Literature DB >> 22548424

Unwillingness to participate in colorectal cancer screening: examining fears, attitudes, and medical mistrust in an ethnically diverse sample of adults 50 years and older.

Shalanda A Bynum1, Jenna L Davis, B Lee Green, Ralph V Katz.   

Abstract

PURPOSE: Identify the influence of medical mistrust, fears, attitudes, and sociodemographic characteristics on unwillingness to participate in colorectal cancer (CRC) screening.
DESIGN: Cross-sectional, disproportionally allocated, stratified, random-digit-dial telephone questionnaire of noninstitutionalized households.
SETTING: New York City, New York; Baltimore, Maryland; San Juan, Puerto Rico.
SUBJECTS: Ethnically diverse sample of 454 adults ≥50 years of age. MEASURES: Health status, cancer screening effectiveness, psychosocial factors (e.g., perceptions of pain, fear, trust), and CRC screening intentions using the Cancer Screening Questionnaire, which addresses a range of issues related to willingness of minorities to participate in cancer screening. ANALYSIS: Multivariate logistic regression was used to model the probability of reporting unwillingness to participate in CRC screening.
RESULTS: Fear of embarrassment during screening (odds ratio [OR] = 10.72; 95% confidence interval [CI], 2.15-53.39), fear of getting AIDS (OR = 8.75; 95% CI, 2.48-30.86), fear that exam might be painful (OR = 3.43; 95% CI, 1.03-11.35), and older age (OR = 1.10; 95% CI, 1.04-1.17) were positively associated with unwillingness to participate in CRC screening. Fear of developing cancer (OR = .12; 95% CI, .03-.57) and medical mistrust (OR = .19; 95% CI, .06-.60) were negatively associated with unwillingness to screen.
CONCLUSIONS: Findings suggest that CRC health initiatives should focus on increasing knowledge, addressing fears and mistrust, and normalizing CRC screening as a beneficial preventive practice, and should increase focus on older adults.

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Mesh:

Year:  2012        PMID: 22548424      PMCID: PMC3807238          DOI: 10.4278/ajhp.110113-QUAN-20

Source DB:  PubMed          Journal:  Am J Health Promot        ISSN: 0890-1171


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