African American men present with cancer at a later stage and have higher cancer related mortality than white men, especially due to prostate and colorectal cancer. These men also have low rates of cancer screening. Several programs have attempted to increase cancer screening rates among African American, but their screening rates remain low. There has not been systematic documentation of minority men's beliefs about prostate and colorectal cancer or cancer screening. This information is needed to improve early detection of cancer among these men. This study will delineate the beliefs and knowledge of African American needed to improve prostate and colorectal cancer screening rates and early cancer detection by: (1) documenting the knowledge, beliefs and behavior of African American men about prostate and colorectal cancer and screening, and (2) determining if differences in attitudes and behaviors about prostate and colorectal cancer screening between African American and white men are related to social class differences, health care access differences, or cultural differences. A model integrating concepts from Explanatory Models of Illness and Health Self-Management will structure this investigation. This research will use a qualitative design in which a series of 3 individual in-depth interviews are conduced with a representative sample of 40 African American and 40 white men residing in rural and urban communities. We will use a systematic approach to analyze the textual data to ensure reliable and valid results. The results of this study will provide the foundation for an R01 application that will be submitted for the October, 2007, deadline. That application will propose an intervention study with the goal of increasing prostate and colorectal cancer screening among African American men. Results from the current project will inform the intervention study by providing insight into the most appropriate target for intervention (e.g., men's knowledge of cancer risk versus access to cancer screening), the modality of intervention (e.g., lay health advisors versus media campaigns if cancer-related knowledge is the target), and for assuring the intervention uses culturally informed and appropriate materials. A preliminary framework of the intervention strategy for this R01 application will be developed and evaluated as part of this project.

R21CA113943

2006-04-03

2009-03-31