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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): A major goal of Healthy People 2010 is the elimination of health disparities. The Institute of Medicine and the National Cancer Institute have suggested cultural appropriateness of education materials and interventions as one strategy to reduce disparities. With few exceptions, rates of incidence and mortality are higher and 5-year survival lower among African American men and women than Whites for the leading causes of cancer death. Researchers have recognized that behavior, including those relevant to cancer prevention and control, occurs in a social context. Thus, an understanding of which social and cultural constructs are related to cancer screening and how seems appropriate. Measurement of behavioral and social science constructs requires that we be able to make distinctions among constructs, as well as dimensions of constructs with reasonable accuracy. A review of the current literature highlights concerns related to the measurement of cultural constructs, including strategies for operationalizing constructs, the variety of measures, psychometric properties of current measures, and difficulties studying constructs, and their relevant dimensions simultaneously rather than individually. This state of affairs limits our ability to determine the relative importance of cultural attitudes and norms for cancer prevention and control activities. To further knowledge in this area it is important that commonly accepted measures of the identified variables exist so that work from various studies can be easily compared. We propose to develop a measure of socio-cultural attitudes that taps the cultural values linked to cancer screening behaviors in the African American community. Colorectal cancer (CRC) is the third most common cancer among African American men and women and has an authoritative set of screening guidelines; thus, we have selected colorectal cancer screening as our focus. The African American Multi-Construct Survey of Cultural Attitudes will provide an easily administered measure of cultural variables. We will use item response theory (IRT) to simultaneously development long, short and computer-adapted versions of an instrument capable of allowing quick, accurate assessment of multiple cultural constructs. At the end of this project, we will provide data on the computer adapted test of cultural constructs and their relevance to colorectal cancer screening behaviors among African Americans. PUBLIC HEALTH RELEVANCE: This study will yield a core set of valid and reliable survey items that can improve the measurement of culture in cancer research, facilitate comparisons and minimize the redundancy of effort across research projects. This study also provides data on the relationship between cultural constructs and CRC cancer screening attitudes and behaviors. This information will be used in developing health education and promotion materials and interventions that more effectively target the African American community.