Abstract A96: African Americans and colorectal cancer: Using multilevel analysis to understand the influence of neighborhood and individual level factors on screening behavior

Background: Early detection of colorectal cancer (CRC) effectively prevents premature deaths. However, racial disparities in CRC persist due to underutilization of cancer screening, which is associated with late stage diagnosis and higher mortality rates among African Americans. It is well documented that “…individual behavior both influences and is influenced by the social and physical environment…” Interventions that incorporate the environmental context of the individual behavior are more associated with increasing CRC screening. Methods: Using a community-engaged approach we recruited 230 African American adults aged 50 to 74 years to complete a psychosocial survey. Participants were recruited from a variety of venues, including churches, barbershops, community centers and public housing complexes in the Washington, DC Metropolitan Area. The survey instrument included valid standardized scales designed to assess 1) knowledge of cancer, 2) risk perception, 3) neighborhood perceptions, 4) social support, 5) behavioral risk factors, 6) religiousness and 7) trust in research. Results: Participants were women (80%), married (39%) and low income (34%). Preliminary analysis demonstrated that participants who were midlife (< 60 years of age), unmarried, unemployed and reported no medical home were less likely to be screened for CRC (p<0.01). Additionally, subscale measures for neighborhood perceptions, “social cohesion” (p<0.04) and CRC knowledge were also significantly associated with receiving a CRC screening (p<0.001). Additional analyses (multilevel modeling) are underway, using census data. Conclusions: Understanding the combined effects of individual and neighborhood factors may contribute to the development of scientifically sound and culturally relevant interventions to increase CRC screening among African Americans.

Citation Format: Mary A. Garza, Luciana C. Assini, Gabriella Villacis, Jean G. Ford. African Americans and colorectal cancer: Using multilevel analysis to understand the influence of neighborhood and individual level factors on screening behavior. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A96.