Mitchell Jamie A, Watkins Daphne C, Modlin Charles S
School of Social Work, Wayne State University, Detroit, Michigan.
School of Social Work, University of Michigan, Ann Arbor, Michigan.
J Mens Health. 2013 Mar;10(1):14-21. doi: 10.1016/j.jomh.2012.09.003. Epub 2013 Nov 12.
African-American men are disproportionately burdened with colorectal cancer (CRC). Research is scarce on the social determinants that may influence CRC screening as the primary strategy for early detection among African-American males.
African-American men over the age of 18 years ( = 558) were recruited from a community health fair and anonymously surveyed about their health and cancer screening behaviors. A social ecological theoretical framework was utilized to identify intrapersonal, interpersonal, organizational, and community predictors of CRC screening, which may be associated with social determinants of health and health behaviors. Analysis included correlations and logistic regression.
The mean age of participants was 54.3 years with 85.8% of men being over 40 years of age. Regarding CRC screening: 50.5% ( = 282) of African-American male participants had received any type of CRC screening at any time. Positive predictors of CRC screening included: health insurance status, older age, having spoken with a health provider about family cancer risk, and having a regular doctor. However, employment status and poor self-rated health were negative predictors of the outcome.
Social determinants of health, such as healthcare access and interactions with health systems, along with employment play a critical role in facilitating CRC screening completion in high-risk underserved populations such as African-American men.
非裔美国男性在结直肠癌（CRC）方面负担过重。关于可能影响CRC筛查这一非裔美国男性早期检测主要策略的社会决定因素的研究很少。
从社区健康博览会上招募了18岁以上的非裔美国男性（n = 558），并对他们的健康和癌症筛查行为进行了匿名调查。利用社会生态理论框架来确定CRC筛查的个人、人际、组织和社区预测因素，这些因素可能与健康和健康行为的社会决定因素相关。分析包括相关性和逻辑回归。
参与者的平均年龄为54.3岁，85.8%的男性年龄超过40岁。关于CRC筛查：50.5%（n = 282）的非裔美国男性参与者在任何时候都接受过任何类型的CRC筛查。CRC筛查的积极预测因素包括：医疗保险状况、年龄较大、曾与医疗服务提供者谈论过家族癌症风险以及有固定医生。然而，就业状况和自我健康评分较差是该结果的负面预测因素。
健康的社会决定因素，如医疗保健可及性以及与医疗系统的互动，连同就业情况，在促进高危且服务不足人群（如非裔美国男性）完成CRC筛查方面起着关键作用。
