Marcell, A. V., Jagers, R. J., Mayden, B., & Mobley, C. (2008). Exploring Perceptions of Health Needs Among Young African American Men. American Journal of Mens Health,4(1), 16-21. doi:10.1177/1557988308324030
The aim of this study was to examine the general and reproductive health needs of adolescents and young males in an effort to increase male use of health services. The study surveyed 47 African American men, from ages 12 to 25, on their life priorities, health concerns, and sexual/reproductive health care needs. When asked about life priorities, the researchers found that health was ranked as the fourth highest life priority and that it was mainly emphasized by the older participants. The main sexual/reproductive health priorities observed were HIV/AIDS, followed by general cancer, STI’s, and pregnancy. The researchers concluded that there needs to be an improvement in the delivery and promotion of reproductive and clinical health care services to men. They also concluded that parents, schools, and healthcare providers need to better educate men, particularly young men, about their health needs. This study is relevant to the colorectal cancer (CRC) study because although the participants ranked cancer as a health priority, no specific form of cancer was mentioned. This may indicate that young African American males are unaware of the types of cancer they may be most at risk for in the future, such as CRC. The study also mentions that behavioral experiences among young males could potentially play a role in health risk judgement, which may explain the lack of health care service use.
Shi, L., Lebrun, L. A., & Tsai, J. (2009). The influence of English proficiency on access to care. Ethnicity & Health,14(6), 625-642. doi:10.1080/13557850903248639
The aim of this study was to assess whether lack of English fluency has an impact on patients’ access to medical care. The researchers argue that addressing language barriers in health care settings is becoming increasingly important because the number of United States residents that speak a language other than English at home has been growing over time. The study analyzed data from the Family Core component of the 2006 NHIS, using geographic primary sampling units to ensure a nationally representative sample. The three outcome measures of interest were self-reported delayed medical care, inability to obtain needed care, and any visits to a health professional. The findings demonstrate that individuals with limited English proficiency, primarily Latinos, were more likely to receive delayed medical care and/or no medical care at all. Individuals with limited English proficiency also reported having trouble communicating and understanding health care providers. The researchers concluded that language barriers have a negative impact on access to medical care and suggest that health care providers and policy makers provide more “linguistically accessible” health care settings so that the growing population of residents who are not proficient in English can have equal access to health care services. This study is relevant to the colorectal cancer (CRC) study because the findings suggest that language barriers are not a significant issue for African American patients. These findings can be used to argue that other factors, such as lack of perceived risk, may be preventing African Americans from seeking necessary medical care and/or from participating in preventive methods, such as screening.
Courtenay, W. H., Mccreary, D. R., & Merighi, J. R. (2002). Gender and Ethnic Differences in Health Beliefs and Behaviors. Journal of Health Psychology,7(3), 219-231. doi:10.1177/1359105302007003216
The aim of this study was to investigate the role of gender and race/ethnicity in the involvement of health risk behaviors and health-related benefits. The study surveyed 1,816 undergraduate students between the ages of 18 and 72 years of age from three four-year public universities in California. Survey responses were analyzed according to six domains which included diet, anger/stress, preventive care, medical compliance, substance use, and beliefs about masculinity. The findings demonstrated that men are more likely to engage in risky behaviors and are less likely to exhibit medical compliance and preventive health behaviors as compared to women. The findings also demonstrate that European Americans are more likely to hold healthier beliefs about masculinity and are less likely to adopt risky dieting practices as compared to the other race/ethnicity groups. The researchers concluded that although there were some differences in risky behavior and health beliefs among the different races/ethnicities, overall men remained more likely to engage in behaviors and adopt beliefs that were detrimental to their health. The researchers suggest that gender and race specific health promotion, educational, and disease prevention programs are needed to improve the life expectancy and life quality of men. These findings are relevant to the colorectal cancer (CRC) study because the CRC study focuses primarily on African American men, which represents two of the main groups that were found to engage in the riskiest behaviors and have the least healthy beliefs in this study. Some of the background information in the introduction is relevant to the CRC study as well. The researchers mention that there is strong evidence that fewer health-promoting behaviors and greater risk taking among men may contribute to their increased risk of serious chronic disease, injury, or death. Findings of poor dietary habits among African Americans can also be used as a contributing factor to the development of CRC.
Lipkus, I. M., Rimer, B. K., Lyna, P. R., Pradhan, A. A., Conaway, M., & Woods-Powell, C. T. (1996). Colorectal screening patterns and perceptions of risk among African-American users of a community health center. Journal of Community Health,21(6), 409-427. doi:10.1007/bf01702602
The aim of this study was to assess perceived risk and predictors of perceived risk for colorectal cancer (CRC) primarily among low-income African Americans age 50 and older. The researchers note that although screening rates for CRC are generally low, African Americans report less use than whites of the three recommended screening practices, which may be attributed to a decrease in perceived risk among African Americans. The study surveyed 547 adult users of the Lincoln Community Health Center in Durham, NC. Survey questions consisted of demographic characteristics, smoking habits, health status, perceptions and attributions of risk, belief about CRC, experiences with CRC, and screening. The findings demonstrated that the majority of the participants estimated their risk to be below average and the majority attributed their risk to physiological factors rather than personal actions. The researchers concluded that modifying or creating new health promotion and intervention programs directed towards African Americans may increase the rate of CRC screening. African American patients may also benefit from educational workshops that help them to understand CRC and how personal actions can influence their risk. This study is relevant to the CRC study because it focuses primarily on the African American population and it demonstrates how reckless behavior influenced by a decrease in perceived risk can result in the development of CRC.
