Justice beliefs buffer against perceived barriers to colorectal cancer screening among African Americans

Abstract

Objectives

African Americans develop and die from colorectal cancer (CRC) more than any other racial group in the United States. Perceived barriers to screening (e.g. embarrassment and financial costs) likely exacerbate these disparities. Identifying psychological factors that can reduce the impact of perceived barriers and encourage CRC screening is therefore critical. This study explored whether believing the world is fairer for oneself than in general (personal justice ascendancy) would moderate the impact that perceived barriers have on receptivity to CRC screening.

Method

Four-hundred fifty-seven screening eligible African Americans completed measures of beliefs about justice for self and others, as well as perceived barriers to CRC screening. Participants also completed theory of planned behaviour (TPB) measures of screening receptivity (attitudes, norms, perceived behavioural control and intentions).

Results

Perceived barriers and justice beliefs interacted to predict perceived behavioural control over screening. Perceived barriers were associated with less perceived behavioural control only when personal justice beliefs were low. In turn, perceived behavioural control predicted stronger intentions to obtain CRC screening.

Conclusions

Interactive effects with perceived barriers highlight that strong personal justice beliefs play an important role in CRC screening and could aid in addressing CRC screening disparities among African Americans.

Keywords:

• Colorectal cancer screening
• African Americans
• theory of planned behaviour, barriers, justice beliefs

Acknowledgements

This research was supported by Award Number R01CA175088 from the National Cancer Institute awarded to the second author. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. We thank Dana Brown, Rhonda Dailey, Anurag Dawadi, Mercedes Price, Philip Lupo, Voncile Brown-Miller, Adam Regalski and Jacqueline Regan for their assistance in preparation of study materials and data collection. Finally, we appreciate community support and participant recruitment efforts provided by members of the Cancer Action Councils, within the Detroit HealthLink for Equity in Cancer Care as, well as by members of Mack Alive.

Disclosure statement

The authors report no conflicts of interest.

Data availability statement

The data that support the findings of this study are available from the authors, upon reasonable request. For data requests email [email protected].