African American men have the highest incidence and mortality rates for colorectal and prostate cancer compared to other ethnic groups in the United States. One factor that contributes to higher mortality is later stage cancer detection. Guided by the Common Sense Model (CSM) of illness representations that posits that the individual as well as cultural values and beliefs play an active role in the response to and interpretation of health threat information and the Cultural Empowerment Model (CEM) which offers a framework for understanding the adaptive and maladaptive dimensions of culture, this study will involve a two phased exploration into the cultural factors among African American men that facilitate and impede colorectal and prostate cancer screening. In particular, the study will examine religiousness as part of the cultural perspective of African Americans with attention to religiousness' influence on causal views of illness, including fatalistic causes. Using the CEM, this study will examine the positive and negative influences of religiousness and fatalism on colorectal and prostate cancer screening behavior and the CSM will clarify the mechanisms of this association in 402 African American men.
The specific aims are as follows: (1) to identify religiously based illness perceptions of cancer screening in African American men, and (2) to examine the relationships among religious factors, fatalism, illness perceptions, and colorectal and prostate cancer screening behavior.
For Aim 1, key themes related to religiously based causal attributions will be identified from two focus groups of spiritual experts and 40 interviews of men selected from an earlier study of religiousness and PCS. These causal attributions will be used to adapt the Illness Perception Survey- Revised (IPQ-R).
For Aim 2, 350 African American men will complete a survey assessing religious factors, fatalism, illness perceptions, and colorectal and prostate cancer screening behavior. If associations are found, this would provide theoretical support for the CSM, a cultural adaptation of the IPQ-R, and clarification of how religiousness may be helpful or harmful to cancer screening. The long-term goals of this work are to conduct research that is guided by theoretical frameworks that incorporate cultural perspectives, identify culturally relevant factors that are related to health behavior in different ethnic groups, understand what mechanisms explain these associations, and develop culturally competent interventions that target these mechanisms for different ethnic groups. ? ?
