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Colorectal cancer (CRC) screening rates in the U.S. have historically been lower among blacks and Latinos than whites. The advent of a new stool-based test, Cologuard, calls for research to determine which CRC screening test minority individuals might prefer. Ninety black and Latino patients who had undergone screening colonoscopy were personally educated about four CRC screening tests and subsequently asked about their test preference, attributes that influenced preference, and strength of preference. Cologuard (31.1 %) and colonoscopy (64.4 %) were preferred over computerized tomographic colonography and fecal immunochemical tests. Preference was influenced by distinct test attributes. Individuals who selected Cologuard over colonoscopy were more likely to be >60 and have greater strength of test preference. There was an overriding preference for Cologuard and colonoscopy among black and Latino individuals who had undergone screening colonoscopy. To further improve CRC screening in these populations, patient preferences should guide recommendations.

Latinos are a diverse population comprised of multiple countries of origin with varying cultural profiles. This study examines differences in colonoscopy completion across place of birth and migration-related factors in a sample of predominantly Dominican and Puerto Rican Latinos living in New York City after receiving a recommendation for colonoscopy screening and navigation services. The sample included 702 Latinos recruited for two cancer screening projects targeting Latinos eligible for colonoscopy who seek healthcare in New York City. Participants completed a survey that included sociodemographic, health-related questions, psychosocial assessments and cancer screening practices, in Spanish or English. Migration, acculturation, and language factors were found to predict colonoscopy completion. The results indicated that Latinos born in the Dominican Republic and Central America were more likely to complete a screening colonoscopy than their counterparts born in the US. Further, those who emigrated at an older age, who have resided in the US for less than 20 years, preferred Spanish and those with lower US acculturation levels were also more likely to complete a screening colonoscopy. The findings suggest that Latinos who are less acculturated to the US are more likely to complete a screening colonoscopy after receiving a physician recommendation for colonoscopy screening. The results provide important information that can inform clinical practice and public health interventions. Continued attention to cultural and migration influences are important areas for cancer screening intervention development., Competing Interests: The authors declare that they have no conflict of interest.

In an effort to address reports from men that their sex life is worse after treatment for rectal cancer, this qualitative study was designed to better understand their experience with sexual dysfunction following rectal cancer treatment, thus providing information on the adaptation of a psycho-educational sexual health intervention for male rectal cancer survivors and simultaneously investigating barriers and promoters that would influence their participation in a psycho-educational sexual health intervention. Thirteen male rectal cancer survivors who were treated at Memorial Sloan-Kettering Cancer Center (MSKCC) for rectal cancer participated (median time post-treatment was 6.4 years). Six survivors participated in individual semi-structured phone interviews, and seven others took part in focus groups. We performed standard procedures of qualitative thematic text analysis, which involved independent review of interview and focus group transcripts by several analysts followed by consensus meetings to identify key themes. Participants reported bowel dysfunction (N = 13, or 100%) and erectile dysfunction (N = 12, or 92%) as chief complaints. The participants thought a psychoeducational sexual health intervention post-surgery would be helpful because it would provide educational information regarding the etiology of their problems and treatments to improve their sexual health (N = 8, or 62%). Most participants' primary concern immediately after treatment was surviving their disease; improving sexual functioning seemed to become more important over time. Barriers to potentially participating in a psycho-educational sexual health intervention included geographical distance from MSKCC (N = 3, or 3/13) and the risk of embarrassment when discussing sexual issues (N = 5, or 5/13). Men reported that a psycho-educational sexual health intervention would be helpful to improve their sexual functioning post-treatment. Discussion of bowel issues and logistical concerns gave information on the psycho-educational sexual health intervention.

Colorectal cancer (CRC) can be effectively prevented via screening colonoscopy, yet adherence rates remain low among Latinos. Interventions targeting individual and cultural barriers to screening are needed. We developed an educational brochure to target these barriers faced by a diverse Latino population. The objective was to evaluate the responses of the target population to the culturally and theoretically informed brochure through community member focus groups. Facilitators conducted six focus groups, stratified by gender, language, and prior colonoscopy experience. Topics included: brochure content and layout, cancer knowledge, and CRC screening determinants. Focus groups documented community members' responses to the brochure's overall message and its informational and visual components. Changes to wording, visual aids, and content were suggested to make the brochure culturally more acceptable. Results indicated relevance of the theoretically and culturally guided approach to the development of the brochure leading to refinement of its content and design.

For between one third and one half of all cancer survivors, disturbances in mood and cognition do not end with the conclusion of treatment. Recognizing this problem, the Institute of Medicine emphasized in its 2008 report, the importance of addressing psychosocial issues, such as distress, to providing quality cancer care. The National Cancer Institute (NCI) has recognized that there is a severe lack of trained professionals who can address these needs. In response to this need, an interactive training program was developed and implemented to teach frontline cancer care professionals Cognitive Behavioral Therapy (CBT) skills. This training includes a structured curriculum, centered around a 3-day training workshop that includes didactic discussion, small group interactive sessions, role playing, post course support, and follow-up evaluation. Four of the planned eight workshops have been conducted thus far and indicate successful recruitment and implementation of a unique training model related to the CBT skills learned.

