Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African Americans
Background: The purpose of this study is to determine whether underserved middle-aged and older African Americans are receiving a colorectal cancer (CRC) screening test (sigmoidoscopy or colonoscopy) and if recommended by their provider. Additionally, we examined correlates of both provider recommen...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Tabriz University of Medical Sciences
2022-12-01
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| Series: | Health Promotion Perspectives |
| Subjects: | |
| Online Access: | https://hpp.tbzmed.ac.ir/PDF/hpp-12-399.pdf |
| _version_ | 1797894258717360128 |
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| author | Sharon Cobb Tavonia Ekwegh Edward Adinkrah Hoorolnesa Ameli Attallah Dillard Lucy W. Kibe Mohsen Bazargan |
| author_facet | Sharon Cobb Tavonia Ekwegh Edward Adinkrah Hoorolnesa Ameli Attallah Dillard Lucy W. Kibe Mohsen Bazargan |
| author_sort | Sharon Cobb |
| collection | DOAJ |
| description | Background: The purpose of this study is to determine whether underserved middle-aged and older African Americans are receiving a colorectal cancer (CRC) screening test (sigmoidoscopy or colonoscopy) and if recommended by their provider. Additionally, we examined correlates of both provider recommendation and uptake of CRC screening. Methods: Seven hundred forty African American individuals, aged 55 and older, participated in this local community cross-sectional survey. We used a multivariate technique of logistic regression. Results: One out of three participants reported that they never received a sigmoidoscopy or colonoscopy for CRC screening. More than 31% indicted that their providers never suggested CRC testing. However, participants who indicated that their providers recommended sigmoidoscopy/colonoscopy were almost 49 times (odds ratio [OR]: 48.9, 95% confidence interval [CI]: 29.5–81.2) more likely to obtain it compared to their counterparts who were not advised to have these procedures. Our data suggest that African American men were significantly less likely than women to receive recommendations from their providers (OR: 0.70, 95% CI: 0.50-0.91). Furthermore, controlling for other variables, the following factors: 1) living arrangement (OR: 1.44, 95% CI: 1.02–2.04), 2) health maintenance organization (HMO) membership (OR: 1.84, 95% CI: 1.28–2.67), 3) number of providers (OR: 1.15, 95% CI: 1.01–1.32), 4) satisfaction with access to and quality of care (OR: 1.24, 95% CI: 1.03–1.51), 5) depressive symptoms (OR: 0.92, 95% CI: 0.86–0.98), and 6) gastrointestinal conditions (OR: 1.73, 95% CI: 1.16–2.58) were associated with obtaining a sigmoidoscopy or colonoscopy test. Conclusion: Our findings suggest that the absence of a provider recommendation is the primary barrier preventing underserved older African Americans from obtaining CRC screening. In addition, our data revealed significant association between obtaining CRC screening and some of the predisposing characteristics of participants, satisfaction with access to and quality of care, and physical and mental health. These findings are consistent with this notion that disparities in health care for African Americans can be traced back to four primary factors: patients, healthcare providers, the healthcare system, and society as a whole, and emphasize the need for establishing theory-driven, culturally-sensitive, and cost-effective CRC screening interventions that recognize and address the constraints to cancer screening experienced by this segment of population. |
| first_indexed | 2024-04-10T07:06:07Z |
| format | Article |
| id | doaj.art-5faee3452a67467d82295f4f39ce8941 |
| institution | Directory Open Access Journal |
| issn | 2228-6497 |
| language | English |
| last_indexed | 2024-04-10T07:06:07Z |
| publishDate | 2022-12-01 |
| publisher | Tabriz University of Medical Sciences |
| record_format | Article |
| series | Health Promotion Perspectives |
