Defense Date


Document Type


Degree Name

Doctor of Philosophy


Educational Studies

First Advisor

Dr. Lisa M. Abrams


Despite strong evidence that screening for Colorectal cancer (CRC) can reduce cancer incidence and mortality, screening adherence remains low. Racial differences in CRC incidence and mortality are well documented in the literature. Racial differences in CRC screening use remain mixed with most studies using race as an independent variable and focusing on racial differences in CRC screening rates. Few studies have examined correlates of CRC screening use, stratifying by race. The purpose of this study was to determine if there are racial differences in correlates of CRC screening, using the Health Belief Model as the theoretical framework. Data analyzed in this study came from the 2003 Health Information National Trends Survey (HINTS) of the National Cancer Institute. White (n=1988) and non-white (562) respondents age ≥50 years, without a history of cancer were interviewed by phone. Multivariable logistic regression was used to identify correlates of FOBT and endoscopy adherence stratified by race and screening test. Independent variables included age, gender, education, income, insurance status, regular care visit frequency, perceived risk of CRC, family history of cancer, CRC knowledge, cancer worry, perceptions of screening benefits, and perceptions of expense as a barrier. Predictors of adherence to FOBT for whites included being older and having at least 1 regular car visit. Predictors of FOBT adherence for non-whites included having health insurance. Endoscopy adherence for whites was significantly associated with being older, being female, and agreeing with perceptions of benefits to CRC screening. Predictors of endoscopy adherence for non-whites included being older, and disagreeing with perceptions of benefits to CRC screening. Such differences, if confirmed in future studies, may inform race-specific interventions to increase CRC screening utilization.


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VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

June 2008

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