Perspectives of American Indians in Eastern North Carolina on Socio-cultural Factors that Influence Colorectal Cancer Screening Decisions.

Abstract

American Indians (AI) have disproportionately high rates of colorectal cancer (CRC), but there is relatively little research focused on developing AI CRC screening interventions. We held six focus groups with AIs in rural Eastern U.S. (n=74) and analyzed the qualitative data from them in order to identify individual and socio-cultural factors that influence AI CRC screening decisions. Screening fear and anxiety was a central theme of the focus groups. For example, participants told stories about how late-stage cancer diagnoses and deaths in the community contributed to their fears and cancer fatalism. Furthermore, CRC screening fears were reinforced by health communication norms that limited productive conversations about CRC screening. Our findings indicate that culturally adapted interventions, such as CRC screening decision aids, are needed to help AIs communicate and make informed decisions about CRC screening with support from family and health care providers. More research is needed on the influence of these interventions on CRC screening intentions, social norms, and shared decision-making.