors which influence African Americans’ decisions about health care seeking and CRC screening behavior.

UB Principal Investigator: Marc T. Kiviniemi, PhD

Co-Principal Investigators: Deborah O. Erwin, PhD, Roswell Park Cancer Institute; Lina Jandorf, MA, Mount Sinai School of Medicine

Funding Agency: National Cancer Institute

Period: 7/2013 – 3/2017

Abstract: African Americans have the highest colorectal cancer (CRC) incidence and mortality of any ethnic/racial group. While screening, and particularly colonoscopy, is effective in reducing the incidence of CRC, adherence is low. There is a critical need to improve our understanding of adherence and the factors which influence African Americans’ decisions about engaging in CRC screening, as well as efficacious intervention strategies. Behavioral research has shown links to cognitive decision-making factors (perceived benefits and barriers) and affective decision-making factors (fear and worry) in predicting CRC screening and intentions to screen. However, little or no work has systematically examined these factors in African Americans; this creates significant gaps in knowledge about the role of these factors in predicting (and potentially increasing) CRC screening for minorities.

The goal of the proposed application is to understand factors influencing the decisions of African Americans to engage in (or not engage in) screening for CRC and the ability to positively impact these factors through intervention strategies at a community level. The central hypotheses are: a) that decisions to engage in CRC screening will be a function of both cognitive and affective factors; and b) that educational interventions can effectively alter both affective and cognitive factors and therefore increase CRC screening rates for African Americans.

The specific aims proposed to test our hypotheses are:

  • Examine the impact of two randomized community interventions on cognitive and affective factors and their resulting influence on health care seeking and CRC screening behaviors for African Americans.
  • Examine and explore contextual factors that may influence the process of behavior change to better understand CRC screening and health care seeking behaviors at the community level.

This study will significantly increase our understanding of factors which influence African Americans’ decisions about health care seeking and CRC screening behavior and whether a community-based intervention can positively impact these factors and behaviors to reduce disparities.

Th expected outcomes are that the work proposed in these aims will provide crucial information about behavioral change specific to health care seeking and CRC screening by African Americans.