Online Program

Colorectal cancer screening knowledge and attitudes among providers serving American indians

Monday, November 4, 2013

Felicia Schanche Hodge, DrPH, School of Nursing, University of California, Los Angeles, Los Angeles, CA
Fernando Martinez, School of Nursing, University of California, Los Angeles, Los Angeles, CA
Margaret Susan Stemmler, PhD, FNP, CNM, Department of Family Medicine, Center for Behavioral and Addiction Medicine, University of California, Los Angeles, Los Angeles, CA
Colorectal cancer (CRC) disproportionately affects American Indians and is a leading cause of mortality despite being treatable when detected early. To better understand the level of provider CRC education and awareness, a survey was administered to 33 healthcare providers serving American Indians in California. Demographic data, provider knowledge of screening guidelines, communication, and cultural competency was measured. Data was analyzed using Chi Square and Fischer's Exact Test. In screening guidelines, the majority scored high on FOBT (57.57%); however they scored lower in knowledge of flexible sigmoidoscopy (36.37%), colonoscopy (36.37%), colonography (30.30%) and double contrast barium enema (21.21%). In counseling patients, 87.87% recommended the maintenance of proper diet, 36.63% recommended regular exercise and 54.54% recommended limited intake of processed foods/red meats. In areas of CRC knowledge, more than 80% of providers answered questions correctly. Sixty-four percent recommended a colonoscopy for patients at high-risk for CRC. In cultural competency, the majority of providers did not think that American Indians would understand the need/importance for CRC screening (72.72%) and felt they would not be able to follow provider advice (54.54%). Sixty-six percent felt it unlikely American Indians would discuss CRC screening with them and 57.58% felt that there were barriers to communication with their patients. Recommendations include routine training for clinic staff in more effective screening guidelines and cultural competency. This will ensure more effective patient-provider communication and provide patients with accurate information to promote screening and increase rates.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Diversity and culture
Public health or related education
Public health or related nursing

Learning Objectives:
Assess CRC screening knowledge of healthcare providers serving California American Indians. Identify strategies to improve CRC screening knowledge and patient-provider communication about proper screening

Keyword(s): American Indians, Cancer Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been closely involved with the analysis of the data for this presentation. My clinical expertise as a family practice nurse practitioner and midwife makes me uniquely aware of the importance of preventive health care and the implications of delayed diagnosis and treatment of preventable disorders. Last, as a Choctaw Indian woman, I can certainly relate to fears, need for reassurances and learning that was needed to contemplate preventive screening and treatment.
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.