Racial and ethnic minorities are significantly underrepresented in clinical research trials. Several socio-cultural and systemic barriers, ranging from discrimination by the health care system, medical mistrust, to low physician referral rates and lack of knowledge of research studies have been identified as impacting participation. One hundred and fifteen participants were culturally matched and were interviewed followed by up to an additional four interviews over a 12 month period. Responses were analyzed to understand the perceived benefits to participating in a prospective, randomized, longitudinal clinical research trial about screening colonoscopy. Over two-thirds (64.4%) of participants reported "knowledge, awareness, and/or information about colonoscopy and general health" as being the greatest benefit they received. Desire to undergo the screening and the pride of completing the study was ranked second and third, respectively. Understanding the reasons that participants choose to participate in research studies will ultimately assist researchers close the gap in minority representation, allowing for greater generalizability of research findings.

Existing disparities are evident in colorectal cancer (CRC) screening. We sought to assess preferred sources of colonoscopy screening information among Hispanics in East Harlem, NY. Face-to-face interviews were conducted among average-risk for CRC, non-symptomatic Hispanics in community-based sites and health clinics. SPSS 16 analysis explored the relationships between sociodemographic and health care variables and preferred sources of colonoscopy information for 395 participants. The top four preferred information sources were doctor/provider, brochures, television, and from someone who speaks the same language. We found significant differences in preferred information sources by a Chi-Square analysis of age (50-64 years; 65 or older), education (0-8th grade; 9th or above), language preferred (English; Spanish), and origin (US-born; foreign-born). Using the identified preferences for sources of information among this growing segment of the US population could inform interventions to address the important public health issue of CRC disparities.

The present analysis sought to determine the usefulness and validity of the Short Acculturation Scale for Hispanics (SASH) in assessment of acculturation among Hispanics participating in a colorectal cancer screening study. Primary data was collected from 2008 to 2009 through surveys in East Harlem community-based sites and health clinics among Hispanics. Bivariate correlations and independent samples t tests assessed SASH correlation with acculturation proxies and relationships between proxies, SASH, and sociodemographics. SASH was highly correlated with commonly used acculturation proxies; inter-scale correlations and alpha scores were high. Sociodemographics associated with proxy variables were associated with SASH. In conclusion, SASH is useful and valid for assessing acculturation among Hispanics; however, a shortened version or acculturation proxy variables could also be utilized.

Colorectal cancer (CRC) screening rates are low among Hispanics; thus understanding screening barriers and facilitators is essential. A survey, based on blended health promotion theories, was conducted with low income, mostly immigrant, Hispanics at community based organizations and health clinics in New York City. Correlates of undergoing colonoscopy screening were examined. Four hundred men (28%) and women were interviewed. Older age, longer US residence, having a regular health care provider and provider recommendation predicted colonoscopy receipt (P values <0.01). Greater fear and worry concerning colonoscopy and fewer perceived screening benefits were associated with reduced screening likelihood (P values <0.05). In a multivariate model, colonoscopy receipt was negatively associated with Medicaid and positively associated with English preference, physician recommendation for and encouragement of screening and less fear. Interventions that educate physicians and patients regarding colonoscopy screening guidelines, increase physicians' screening referrals, and reduce patients' fear are needed.

Colorectal cancer (CRC) is a major cause of cancer deaths among US Hispanics. Screening decreases mortality through early detection. To understand factors related to CRC screening among Hispanics, focus groups were conducted. Reasons for getting screened included peace of mind; influence from family and friends; and wanting to prevent CRC. Barriers included fear of finding cancer and fear of the examination. These results informed a survey to better understand CRC screening among Hispanics in a cross-sectional study. The information from both will direct the development of interventions to increase CRC screening among Hispanics.

African Americans (AAs) have the highest incidence rates of colorectal cancer (CRC) among all races in the US. These disparities may be attributed to lower participation in CRC prevention and control activities [e.g., flexible sigmoidoscopy (FS), fecal occult blood testing (FOBT)]. This is a current issue in East Harlem where less than half the residents in this area participate in CRC screening and mortality rates due to CRC are higher than the national average. We examined correlates of FS and FOBT screening among AAs based on the transtheoretical model (TTM) of behavior change. One hundred and eleven AA men and women, 50 years and older (51-92), low-income, and at average risk for CRC were recruited at an ambulatory care center in East Harlem. Assessments focused on sociodemographic, medical, psychosocial and TTM variables. The first logistic regression model showed that higher levels of education (p < 0.05), greater knowledge of FS (p < 0.05), and greater endorsements of Thinking Beyond Oneself (p < 0.05) were associated with adherence to FS screening guidelines. The second model showed that only greater knowledge of FOBT (p < 0.05) and receiving a physician's recommendation (p < 0.01) were significant correlates of adherence to FOBT screening guidelines. This study supported the application of components of the TTM for FS and FOBT screening among low-income AAs receiving care in an urban medical center and illustrated the need for interventions targeting both patients and their providers.