216908 Cognitive Response Testing to Inform the Use of Culture in Cancer Communication and Intervention

Monday, November 8, 2010

Vetta Thompson Sanders, PhD , Institute of Public Health, Washington University in St. Louis, Saint Louis, MO
Tanisha Lewis, MA , Health Communication Research Laboratory, Washington University in St. Louis, Saint Louis, MO
Background: Colorectal cancer (CRC) is the third most common cancer among African American men and women, and the third most common cause of cancer death among African Americans. CRC disparity may be partly attributable to differences in African Americans' screening utilization, which remain below the national objective of 50% established by Healthy People 2010. Aim: To use cognitive response testing to develop a refined set of socio-cultural constructs and obtain information on African American question interpretation and judgment formation related to the socio-cultural constructs and CRC screening items. Methods: A community sample of 51 African Americans, age 50 to 75, engaged in one-on-one, retrospective think-aloud interviews; which assessed comprehension, interpretation, and judgments about how to respond to items and constructs. Results: A belief in God was central to spirituality and religiosity; only religious items and a belief in God were perceived to affect decisions about health. Trust of the medical profession and issues of discrimination were based on the interplay between insurance, socio-economic status and race, which participants related to the care they received and not their own health behaviors. Participants responded negatively to items that queried fatalism, as well as inaccurate cancer beliefs perceived as commonly held in the African American community. They were concerned about cancer misinformation. Participants had great difficulty with items that addressed complex constructs such as prevention and spirituality. Conclusion: Researchers should carefully word items and communications related to prevention and distinguish between cultural constructs perceived as relevant to health behavior versus healthcare delivery.

Learning Areas:
Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
1. Participants will be able to list constructs and terms that may be difficult for African Americans learning about colorectal cancer screening to understand. 2. Participants will be able to describe a strategy for determining the importance of cultural constructs in influencing decisions about colorectal cancer screening.

Keywords: Culture, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversee research on the role and impact of culture in cancer communication and health behavior.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.