ABSTRACT
This mixed-methods study reports barriers and facilitators to screening colonoscopy among inner-city African-Americans. A purposive sample of 29 African-Americans ≥ 50 years old with average risk of colorectal cancer (CRC) was recruited from CRC education programs in an urban setting (June 2011-April 2012). A demographic survey collected quantitative data (e.g., socioeconomic status), and a semi-structured interview assessed qualitative data (e.g., perspectives of colonoscopies). Sample and between-group analyses were conducted using descriptive statistics and content analysis of quantitative and qualitative data, respectively. The sample consisted of 17 people who completed a colonoscopy and 12 who had not. Mean age was 68 years; 79 % completed at least high school, and all had health care coverage and had visited a physician within the last year. Physician recommendation was prevalent among both groups (15/17 in completers vs. 8/12 in non-completers) and thus did not fully explain the differences in adherence. The greatest barrier for the non-colonoscopy group was lack of knowledge about the importance of screening while the commonest facilitator for the colonoscopy group was physician recommendation. Improved knowledge about colonoscopies is a significant facilitator to adherence, while physician recommendation was not significantly different between groups. Promotion of screening colonoscopies by both physicians and community programs has the potential to improve adherence rates in the African-American population.
Subject(s)
Black or African American/psychology , Colorectal Neoplasms/diagnosis , Early Detection of Cancer/psychology , Health Behavior/ethnology , Health Knowledge, Attitudes, Practice , Aged , Aged, 80 and over , Colonoscopy , Colorectal Neoplasms/prevention & control , Colorectal Neoplasms/psychology , Female , Humans , Male , Middle Aged , Physician-Patient Relations , Referral and ConsultationABSTRACT
Childhood parasomnias and movement disorders arise from a variety of etiologic factors. For some children, psychopathology plays a causal role in sleep disorders; in other cases, recurrent parasomnia episodes induce psychopathology. Current research reveals complex interconnections between sleep and mental health. As such, it is important that clinicians consider the impact psychiatric disorders have on childhood parasomnias. This article describes common parasomnias and movement disorders in children and adolescents, with emphasis on psychologic and behavioral comorbidities.
