Dataset Information

Identifying key variables in African American adherence to colorectal cancer screening: the application of data mining.

ABSTRACT:

Background

This paper reports on an effort to identify a streamlined set of issues important for colorectal cancer communication and interventions with older African Americans.

Methods

African American (N = 1,021), 683 women and 338 men, 50 to 75 years completed a telephone survey addressing demographics, colorectal cancer screening, cancer attitudes, and cancer related cultural attitudes. Several data analytics methods were applied and evaluated. Among them, results from associative data mining identified key variables and logistic regression was used to confirm associations to screening adherence.

Results

Sets of co-occurring variables identified by associative data mining methods are extracted to further study differences between adherent and non-adherent groups. Logistic regressions suggested four variables were significantly associated with adherence: healthcare provider colonoscopy recommendation, prevention services at the place health care is usually sought, a history of colitis, and a history of polyps.

Conclusions

The findings suggest a streamlined set of issues and concerns that may be used by providers advising patients or developing colorectal cancer intervention strategies for older African Americans. The data suggest the continued importance of healthcare provider recommendation to screen. It is important that providers give a clear recommendation to screen regardless of the test ultimately selected and should advise all patients that family history and the absence of symptoms or colitis do not eliminate the value of screening.

SUBMITTER: Thompson VL

PROVIDER: S-EPMC4256804 | biostudies-literature | 2014 Nov

REPOSITORIES: biostudies-literature

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Publications

Identifying key variables in African American adherence to colorectal cancer screening: the application of data mining.

Thompson Vetta L Sanders VL Lander Sean S Xu Shuyu S Shyu Chi-Ren CR

BMC public health 20141118

<h4>Background</h4>This paper reports on an effort to identify a streamlined set of issues important for colorectal cancer communication and interventions with older African Americans.<h4>Methods</h4>African American (N = 1,021), 683 women and 338 men, 50 to 75 years completed a telephone survey addressing demographics, colorectal cancer screening, cancer attitudes, and cancer related cultural attitudes. Several data analytics methods were applied and evaluated. Among them, results from associat ...[more]

PMID: 25404373

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Project description:Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC's high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age < 50) African American men's intention to screen and/or their CRCS behaviors has not been systematically assessed. To assess whether the factors influencing young adult African American men's screening intentions and behaviors are changeable through structured health education interventions, we conducted a systematic review, with the two-fold purpose of: (1) synthesizing studies examining African American men's knowledge, beliefs, and behaviors regarding CRCS; and (2) assessing these studies' methodological quality. Utilizing Garrard's Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS - ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions.

Project description:Promoting family communication about inherited disease risk is an arena in which family systems theory is highly relevant. One family systems' construct that can support promotion of family communication regarding inherited disease risk is the notion of "kin keeping." However, kin keeping and whether it might be capitalized on to encourage family communication about inherited risk has been understudied. The goal of this report was to propose a broadened conceptualization of kin keeping that distinguishes between a structural functional perspective (role conceptualization) and transitional behaviors (skill conceptualization), and to develop and evaluate a scale that would enable this assertion to be tested among a sample of African American community health workers. We developed a scale using four steps: item development using concept analysis and content validity, scale development among a national sample (n = 312), scale evaluation using exploratory factor analysis (n = 52), and scale reduction. We then posed suppositions of associations that would indicate whether the developed kin keeping measure was assessing a specific family role or set of behaviors. Our results included the development of the first quantitative measure of kin keeping (9- and 15-item scales). Model fit for 9-item scale (CFI = 0.97, AFGI = 0.89, RMSEA = 0.09, SMRM = 0.06) and model fit for 15-item scale (CFI = 0.97, AFGI = 0.89, RMSEA = 0.06, SMRM = 0.05). These findings allow us to move toward more rigorous research about the role of kin keeping on information sharing and health decision making. Results also suggest that, contrary to the historical structural functional conceptualization of kin keeping as a role, kin keeping might also be conceptualized as a behavior or set of modifiable behaviors. Ultimately, the kin keeping scale could be used to operationalize kin keeping in various theoretical models and frameworks, guide intervention development to encourage or train for kin keeping behaviors, and test assumptions of whether families vary in the density of kin keeping.

Project description:BackgroundAfrican-American men have the lowest 5-year survival rate in the U.S. for colorectal cancer (CRC) of any racial group, which may partly stem from low screening adherence. It is imperative to synthesize the literature evaluating the effectiveness of interventions on CRC screening uptake in this population.Materials and methodsIn this systematic review and meta-analysis, Medline, CINAHL, Embase, and Cochrane CENTRAL were searched for U.S.-based interventions that: were published after 1998-January 2020; included African-American men; and evaluated CRC screening uptake explicitly. Checklist by Cochrane Collaboration and Joanna Brigg were utilized to assess risk of bias, and meta-regression and sensitivity analyses were employed to identify the most effective interventions.ResultsOur final sample comprised 41 studies with 2 focused exclusively on African-American men. The most frequently adopted interventions were educational materials (39%), stool-based screening kits (14%), and patient navigation (11%). Most randomized controlled trials failed to provide details about the blinding of the participant recruitment method, allocation concealment method, and/or the outcome assessment. Due to high heterogeneity, meta-analysis was conducted among 17 eligible studies. Interventions utilizing stool-based kits or patient navigation were most effective at increasing CRC screening completion, with odds ratios of 9.60 (95% CI 2.89-31.82, p = 0.0002) and 2.84 (95% CI 1.23-6.49, p = 0.01). No evidence of publication bias was present for this study registered with the International Prospective Registry of Systematic Reviews (PROSPERO 2019 CRD42019119510).ConclusionsAdditional research is warranted to uncover effective, affordable interventions focused on increasing CRC screening completion among African-American men. When designing and implementing future multicomponent interventions, employing 4 or fewer interventions types may reduce bias risk. Since only 5% of the interventions solely focused on African-American men, future theory-driven interventions should consider recruiting samples comprised solely of this population.

Dataset Information

Identifying key variables in African American adherence to colorectal cancer screening: the application of data mining.

Background

Methods

Results

Conclusions

Publications

Identifying key variables in African American adherence to colorectal cancer screening: the application of data mining.

Similar Datasets

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