Maxwell Annette E, Lucas-Wright Aziza, Chang L Cindy, Santifer Rhonda E, Crespi Catherine M
Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, 650 Charles Young Drive South, Box 956900, Los Angeles, CA 90095-6900, USA.
Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, 1721 East 120th Street, Los Angeles, CA 90059, USA.
Prev Med Rep. 2020 Dec 8;20:101280. doi: 10.1016/j.pmedr.2020.101280. eCollection 2020 Dec.
Colorectal cancer (CRC) mortality is 47% higher in African American men and 34% higher in African American women compared to non-Hispanic white men and women. This analysis assessed factors associated with CRC screening among 163 African American participants of a peer-counseling intervention study (2016-2018). In a one-group pre/post-test pilot study, trained Community Health Advisors (CHAs) at 9 African American churches in Los Angeles (LA) promoted CRC screening via one-on-one counseling, print materials and telephone reminder calls. Participants completed telephone surveys 3-6 months after the intervention. We fit bivariate and multivariate mixed effects logistic regression models to assess correlates, including participants' demographic characteristics, access to care, cancer-related knowledge and attitudes and receipt of CHA counseling of (1) discussion of CRC screening with provider and (2) receipt of CRC screening during follow-up. After controlling for gender and education, receipt of CHA counseling (OR 3.77) was significantly associated with discussing CRC screening with a provider during follow-up but not with CRC screening. Instead, a routine check-up in the past 12 months (OR 4.47) and discussion of CRC screening with a provider (OR 3.07) were significantly associated with CRC screening during follow-up. Residence in South LA (OR 0.38) was significantly associated with lack of CRC screening. Findings confirm the important role of health care providers and suggest that residence in South LA constitutes an additional barrier to CRC screening. Further research and additional resources are needed to address disparities in the uptake of CRC screening among African Americans, especially in South LA.
与非西班牙裔白人男性和女性相比，非裔美国男性的结直肠癌（CRC）死亡率高47%，非裔美国女性高34%。本分析评估了一项同伴咨询干预研究（2016 - 2018年）中163名非裔美国参与者的CRC筛查相关因素。在一项单组前后测试的试点研究中，洛杉矶（LA）9所非裔美国教堂的经过培训的社区健康顾问（CHA）通过一对一咨询、印刷材料和电话提醒促进CRC筛查。参与者在干预后3 - 6个月完成电话调查。我们采用双变量和多变量混合效应逻辑回归模型来评估相关性，包括参与者的人口统计学特征、就医机会、癌症相关知识和态度以及接受CHA咨询的情况，内容涉及（1）与医疗服务提供者讨论CRC筛查以及（2）随访期间接受CRC筛查。在控制性别和教育程度后，接受CHA咨询（比值比[OR] 3.77）与随访期间与医疗服务提供者讨论CRC筛查显著相关，但与CRC筛查无关。相反，过去12个月内进行常规体检（OR 4.47）以及与医疗服务提供者讨论CRC筛查（OR 3.07）与随访期间的CRC筛查显著相关。居住在洛杉矶南部（OR 0.38）与未进行CRC筛查显著相关。研究结果证实了医疗服务提供者的重要作用，并表明居住在洛杉矶南部是CRC筛查的又一障碍。需要进一步研究并提供更多资源来解决非裔美国人在CRC筛查接受率方面的差异，尤其是在洛杉矶南部。
