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.

 抽象的

非裔美国人患结直肠癌 (CRC) 的比例过高，部分原因是结直肠癌筛查的差异。因此，更好地了解影响 CRC 筛查的文化相关心理社会因素至关重要。这项研究探讨了非裔美国人对医生文化能力的认知与对带回家的基于粪便的结直肠癌筛查的接受程度之间的关系。 CRC 筛查存在缺陷的非裔美国人 ( N = 457) 完成了一项以患者为中心的感知文化能力测量，并观看了一段有关 CRC 风险、预防和筛查的简短视频。使用计划行为理论 (TPB) 结构测量对基于粪便的 CRC 筛查的接受度。参与者还有机会获得免费的家庭粪便免疫化学测试 (FIT) 套件，我们将对此提议的接受程度作为行为结果进行衡量（是/否）。结果表明，感知的文化能力与更高的接受态度、更有利的规范、对基于粪便的筛查的更大的感知行为控制以及参与 FIT Kit 筛查的更大意愿相关（ p < 0.001）。我们还发现，感知文化能力通过意向介导途径对 FIT 套件的吸收产生显着的间接影响。这项研究提供了重要的证据，表明参与者的文化能力可能在少数族裔的预防性健康行为中发挥重要作用，包括非裔美国人的结直肠癌筛查率。