| spelling | doaj.art-5faee3452a67467d82295f4f39ce89412023-02-27T07:43:03ZengTabriz University of Medical SciencesHealth Promotion Perspectives2228-64972022-12-0112439940910.34172/hpp.2022.52hpp-40998Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African AmericansSharon Cobb0Tavonia Ekwegh1Edward Adinkrah2Hoorolnesa Ameli3Attallah Dillard4Lucy W. Kibe5Mohsen Bazargan6Mervyn M. Dymally School of Nursing, Charles R. Drew University of Medicine and Science (CDU), CA, USAMervyn M. Dymally School of Nursing, Charles R. Drew University of Medicine and Science (CDU), CA, USADepartment of Public Health, College of Science & Health, CDU, CA, USAMellie’s Bank Hospital, Tehran, IranMervyn M. Dymally School of Nursing, Charles R. Drew University of Medicine and Science (CDU), CA, USAPhysician Assistant Program, College of Science & Health, CDU, CA, USADepartment of Family Medicine, College of Medicine, CDU, CA, USABackground: The purpose of this study is to determine whether underserved middle-aged and older African Americans are receiving a colorectal cancer (CRC) screening test (sigmoidoscopy or colonoscopy) and if recommended by their provider. Additionally, we examined correlates of both provider recommendation and uptake of CRC screening. Methods: Seven hundred forty African American individuals, aged 55 and older, participated in this local community cross-sectional survey. We used a multivariate technique of logistic regression. Results: One out of three participants reported that they never received a sigmoidoscopy or colonoscopy for CRC screening. More than 31% indicted that their providers never suggested CRC testing. However, participants who indicated that their providers recommended sigmoidoscopy/colonoscopy were almost 49 times (odds ratio [OR]: 48.9, 95% confidence interval [CI]: 29.5–81.2) more likely to obtain it compared to their counterparts who were not advised to have these procedures. Our data suggest that African American men were significantly less likely than women to receive recommendations from their providers (OR: 0.70, 95% CI: 0.50-0.91). Furthermore, controlling for other variables, the following factors: 1) living arrangement (OR: 1.44, 95% CI: 1.02–2.04), 2) health maintenance organization (HMO) membership (OR: 1.84, 95% CI: 1.28–2.67), 3) number of providers (OR: 1.15, 95% CI: 1.01–1.32), 4) satisfaction with access to and quality of care (OR: 1.24, 95% CI: 1.03–1.51), 5) depressive symptoms (OR: 0.92, 95% CI: 0.86–0.98), and 6) gastrointestinal conditions (OR: 1.73, 95% CI: 1.16–2.58) were associated with obtaining a sigmoidoscopy or colonoscopy test. Conclusion: Our findings suggest that the absence of a provider recommendation is the primary barrier preventing underserved older African Americans from obtaining CRC screening. In addition, our data revealed significant association between obtaining CRC screening and some of the predisposing characteristics of participants, satisfaction with access to and quality of care, and physical and mental health. These findings are consistent with this notion that disparities in health care for African Americans can be traced back to four primary factors: patients, healthcare providers, the healthcare system, and society as a whole, and emphasize the need for establishing theory-driven, culturally-sensitive, and cost-effective CRC screening interventions that recognize and address the constraints to cancer screening experienced by this segment of population.https://hpp.tbzmed.ac.ir/PDF/hpp-12-399.pdfmass screeningearly detection of cancercolonoscopyhealth maintenance organizationsblack or african americandepressionquality of health careaged |
| spellingShingle | Sharon Cobb Tavonia Ekwegh Edward Adinkrah Hoorolnesa Ameli Attallah Dillard Lucy W. Kibe Mohsen Bazargan Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African Americans Health Promotion Perspectives mass screening early detection of cancer colonoscopy health maintenance organizations black or african american depression quality of health care aged |
| title | Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African Americans |
| title_full | Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African Americans |
| title_fullStr | Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African Americans |
| title_full_unstemmed | Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African Americans |
| title_short | Examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older African Americans |
| title_sort | examining colorectal cancer screening uptake and health provider recommendations among underserved middle aged and older african americans |
| topic | mass screening early detection of cancer colonoscopy health maintenance organizations black or african american depression quality of health care aged |
| url | https://hpp.tbzmed.ac.ir/PDF/hpp-12-399.pdf |
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