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Sociocultural and Health Correlates Related to Colorectal Cancer Screening Adherence Among Urban African Americans

Brittain, Kelly PhD, RN; Murphy, Virginia P.

doi: 10.1097/NCC.0000000000000157

Background: Colorectal cancer (CRC) incidence and mortality are highest among African Americans. African Americans lag behind whites in CRC screening rates. Research has examined the role of CRC screening knowledge and beliefs and their relationship to CRC screening adherence. However, studies have not examined the effect cultural identity, social support, CRC beliefs, an informed decision, and having a chronic disease has on CRC screening among African Americans.

Objectives: This study examined CRC screening adherence among African Americans within the context of sociocultural variables, an informed decision, and health factors.

Methods: A secondary data analysis was performed on survey data collected from 129 African American men and women.

Results: Social support and family influence were related to having a colonoscopy. Having diabetes was negatively related to having a colonoscopy. There was no relationship between having a primary care provider and making an informed decision about CRC screening. Religiosity and having a primary care provider predicted colonoscopy.

Conclusions: The results indicate that certain sociocultural variables are related to colonoscopy. However, those same variables may not be related to or predictive of fecal occult blood test adherence. The diagnosis of diabetes may present a challenge to CRC screening adherence.

Implications for Practice: The results of the study suggest that social support and family influence concerning CRC screening be assessed to provide additional support to colonoscopy adherence. The results also suggest that diabetic patients may require additional intervention to increase colonoscopy adherence rates.

Author Affiliations: College of Nursing (Dr Brittain) and Honors College (Ms Murphy), Michigan State University, East Lansing.

Funding for this research was provided in part by the National Institutes of Health/National Institute of Nursing Research through the Ruth L. Kirschstein National Research Service Awards, grant number 1F31NR010421, and the Rackham Graduate School at the University of Michigan through the King Chavez Parks Future Faculty Fellowship to Kelly Brittain

The authors have no conflicts of interest to disclose.

Correspondence: Kelly Brittain, PhD, RN, 1355 Bogue Street, C348, East Lansing, MI 48824-1317 (

Accepted for publication March 5, 2014.

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