A qualitative study of barriers and enablers associated with colorectal cancer screening among Somali men in Minnesota.

The rate of cancer screening is generally increasing in the US. In Minnesota, the statewide average rate of screening for colorectal cancer (CRC) is 73%. However, screening completion is relatively low among Somali men; overall, only 27% of Somali immigrants have been screened for CRC. Factors contributing to this disparity have not been well researched. The purpose of this pilot study was to employ focus group methodology to describe and advance understanding of the barriers and enablers associated with CRC screening among Somali men ages 50-74 in Minnesota. Three focus groups were conducted among 27 Somali men in Minnesota. A 9-question, semi-structured interview guide was used. The sessions were audio recorded, transcribed verbatim, and checked for accuracy by research staff prior to data analysis. Three research team members utilized the constant comparative method and NVivo to conduct data analysis. Five barriers to CRC screening emerged from the analyses: (1) lack of knowledge, (2) emotional barriers, (3) acculturation, (4) accountability, and (5) fatalistic beliefs. In addition, two factors enabling CRC screening and prevention emerged: the need for tailored interventions and preventive lifestyle behaviors. The insights gained from this research will assist in developing health promotion and education-focused interventions that encourage Somali immigrants in Minnesota and beyond to seek early detection screening for CRC.Abbreviations: CRC: Colorectal Cancer; FIT: Fecal Immunochemical Test; FOBT: Fecal Occult Blood Test; FQHC: Federally Qualified Health Center; PA: Project Assistant; PI: Principal Investigator.

Measuring Factors Associated with Colorectal Cancer Screening among Young Adult African American Men: A Psychometric Study.

The Male Role Norms, Knowledge, Attitudes, and Perceptions associated with Colorectal Cancer Screening (MKAP-CRCS) survey was developed to assess the attitudes, knowledge, male role norms, perceived barriers, and perceived subjective norms associated with screening for colorectal cancer (CRC) among young adult African American men. There is a critical need for exploring the complex factors that may shape attitudes towards CRC screening among men who are younger (i.e., ages 19-45) than those traditionally assessed by clinicians and health promotion researchers (age 50 and older). Psychometrically sound measures are crucial for eliciting valid and reliable data on these factors. The current study, therefore, assessed the psychometric properties of the MKAP-CRCS instrument using an online sample of young adult African American men (N = 157) across the United States. Exploratory principal component factor analyses revealed that the MKAP-CRCS measure yielded construct valid and reliable scores, suggesting that the scale holds promise as an appropriate tool for assessing factors associated with CRC screening among younger African American men. Strengths and limitations of this study, along with directions for future research are discussed, including the need for more research examining the relationship between masculinity and CRC screening among African American men.

Attitudes Toward Genomic Testing and Prostate Cancer Research Among Black Men.

INTRODUCTION: Black men are diagnosed with prostate cancer at nearly twice the rate of white men and are underrepresented in prostate cancer research, including validation studies of new clinical tools (e.g., genomic testing). Because healthcare system mistrust has contributed to these disparities for centuries, black men may be less inclined to pursue novel testing, and identification of facilitators to their participation in prostate cancer research studies remains warranted. METHODS: A community-engaged approach involving a partnership with a community organization was used to conduct seven focus groups in Minnesota, Alabama, and California to explore black men's attitudes toward prostate cancer research participation and genomic testing for prostate cancer. Data were collected and analyzed from April 2015 to April 2017. RESULTS: Identified genomic testing barriers included a lack of terminology understanding, healthcare system mistrust, reluctance to seek medical care, and unfavorable attitudes toward research. Facilitators included family history, value of prevention, and the desire for health education. Lack of prostate cancer knowledge, prostate-specific antigen testing confusion, healthcare system distrust, and misuse of personal health information were barriers to research study participation. Some black men were motivated to participate in research if it was seen as constructive and transparent. CONCLUSIONS: Disparities for black men can both motivate and disincentivize participation depending upon a positive or negative view of research. Confusion over prostate cancer clinical care has fueled some mistrust among black men affecting both clinical care and research participation. With increased education, health literacy, and assurances of research integrity and transparency, black men may be more willing to participate in prostate cancer testing and research. SUPPLEMENT INFORMATION: This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Colorectal Cancer Screening Uptake's Association With Psychosocial and Sociodemographic Factors Among Homeless Blacks and Whites.

The homeless represent an extremely disadvantaged population that fare worse than minority groups in access to preventive services and health, and minority groups fare worse than Whites. Early detection screening for colorectal cancer (CRC) saves lives, but empirical data about CRC screening practices among homeless Blacks and Whites are limited. Psychosocial risk factors may serve as a barrier to CRC screening completion among homeless Black individuals. A secondary data analysis of a randomized clinical trial for smoking cessation among homeless smokers was conducted to determine whether psychosocial factors and sociodemographic factors were more highly associated with CRC screening uptake among homeless Blacks than among their White counterparts. Study participants ( N = 124) were surveyed on their CRC screening status, sociodemographic variables, and psychosocial correlate measures including anxiety, depression, hopelessness, depression severity, and perceived stress. Associations between these factors were examined with logistic regression. White participants who were currently disabled/unable to work were 6.2 times more likely to ever receive CRC screening than those who were employed. Black participants with public health insurance coverage were 90% less likely to ever obtain CRC screening than participants without health insurance. Black and White participants had similar levels of anxiety symptoms, depression, and hopelessness, yet depression was the only psychosocial variable negatively associated with CRC screening status. Black and White participants with symptoms of depression were 58% less likely to complete screening than those without depression. Mental health risk and sociodemographic factors may serve as barriers to CRC screening among homeless Blacks and Whites.