Colorectal Cancer in Ethnic Subgroups of U.S. Blacks: Exploring Diversity

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DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is the second leading cause of cancer deaths among Americans, with 54,650 deaths and 148, 610 new cases expected in 2006. U.S. blacks have the highest CRC incidence and mortality rates of all groups and these disparities have remained startlingly unchanged over decades. As a group, U.S. blacks also demonstrate much lower use of cancer screening and treatment technology, and foreign-born blacks may have even lower rates of CRC screening. The diversity within the population of U.S. blacks is largely unexplored because blacks are commonly treated as a homogenous group, without consideration of possible cultural and behavioral differences associated with national ancestry in the various distinct immigrant communities. Three critical factors-rising numbers of the black immigrant population, lack of research data regarding immigrant blacks, and wide availability of screening tests for CRC-create complex challenges and opportunities for reducing the startling health disparities. In this pilot study we will use mixed qualitative and quantitative research methods to examine CRC related beliefs and behaviors among three ethnic subgroups of U.S. blacks: (1) native U.S.-born, i.e. African American; (2) Haitian-born; and (3) immigrants from English-speaking Caribbean countries [e.g., Jamaica, Trinidad & Tobago]. Twenty men and women (aged 50 years or older) from each ethnic subgroup (total sample: 60) will be recruited from medically underserved areas (MUAs) in Hillsborough County, FL, the main geographic site for the "Tampa Bay Community Cancer Network (TBCCN)" parent grant. The study is guided by community-based participatory approaches facilitated and informed by community advisors and TBCCN community partners. Eligible and consenting individuals will take part in face-to-face qualitative in-depth interviews and brief quantitative questionnaires read out aloud by a trained interviewer in the community. Qualitative and exploratory quantitative data analyses will focus on: (1) examining and describing cultural beliefs (e.g., health beliefs, cancer fatalism, acculturation, ethnic discrimination), knowledge, awareness and perceived determinants of screening utilization; and (2) assessing the feasibility of recruitment methods among the defined ethnic subgroups. An understanding of ethnic subgroup similarities and differences will be useful in planning future larger scale observational or intervention studies to reduce the disparate burden of CRC.