The Influence of Sociocultural Factors on Colonoscopy and FOBT Screening Adherence among Low-income Hispanics

Shelton, Rachel C.; Jandorf, Lina; Ellison, Jennie; Villagra, Cristina; DuHamel, Katherine N.

doi:10.1353/hpu.2011.0074

Cited by 44 publications

(67 citation statements)

References 57 publications

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“…Fatalistic beliefs have been associated with lower utilization of screening for early detection of other malignancies such as breast [36–38], colorectal [39,40], and cervical cancer [41,42]. Similarly, other studies have found an association between fear and anxiety related to the procedure and underutilization of colonoscopy and Pap smears [43–45].…”

Section: Discussionmentioning

confidence: 99%

Beliefs and attitudes about lung cancer screening among smokers

Jonnalagadda¹,

Bergamo²,

et al. 2012

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The National Lung Screening Trial (NLST) recently reported that annual computed tomography (CT) screening is associated with decreased lung cancer mortality in high-risk smokers. Beliefs about lung cancer and screening, particularly across race and ethnicity, and their influence on CT screening utilization are largely unexamined. Our study recruited asymptomatic, high-risk smokers, 55–74 years of age from primary care clinics in an academic urban hospital. Guided by the self-regulation theory, we evaluated cognitive and affective beliefs about lung cancer. Intention to screen for lung cancer with a CT scan was assessed by self-report. We used univariate and logistic regression analyses to compare beliefs about screening and intention to screen among minority (Blacks and Hispanics) and non-minority participants. Overall, we enrolled 108 participants, of which 40% were Black and 34% were Hispanic; the mean age was 62.3 years, and median pack-years of smoking was 26. We found that intention to screen was similar among minorities and non-minorities (p = 0.19); however, Hispanics were less likely to report intention to screen if they had to pay for the test (p = 0.02). Fatalistic beliefs, fear of radiation exposure, and anxiety related to CT scans were significantly associated with decreased intention to screen (p < 0.05). Several differences were observed in minority versus non-minority participants’ beliefs toward lung cancer and screening. In conclusion, we found that concerns about cost, which were particularly prominent among Hispanics, as well as fatalism and radiation exposure fears may constitute barriers to lung cancer screening. Lung cancer screening programs should address these factors to ensure broad participation, particularly among minorities.

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Section: Discussionmentioning

confidence: 99%

Beliefs and attitudes about lung cancer screening among smokers

Jonnalagadda¹,

Bergamo²,

et al. 2012

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“…CRC information requires a wide range of literacy skills that cover basic concepts of health to more advanced concepts of risk probability and statistics (Schapira et al, 2014). Low health literacy has been found to be a barrier to CRC screening in prior research (Kobayashi, Wardle, & von Wagner, 2014; Shelton, Jandorf, Ellison, Villagra, & DuHamel, 2011) and is associated with less CRC awareness, CRC test knowledge, CRC screening test efficacy, and negative attitudes toward fecal occult blood test [FOBT] (Arnold et al, 2012; Dolan et al, 2004). In addition, low health literacy has been associated with less confidence in obtaining a stool blood test and CRC screening completion (Arnold et al, 2012).…”

mentioning

confidence: 99%

Health Literacy among Medically Underserved: The Role of Demographic Factors, Social Influence, and Religious Beliefs

Christy

Gwede

Sutton

et al. 2017

Journal of Health Communication

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The current study examined the sociodemographic and psychosocial variables that predicted being at risk for low health literacy among a population of racially and ethnically diverse patients accessing primary care services at community-based clinics. Participants (N=416) were aged 50–75, currently not up-to-date with colorectal cancer (CRC) screening, at average CRC risk, and enrolled in a randomized controlled trial aimed at promoting CRC screening. Participants completed a baseline interview that assessed health literacy as measured by Rapid Estimate of Adult Literacy in Medicine-Revised, sociodemographic factors, and psychosocial variables (e.g., health beliefs) prior to randomization and receipt of an intervention. Thirty-six percent of participants were found to be at risk for low health literacy. Sociodemographic and psychosocial variables were assessed as predictors of being at risk for low health literacy using logistic regression. In the final model, predictors were male gender, being from a racial/ethnic minority group, being unable to work, having higher social influence scores, and having higher religious belief scores. These findings suggest several patient characteristics that may be associated with low health literacy, and highlight the importance of supporting all patients through simplified and clear communications and information to improve understanding of CRC screening information.

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“…Persistent disparities in CRC screening exist between Hispanic and non-Hispanic white males [24]. Many disparities result from economic barriers to care such as health insurance status, as well as fear and mistrust of medical care [7,8]. Thus, tailored interventions based on patient navigation may be effective in improving adherence to clinical preventive guidelines and health care outcomes [7,25,26].…”

Section: Discussionmentioning

confidence: 99%

“…Recent research work on CRC screening for Hispanics suggests that interventions targeting this population must go beyond improving access to care or socioeconomic status [4,5]. Rather, a promising avenue of intervention for Hispanics may be through a better understanding of group-specific behavioral and cultural factors that are likely to influence CRC screening (e.g., fear of medical encounters, stigma of lower endoscopy, and low levels of health literacy) [6][7][8]. There is already some evidence in the literature about the utility of patient navigation to improve CRC screening by targeting these behavioral and cultural factors [9].…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of a Colonoscopy Screening Navigator Program Designed for Hispanic Men

et al. 2014

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Although Hispanic men are at higher risk of developing colon cancer compared to non-Hispanic white men, colonoscopy screening among Hispanic men is much lower than among non-Hispanic white men. University Health System (UHS) in San Antonio, Texas, instituted a Colorectal Cancer Male Navigation (CCMN) Program in 2011 specifically designed for Hispanic men. The CCMN Program contacted 461 Hispanic men 50 years of age and older to participate over a 2-year period. Of these age-eligible men, 370 were screened for CRC after being contacted by the navigator. Using participant and program data, a Markov model was constructed to determine the cost-effectiveness of the CCMN Program. An average 50-year-old Hispanic male who participates in the CCMN Program will have 0.3 more quality-adjusted life-years (QALYs) compared to a similar male receiving usual care. Life expectancy is also predicted to increase by 6 months for participants compared to non-participants. The program results in net health care savings of $1,148 per participant ($424,760 for the 370 CCMN Program participants). The incremental cost-effectiveness ratio is estimated at $3,765 per QALY in favor of the navigation program. Interventions to reduce disparities in CRC screening across ethnic groups are needed, and this is one of the first studies to evaluate the economic benefit of a patient navigator program specifically designed for an urban population of Hispanic men. A colorectal cancer screening intervention which relies on patient navigators trained to address the unique needs of the targeted population (language barriers, transportation and scheduling assistance, colon cancer, and screening knowledge) can substantially increase the likelihood of screening and improve quality of life in a cost-effective manner.

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The Influence of Sociocultural Factors on Colonoscopy and FOBT Screening Adherence among Low-income Hispanics

Cited by 44 publications

References 57 publications

Beliefs and attitudes about lung cancer screening among smokers

Beliefs and attitudes about lung cancer screening among smokers

Health Literacy among Medically Underserved: The Role of Demographic Factors, Social Influence, and Religious Beliefs

Cost-Effectiveness Analysis of a Colonoscopy Screening Navigator Program Designed for Hispanic Men

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