Adapting an Ecological Latino Acculturation Theory for Colorectal Cancer Prevention

Context: Colorectal cancer is the second most commonly diagnosed cancer among Latinos. The study of acculturation is crucial to address disparities in accessing colorectal cancer screening and reducing mortality trends. Current acculturation theories are mainly person-centered as opposed to making comprehensive and definitive evidence-based recommendations on how to modify the acculturation effects of the US's social and physical environments on Latino's health. There is also a need for well-founded theoretical frameworks to explain the mechanisms involved in the association (or lack thereof) between acculturation components and cancer screening.

Methods: First, this project reviewed existing acculturation models used to study the relationships between acculturation, health and behavioral outcomes among Latinos. Linear, multidimensional and ecological perspectives were included. Second, a Latino acculturation model for health prevention was adapted from these models. Third, a literature review of approximately 100 articles was conducted to analyze the underlying and proximal determinants for Latino colorectal cancer screening use. Fourth, input from Latino doctors was collected and the proposed ecological acculturation model for colorectal cancer screening was developed.

Conclusions: This is one of the first studies that focuses on the adaptation of an ecological Latino acculturation model for colorectal cancer screening use and organizes the determinants to colorectal cancer screening in four levels: individual, relationship, community and societal. This model could be useful in focusing interventions and policies aimed at reducing Latino cancer mortality. Future Directions: An experimental Delphi study will refine the adaptation of the model and an assessment of the reliability or the predictive validity of the proposed model will be performed.