Despite evidence that early detection of colorectal cancer (CRC) effectively prevents premature deaths, racial disparities in CRC persist and the gap is widening, especially among African Americans. Underutilization of cancer screening services often results in late stage diagnosis and higher mortality rates. Behavioral interventions to increase CRC screening have produced mixed results;therefore, a better understanding of factors that contribute to cancer health disparities is warranted. A review of the literature reveals four promising psychosocial/cultural factors: trust, social support, risk perception, and religiousness that have high potential to inform intervention research design. Additionally, as shown by empirical evidence, the behaviors of individuals and their social and physical environments are mutually influential. Since the study population resides in urban neighborhoods, characterized by poverty and racial residential segregation, a better understanding of neighborhood level factors contributing to cancer health disparities also is necessary. The literature shows interventions that take into account the environment of the individual are more likely to be successful. The proposed research will use a socio-ecologic framework to examine and understand both individual- and neighborhood-level factors associated with CRC screening. The proposed research has three specific aims:1) Investigate the associations among individual-level factors (e.g., psychosocial/cultural constructs, sociodemographics) and their relationship with CRC screening;2) Characterize the associations among neighborhood-level factors (e.g., socioeconomic index, residential poverty, education, income) and their relationship with CRC screening;and 3) Explore the associations of individual-level factors, including perceptions of neighborhoods, and neighborhood-level factors with CRC screening using multi-level modeling. My ultimate aim is to build a research career focused on understanding the combined effects of individual and neighborhood level factors that may contribute to the development of scientifically sound and culturally relevant community-based interventions to increase CRC screening among African Americans.

Public Health Relevance

NIH encourages research that promotes an understanding of the factors contributing to cancer health disparities. My proposed research will provide a more comprehensive understanding of the relationships among individual and neighborhood level factors that may explain CRC health disparities;thus, improving community-based interventions designed to increase CRC screening among African Americans.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01CA140358-04
Application #
8298616
Study Section
Subcommittee G - Education (NCI)
Program Officer
Ojeifo, John O
Project Start
2010-08-11
Project End
2014-07-31
Budget Start
2012-08-01
Budget End
2014-07-31
Support Year
4
Fiscal Year
2012
Total Cost
$122,840
Indirect Cost
$9,869
Name
University of Maryland College Park
Department
Type
Schools of Public Health
DUNS #
790934285
City
College Park
State
MD
Country
United States
Zip Code
20742
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Hararah, Mohammad Khalid; Pollack, Craig Evan; Garza, Mary A et al. (2015) The Relationship Between Education and Prostate-Specific Antigen Testing Among Urban African American Medicare Beneficiaries. J Racial Ethn Health Disparities 2:176-83
Horne, Hisani N; Phelan-Emrick, Darcy F; Pollack, Craig E et al. (2015) Effect of patient navigation on colorectal cancer screening in a community-based randomized controlled trial of urban African American adults. Cancer Causes Control 26:239-46
King, Christopher J; Chen, Jie; Garza, Mary A et al. (2014) Breast and cervical screening by race/ethnicity: comparative analyses before and during the Great Recession. Am J Prev Med 46:359-67
Dagher, Rada K; Garza, Mary A; Kozhimannil, Katy Backes (2014) Policymaking Under Uncertainty: Routine Screening for Intimate Partner Violence. Violence Against Women 20:730-749
Debnam, Katrina J; Howard, Donna E; Garza, Mary A (2014) ""If you don't have honesty in a relationship, then there is no relationship"": African American girls' characterization of healthy dating relationships, a qualitative study. J Prim Prev 35:397-407
Bone, Lee R; Edington, Kristen; Rosenberg, Jessica et al. (2013) Building a navigation system to reduce cancer disparities among urban Black older adults. Prog Community Health Partnersh 7:209-18
Martinez, Kathryn A; Pollack, Craig E; Phelan, Darcy F et al. (2013) Gender differences in correlates of colorectal cancer screening among Black Medicare beneficiaries in Baltimore. Cancer Epidemiol Biomarkers Prev 22:1037-42
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Quinn, Sandra Crouse; Butler 3rd, James; Fryer, Craig S et al. (2012) Attributes of researchers and their strategies to recruit minority populations: results of a national survey. Contemp Clin Trials 33:1231-7

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