ABSTRACT

Objectives

Despite having the highest colorectal cancer (CRC) incidence and mortality across all major racial/ethnic groups, African-American men consistently have poor CRC screening rates. Gendered and racialized beliefs and norms have been associated with African-American men’s lower medical assistance-seeking rates, but how these notions influence African-American men’s CRC screening practices merits further investigation. The purpose of this study was to examine the influence of psychosocial determinants of men’s health on CRC screening uptake among African-American men in three states.

Design

Participants were recruited via CuttingCRC.com and through culturally-tailored flyers, newspaper ads, and snowball sampling, among other methods. From April 2019-August 2019, 11 focus groups were conducted with English-speaking Black/African-American men who (a) were between ages 45-75, (b) were born in the United States, (c) had a working telephone, and (d) lived in Minnesota, Ohio, or Utah. Multiple-cycle coding, Hatch’s 9-step approach, and constant comparative data analysis was employed for de-identified transcript data.

Results

Eighty-four African-American men met inclusion criteria and participated. Their mean age was 59.34 ± 7.43. In regards to CRC screening status, Ohio had the most previously screened participants (85%), followed by Minnesota (84%) and Utah (76%). Two major CRC screening barriers (masculine role norms and medical mistrust) – both encompassed 3–5 subthemes, and one major facilitator (normative support from family members or social networks) emerged.

Conclusions

Despite CRC screening’s life-saving potential, African-American men have had the lowest 5-year relative survival for more than 40 years. When developing interventions and health promotion programs aiming to eliminate the racial disparity in CRC outcomes, addressing both masculine role norms and medical mistrust barriers to CRC screening completion among African-American men is warranted.

中文翻译：

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非裔美国男性结直肠癌筛查的社会心理决定因素：了解男性角色规范、医疗不信任和规范支持的作用

 抽象的

 目标

尽管非裔美国男性的结直肠癌 (CRC) 发病率和死亡率在所有主要种族/族裔群体中最高，但其结直肠癌筛查率始终较低。性别和种族化的信仰和规范与非洲裔美国男性较低的医疗援助寻求率有关，但这些观念如何影响非洲裔美国男性的结直肠癌筛查实践值得进一步研究。本研究的目的是探讨男性健康的社会心理决定因素对三个州非裔美国男性进行结直肠癌筛查的影响。

 设计

参与者是通过 CuttingCRC.com 以及根据文化定制的传单、报纸广告和雪球抽样等方法招募的。从 2019 年 4 月至 2019 年 8 月，针对讲英语的黑人/非裔美国男性进行了 11 个焦点小组，这些男性 (a) 年龄在 45 至 75 岁之间，(b) 出生在美国，(c) 拥有可用电话，并且 (d) 居住在明尼苏达州、俄亥俄州或犹他州。多循环编码、Hatch 的 9 步方法和持续的比较数据分析被用于去识别的转录数据。

 结果

八十四名非洲裔美国男性符合入选标准并参与其中。他们的平均年龄为 59.34 ± 7.43 岁。就 CRC 筛查状况而言，俄亥俄州的筛查参与者最多 (85%)，其次是明尼苏达州 (84%) 和犹他州 (76%)。 CRC 筛查的两大障碍（男性角色规范和医疗不信任）——均包含 3-5 个子主题，并且出现了一个主要促进因素（来自家庭成员或社交网络的规范支持）。

 结论

尽管 CRC 筛查具有挽救生命的潜力，但 40 多年来，非洲裔美国男性的 5 年相对生存率一直是最低的。在制定旨在消除结直肠癌结果中的种族差异的干预措施和健康促进计划时，有必要解决非洲裔美国男性中男性角色规范和阻碍结直肠癌筛查完成的医疗不信任障碍。