Colorectal cancer screening among African American church members: A qualitative and quantitative study of patient-provider communication

Abstract

Background: A healthcare provider's recommendation to undergo screening has been shown to be one of the strongest predictors of completing a colorectal cancer (CRC) screening test. We sought to determine the relationship between the general quality of self-rated patient-provider communication and the completion of CRC screening.

The effects of teamwork and system support on colorectal cancer screening in primary care practices

“…Most studies that examine preventive CRC screening do so aiming to find the problem -e.g., patient barriers, [25][26][27][28][29][30] physician barriers, [5][6][7]31,32] system barriers [14,23,24,33,34] -and implement targeted interventions that solely impact CRC screening. These approaches, while successful to varying degrees, may be limited in their usefulness in applied practice settings for a number of reasons.…”

Colorectal Cancer Screening and African Americans: Findings from a Qualitative Study

“…9 In comparison with non-Hispanic whites in the United States, African Americans suffer disproportionately higher incidence (62.3 vs 52.6 per 100,000) and far are limited in number and have primarily used focus group methodology consisting of study populations not adherent to screening guidelines. 19,[23][24][25] Differentiating why African Americans participate or fail to participate in CRC screening has not been well established. This study seeks to add context to the issue by conducting in-depth personal interviews to help identify what differentiates individuals who have and have not undergone screening for CRC.…”

Physician use of persuasion and colorectal cancer screening

“…Of the barriers and facilitators of CRC screening that have been studied, receipt of a physician recommendation has consistently been found to be associated with screening use [2]. Yet, at the same time, overall adherence to physician-recommended CRC screening remains low [3][4][5] and a 2010 National Institutes of Health (NIH) consensus statement on CRC screening specifically highlighted the need for research on the role of physician recommendation and CRC screening adherence [2].There have now been over a dozen reports describing patient-physician communication and decisionmaking in the context of CRC screening [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Approximately half of these studies relied on patient reports to understand these processes, while the remainder utilized direct observation methods.…”

“…Ling, on the other hand, found that particular elements of an informed decisionmaking process (such as discussion of pros-cons and eliciting patient preferences with regards to CRC screening behavior) were negatively associated with CRC screening use [18]. Studies that have relied upon patients' perceptions of the quality of physician communication have tended to find a positive association between perceived communication quality and being screened for CRC [9,13,15,27]. …”

“…There have now been over a dozen reports describing patient-physician communication and decisionmaking in the context of CRC screening [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Approximately half of these studies relied on patient reports to understand these processes, while the remainder utilized direct observation methods.…”