Bloom, J. R., Stewart, S. L., Oakley-Girvans, I., Banks, P. J., & Chang, S. (2006). Family History, Perceived Risk, and Prostate Cancer Screening among African American Men. Cancer Epidemiology Biomarkers & Prevention,21(2), 388-388. doi:10.1158/1055-9965.epi-11-1118
The aim of this study was to assess African American men awareness of prostate cancer risks and symptoms, their specific level of risk based on race and family history, and their use of early detection methods. The researchers note that many although African American men have two major risk factors for prostate cancer, ethnicity and family history, the majority are not aware of this significant vulnerability. This study surveyed 208 African American men, ages 40 to 74 years, whose prostate cancer diagnosis was reported to the California Cancer registry. Participants were interviewed by telephone and asked about their screening behavior, knowledge of prostate cancer risk factors and symptoms, family history, barriers to screening, etc. The findings demonstrated that men with a family history did not perceive their risk to be higher than those without a family history. Men who were younger and more educated were more likely to perceive their risk as higher, even if they did not have a family history. Men who perceived their risk to be higher were more likely to get screened as well. The researchers concluded that having a family history does not necessarily increase perceived risk. Educating African American populations on the risks of prostate cancer as well as making them more aware of the role family history may play could increase screening rates. This study is relevant to the colorectal cancer (CRC) study because it shows how a decrease in perceived risk is a common theme seen not only in CRC cases but in other cancer cases as well. Lack of cancer education seems to be one of the major issues that leads to a decrease in perceived risk and can result in risky behavior.
Goodman, M. J., Ogdie, A., Kanamori, M. J., Canar, J., & O’Malley, A. S. (2006). Barriers and facilitators of colorectal cancer screening among Mid-Atlantic Latinos: Focus Group Findings. Ethnicity & Disease,16, 255-261.
The aim of this study was to examine patient and provider barriers related to the use of colorectal cancer (CRC) screening methods, primarily among mid-Atlantic Latinos. The study conducted nine focus groups comprised of 70 Latino patients between the ages of 50 and 80 years and 27 primary care providers of different races/ethnicities. Participants were asked a series of open-ended questions about their attitudes and experiences with CRC screening. A demographic questionnaire was given at the end. The findings demonstrated that the main factor prohibiting patients from getting screened was the lack of funds for both initial screening and for follow-ups. When examining gender differences between patients, the researchers found that men expressed more confusion about test procedures for CRC screening, expressing some embarrassment in completing FOBT and discomfort with colonoscopies, referring to jokes about homosexuality and masculinity. The researchers concluded that health care providers and policy makers should work on improving funding and availability for CRC screening particularly for people with low-income. Cultural barriers related to fear and embarrassment involving screening procedures should be addressed as well. Although this study primarily focuses on the Latino population, it is still relevant to the CRC study because it includes gender considerations that may be applicable to men in different racial/ethnic populations. Men may avoid CRC screening in an effort to appear strong or to preserve their feelings of masculinity.
Ward, E., Jemal, A., Cokkinides, V., Singh, G. K., Cardinez, C., Ghafoor, A., & Thun, M. (2004). Cancer Disparities by Race/Ethnicity and Socioeconomic Status. A Cancer Journal for Clinicians,54(2), 78-93. doi:10.3322/canjclin.54.2.78
The aim of this study was to emphasize the major disparities that exist in cancer risk factors, screening, stage at diagnosis, and treatment between different populations and how to possibly reduce or eliminate these differences. The researchers argue that racial/ethnic burdens as well as certain socioeconomic factors can be just as, if not more, important as physiological factors. The study analyzed data from the National Cancer Institutes (NCI) Surveillance, Epidemiology, and End Results (SEER) program, the National Center for Health Statistics (NCHS), and the National Health Interview Survey (NHIS). The findings demonstrated that residents of low-income counties have 13% higher death rates from cancer in men and 3% higher rates in women compared to more affluent counties. African Americans were found to have the highest death rate from all of the cancer sites combined and the highest rate of malignancies out of all the racial/ethnic groups in the United States. Overall, racial/ethnic minority populations were less likely to be screened and were more likely to engage in risky behaviors such as tobacco use and low levels of physical activity. The researchers concluded that improving prevention strategies for risky behaviors, increasing screening for early detection, and providing the same treatment options and recommendations for all patients. This study is relevant to the CRC study because it suggests that the risky behaviors influenced by socioeconomic factors may be the primary reason for low-income minority populations having poorer experiences with cancer and cancer care.