Journal of Cancer Education

, Volume 31, Issue 3, pp 567–574 | Cite as

Addressing Low Colorectal Cancer Screening in African Americans: Using Focus Groups to Inform the Development of Effective Interventions

  • Folasade P. MayEmail author
  • Cynthia B. Whitman
  • Ksenia Varlyguina
  • Erica G. Bromley
  • Brennan M. R. Spiegel


African Americans have the highest burden of colorectal cancer (CRC) in the United States of America (USA) yet lower CRC screening rates than whites. Although poor screening has prompted efforts to increase screening uptake, there is a persistent need to develop public health interventions in partnership with the African American community. The aim of this study was to conduct focus groups with African Americans to determine preferences for the content and mode of dissemination of culturally tailored CRC screening interventions. In June 2013, 45–75-year-old African Americans were recruited through online advertisements and from an urban Veterans Affairs system to create four focus groups. A semi-structured interview script employing open-ended elicitation was used, and transcripts were analyzed using ATLAS.ti software to code and group data into a concept network. A total of 38 participants (mean age = 54) were enrolled, and 59 ATLAS.ti codes were generated. Commonly reported barriers to screening included perceived invasiveness of colonoscopy, fear of pain, and financial concerns. Facilitators included poor diet/health and desire to prevent CRC. Common sources of health information included media and medical providers. CRC screening information was commonly obtained from medical personnel or media. Participants suggested dissemination of CRC screening education through commercials, billboards, influential African American public figures, Internet, and radio. Participants suggested future interventions include culturally specific information, including details about increased risk, accessing care, and dispelling of myths. Public health interventions to improve CRC screening among African Americans should employ media outlets, emphasize increased risk among African Americans, and address race-specific barriers. Specific recommendations are presented for developing future interventions.


African American Colorectal cancer Screening Disparities Qualitative 



Colorectal cancer


Veterans Affairs


Affordable Care Act


United States of America


Conflict of Interest

None of the authors acknowledge any conflict of interest related to the conduction of this study.

Funding Support

This research was supported by the NIH Training grant (T32DK07180—40) for Dr. May. There was no sponsor for this research or publication.


The opinions and assertions contained herein are the sole views of the authors and are not to be construed as official or as reflecting the views of the Department of Veterans Affairs. The corresponding author confirms full access to all aspects of the research and writing process and takes final responsibility for the paper.


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Copyright information

© American Association for Cancer Education 2015

Authors and Affiliations

  • Folasade P. May
    • 1
    • 2
    • 3
    • 4
    Email author
  • Cynthia B. Whitman
    • 4
  • Ksenia Varlyguina
    • 4
  • Erica G. Bromley
    • 2
  • Brennan M. R. Spiegel
    • 1
    • 2
    • 3
    • 4
  1. 1.Division of Gastroenterology, Department of MedicineVA Greater Los Angeles Healthcare SystemLos AngelesUSA
  2. 2.Division of Digestive Diseases, Department of MedicineDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of Health Policy and ManagementUCLA Fielding School of Public HealthLos AngelesUSA
  4. 4.Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Department of MedicineCedars-Sinai Medical CenterLos AngelesUSA

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