Healthcare provider cultural competency and receptivity to colorectal cancer screening among African Americans

ABSTRACT

African Americans suffer disproportionately from colorectal cancer (CRC), due in part to disparities in CRC screening. Better understanding culturally relevant psychosocial factors that impact CRC screening is therefore critical. This study examined how African Americans’ perceived cultural competency of their physician is associated with receptivity to take-home stool-based CRC screening. CRC screening deficient African Americans (N = 457) completed a patient-focused measure of perceived cultural competency and watched a brief video about CRC risks, prevention, and screening. Receptivity to stool-based CRC screening was measured using Theory of Planned Behavior (TPB) constructs . Participants were also given an opportunity to receive a no-cost at-home Fecal Immunochemical Test (FIT) kit, and we measured acceptance of this offer as a behavioral outcome (yes-no). Results showed that perceived cultural competency was associated with higher receptive attitudes, more favorable norms, greater perceived behavioral control towards stool-based screening, and also greater intentions to engage in FIT Kit screening (p < 0.001). We also found significant indirect effects of perceived cultural competency on FIT kit uptake through intention-mediated pathways. This study provides crucial evidence that participants’ perceived cultural competency may play an important role in preventive health behavior among racial minorities, including CRC screening uptake among African Americans.

KEYWORDS:

• African American
• colorectal cancer
• cultural competency
• colorectal cancerscreening
• fit kit

Acknowledgments

This research was supported by Award Number R01CA175088 from the National Cancer Institute awarded to the corresponding 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, Mercedes Price, Philip Lupo, Voncile Brown-Miller, Adam Regalski, Jacqueline Regan, and Penny Matthews 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, Molina Healthcare, as well as by members of Mack Alive.

Disclosure of potential conflicts of interest

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Cancer Institute [R01CA175088].