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

描述（由申请人提供）：结直肠癌（CRC）是美国人癌症死亡的第二大原因，2006年预计有54，650例死亡和148，610例新发病例。美国黑人的CRC发病率和死亡率是所有群体中最高的，这些差异在几十年来一直保持惊人的不变。作为一个群体，美国黑人对癌症筛查和治疗技术的使用率也要低得多，而外国出生的黑人的CRC筛查率可能更低。美国黑人人口的多样性在很大程度上是未被探索的，因为黑人通常被视为一个同质的群体，而没有考虑到各种不同移民社区中与民族血统相关的可能的文化和行为差异。三个关键因素-黑人移民人口数量的增加，缺乏关于移民黑人的研究数据，以及CRC筛查测试的广泛可用性-为减少惊人的健康差距带来了复杂的挑战和机遇。在这项试点研究中，我们将使用定性和定量相结合的研究方法来检查美国黑人的三个种族亚群中CRC相关的信念和行为：（1）美国本土黑人-出生，即非洲裔美国人;（2）海地出生;（3）来自讲英语的加勒比国家的移民[例如，牙买加、特立尼达和托巴哥]。将从佛罗里达州希尔斯伯勒县（“坦帕社区癌症网络（TBCCN）”父母资助的主要地理位置）的医疗服务不足地区（MUA）招募来自每个种族亚组的20名男性和女性（50岁或以上）（总样本：60）。这项研究是由社区顾问和TBCCN社区合作伙伴推动和提供信息的社区参与式方法指导的。符合资格并同意的个人将参加面对面的定性深入访谈和简短的定量问卷，由社区中受过培训的访谈员大声朗读。定性和探索性定量数据分析将集中在：（1）检查和描述文化信仰（例如，健康信念，癌症宿命论，文化适应，种族歧视），知识，意识和筛查利用率的感知决定因素;（2）评估招募方法在定义的种族亚组中的可行性。了解种族亚组的相似性和差异将有助于规划未来更大规模的观察或干预研究，以减少CRC的不同负担。

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.