Exploring disparities and variability in perceptions and self-reported colorectal cancer screening among three ethnic subgroups of U.S. blacks

Purpose/Objectives: To explore perceptions of colorectal cancer (CRC) and self-reported CRC screening behaviors among ethnic subgroups of U.S. blacks. Design: Descriptive, cross-sectional, exploratory, developmental pilot. Setting: Medically underserved areas in Hillsborough County, FL. Sample: 62 men and women aged 50 years or older. Ethnic subgroup distribution included 22 African American, 20 English-speaking Caribbean-born, and 20 Haitian-born respondents. Methods: Community-based participatory research methods were used to conduct face-to-face individual interviews in the community. Main Research Variables: Ethnic subgroup, health access, perceptions of CRC (e.g., awareness of screening tests, perceived risk, perceived barriers to screening), healthcare provider recommendation, and self-reported CRC screening. Findings: Awareness of CRC screening tests, risk perception, healthcare provider recommendation, and selfreported use of screening were low across all subgroups. However, only 55% of Haitian-born participants had heard about the fecal occult blood test compared to 84% for English-speaking Caribbean-born participants and 91% for African Americans. Similarly, only 15% of Haitian-born respondents had had a colonoscopy compared to 50% for the English-speaking Caribbean and African American subgroups. Conclusions: This exploratory, developmental pilot study identified lack of awareness, low risk perception, and distinct barriers to screening. The findings support the need for a larger community-based study to elucidate and address disparities among subgroups. Implications for Nursing: Nurses play a major role in reducing cancer health disparities through research, education, and quality care. Recognition of the cultural diversity of the U.S. black population can help nurses address health disparities and contribute to the health of the community.