Creating health education materials to improve colorectal cancer screening among American Indians

Despite a decline in Colorectal Cancer (CRC) mortality rates among the general population over the past two decades, American Indians and Alaska Natives (AI/ANs) continue to report high mortality rates, which have shown little to no change over time. This paper reports on the development of culturally appropriate colorectal cancer screening educational materials for American Indian adults over age 50 in California. An explanatory model to guide a CRC screening education media campaign was developed from survey and focus group data collected at three American Indian communities (n=29) throughout California. Project data was analyzed using Chi Square, Fisher's Exact Test and thematic analysis. Findings report low perceived susceptibility to CRC resulting from low levels of knowledge and perceived harm and competing threats to daily living requirements. Cultural influences on screening behavior that were observed included present and past temporal orientation, inaccurate etiological beliefs concerning CRC, and an unwillingness to openly discuss illness or prevention. CRC screening strategies and other health messaging materials targeting AI/ANs and other underserved populations must take into account culture, as well as the various health and social demographic characteristics of the target population, in order to make the educational information appealing and accessible.