CRC Screening Thoughts and Feelings: Increasing Engagement of African Americans

描述（由申请人提供）：非裔美国人的结直肠癌（CRC）发病率和死亡率在所有种族/人种中最高。虽然筛查，特别是结肠镜检查，在降低CRC发病率方面是有效的，但依从性很低。事实上，一项新发布的建模研究表明，筛查的差异占发病率差异的40%以上，占死亡率差异的近20%。尤其如此 非洲裔美国人;此外，他们不太可能接受有影响力的医生转诊进行筛查。有一个关键的需要，以提高我们的依从性的理解和影响因素，非洲裔美国人的决定参与CRC筛查，以及有效的干预策略。行为研究表明，在预测CRC筛查和筛查意图时，认知决策因素（感知的益处和障碍）和情感决策因素（恐惧和担忧）存在联系。然而，很少或没有工作系统地研究了这些因素在非洲裔美国人;这造成了显着的差距，这些因素的作用，在预测（和潜在的增加）CRC筛查少数民族的知识。拟议应用程序的目标是了解影响非裔美国人参与（或不参与）CRC筛查的决定的因素，以及通过社区层面的干预策略对这些因素产生积极影响的能力。核心假设是：a）参与CRC筛查的决定将是认知和情感因素的函数;和B）教育干预可以有效地改变情感和认知因素，从而提高非裔美国人的CRC筛查率。提出的具体目标来检验我们的假设是：目标1：检查两个随机社区干预的认知和情感因素的影响，以及他们对非裔美国人的医疗保健寻求和CRC筛查行为的影响。目标二：检查和探索可能影响行为改变过程的背景因素，以更好地了解社区层面的CRC筛查和医疗保健寻求行为。这项研究将显著增加我们对影响非裔美国人寻求医疗保健和CRC筛查行为的决定的因素的理解，以及基于社区的干预是否可以积极影响这些因素和行为，以减少差异。预期成果：在这些目标中提出的工作将提供关于非裔美国人寻求医疗保健和CRC筛查的特定行为变化的关键信息。

DESCRIPTION (provided by applicant): African Americans have the highest colorectal cancer (CRC) incidence and mortality of any ethnic/racial group. While screening, and particularly colonoscopy, is effective in reducing the incidence of CRC, adherence is low. In fact, a newly released modeling study suggests that disparities in screening accounts for over 40 percent of incidence disparities and almost 20 percent of mortality disparities. This is particularly true for African Americans; further, they are less likely to receive influential physician referrals for screening. There is a critical need to improve our understanding of adherence and the factors which influence African Americans' decisions about engaging in CRC screening, as well as efficacious intervention strategies. Behavioral research has shown links to cognitive decision-making factors (perceived benefits and barriers) and affective decision-making factors (fear and worry) in predicting CRC screening and intentions to screen. However, little or no work has systematically examined these factors in African Americans; this creates significant gaps in knowledge about the role of these factors in predicting (and potentially increasing) CRC screening for minorities. The goal of the proposed application is to understand factors influencing the decisions of African Americans to engage in (or not engage in) screening for CRC and the ability to positively impact these factors through intervention strategies at a community level. The central hypotheses are: a) that decisions to engage in CRC screening will be a function of both cognitive and affective factors; and b) that educational interventions can effectively alter both affective and cognitive factors and therefore increase CRC screening rates for African Americans. The Specific Aims proposed to test our hypotheses are: Aim 1: Examine the impact of two randomized community interventions on cognitive and affective factors and their resulting influence on health care seeking and CRC screening behaviors for African Americans. Aim 2: Examine and explore contextual factors that may influence the process of behavior change to better understand CRC screening and health care seeking behaviors at the community level. This study will significantly increase our understanding of factors which influence African Americans' decisions about health care seeking and CRC screening behavior and whether a community-based intervention can positively impact these factors and behaviors to reduce disparities. Expected outcomes: the work proposed in these aims will provide crucial information about behavioral change specific to health care seeking and CRC screening by African Americans.