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社区卫生中心的非裔美国患者的预防保健态度和信念与结直肠癌筛查史的关系。

Association of Preventive Care Attitudes and Beliefs with Colorectal Cancer Screening History among African American Patients of Community Health Centers.

机构信息

College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida A&M University, 1515 South Martin Luther King, Jr. Blvd, Tallahassee, FL, 32307, USA.

Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, 68 President Street, Charleston, SC, 29425, USA.

出版信息

J Cancer Educ. 2023 Dec;38(6):1816-1824. doi: 10.1007/s13187-023-02337-1. Epub 2023 Jul 13.

Abstract

Colorectal cancer (CRC) is the third most common cancer and third leading cause of cancer-related death among African Americans in the United States. However, when detected early, CRC is treatable and survival rates are high. CRC health disparities for African Americans compared with other groups may be due in part to lower screening adherence and later stage diagnosis. The objective of this research phase was to test predictors of ever having received CRC screening (i.e., self-report of lifetime receipt of CRC screening) using survey measures in the domains of healthcare communication, trust in doctors, CRC perceived susceptibility, CRC worry, negative cancer beliefs, CRC screening self-efficacy, and cultural constructs for CRC screening in a sample of African American community health center patients. The study recruited 115 African American patients between the ages of 45 to 64 years old from community health centers in north Florida to complete the baseline survey. Our results show significant differences in CRC screening history by age, marital status, level of mistrust of healthcare providers, and level of empowerment toward cancer screening. To increase CRC screening in this population, the study findings suggest development of intervention programs that focus on priority populations of younger, unmarried African Americans, especially given the current trend of early onset CRC. Moreover, survival rates are lower for unmarried and younger African Americans relative to older and married individuals. Such interventions should also aim to increase trust in healthcare providers and increase empowerment for CRC screening decision making to increase screening participation.

摘要

结直肠癌(CRC)是美国非裔美国人中第三常见的癌症和第三大癌症相关死亡原因。然而,早期发现时,CRC 是可治疗的,生存率很高。与其他群体相比,非裔美国人的 CRC 健康差距可能部分归因于较低的筛查依从性和晚期诊断。本研究阶段的目的是使用医疗保健沟通、对医生的信任、CRC 感知易感性、CRC 担忧、消极的癌症信念、CRC 筛查自我效能和 CRC 筛查的文化结构等领域的调查措施,测试一生中接受过 CRC 筛查(即,自我报告一生接受过 CRC 筛查)的预测因素,在佛罗里达州北部社区卫生中心的 115 名年龄在 45 至 64 岁之间的非裔美国患者中完成基线调查。我们的研究结果显示,CRC 筛查史在年龄、婚姻状况、对医疗保健提供者的不信任程度和对癌症筛查的授权程度方面存在显著差异。为了增加该人群的 CRC 筛查率,研究结果表明,应制定干预计划,重点关注年轻、未婚的非裔美国人这一优先人群,尤其是考虑到当前 CRC 发病年龄提前的趋势。此外,与年龄较大和已婚的个体相比,未婚和年轻的非裔美国人的生存率较低。此类干预措施还应旨在增加对医疗保健提供者的信任,并增强 CRC 筛查决策的授权,以提高筛查参与度。

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