A community needs assessment focused on colorectal cancer (CRC) screening knowledge, behaviors, and barriers was completed in one Ohio Appalachia county. A CRC screening media campaign was developed based on the findings from the needs assessment and feedback was obtained about the media campaign. The survey was completed by 170 self-reported average-risk adults. In a multivariate model, the CRC screening rate was higher for participants who had received a doctor’s recommendation (OR = 6.09) and had adequate CRC knowledge (OR = 2.88), and it was lower among participants employed full-time (OR = 0.23). Having health insurance (OR = 4.20) and being married (OR = 2.58) was associated with having received a doctor’s recommendation for screening. Campaign feedback using a second survey completed by self-reported average-risk adults (n = 61) revealed that 69% recognized the campaign image and message, with a billboard being the most cited source. This study highlights the importance of involving community members in the development of CRC screening programs to reduce cancer disparities in Appalachia.
AbramsonR.HaskellJ. (Eds.). (2006). Encyclopedia of Appalachia. Knoxville: The University of Tennessee Press.
2.
American Cancer Society. (2008). Colorectal cancer facts and figures. Atlanta, GA: Author.
3.
American Cancer Society, Ohio Division. (2005). Ohio cancer facts and figures. Columbus, OH: Author.
4.
Appalachia Community Cancer Network. (2009). The cancer burden in Appalachia. Available from http://www.accnweb.com/
5.
BaierM.CalongeN.CutterG.McClatcheyM.SchoentgenS.HinesS.. (2000). Validity of self-reported colorectal cancer screening behavior. Cancer Epidemiology, Biomarkers & Prevention, 9, 229-232.
6.
BanduraA. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.
7.
BowenD.HickmanK. M.PowersD. (1997). Importance of psychological variables in understanding risk perceptions and breast cancer screening of African American women. Womens Health, 3: 227-242.
8.
BrawarskyP.BrooksD. R.MucciL. A.WoodP. A. (2004). Effect of physician recommendation and patient adherence on rates of colorectal cancer testing. Cancer Detection and Prevention, 28, 260-268.
9.
BroadwaterC.HeinsJ.HoelscherC.MangoneA.RozanasC. (2004). Skin and colon cancer media campaigns in Utah. Preventing Chronic Disease, 1(4), A18.
10.
Centers for Disease Control and Prevention. (2002). Cancer death rates—Appalachia, 1994-1998. Morbidity and Mortality Weekly Report, 51, 527-529.
11.
Centers for Disease Control and Prevention, Division of Cancer Prevention and Control. (2008). Screen for Life campaign. Retrieved from http://www.cdc.gov/cancer/colorectal/sfl/
12.
CoughlinS. S.ThompsonT. D. (2004). Colorectal cancer screening practices among men and women in rural and nonrural areas of the United States, 1999. Journal of Rural Health, 20, 118-124.
13.
EvansW. D.UhrigJ.DavisK.McCormackL. (2009). Efficacy methods to evaluate health communication and marketing campaigns. Journal of Health Communication, 14, 315-330.
14.
FisherJ. L.EngelhardtH. L.StephensJ. A.SmithB. R.HayduG. G.IndianR. W.. (2008). Cancer-related disparities among residents of Appalachia Ohio. Journal of Health Disparities Research and Practice, 2, 61-74.
15.
FriedellG.LinvilleL. H.HulletS. (1998). Cancer control in rural Appalachia. Cancer, 83, 1868-1871.
16.
HannonP.LloydG. P.ViswanathK.SmithT.Basen-EngquistK.VernonS. W.. (2009). Mass media and marketing communication promoting primary and secondary cancer prevention. Journal of Health Communication, 14, 30-37.
17.
Holmes-RovnerM.WilliamsG. A.HoppoughS.QuillanL.ButlerR.GivenC. W. (2002). Colorectal cancer screening barriers in persons with low income. Cancer Practice, 10, 240-247.
18.
HornikR. (2002). Public health communication: Making sense of contradictory evidence. In Public health communication: Evidence for behavior change (pp. 1-22). Mahwah, NJ: Lawrence Erlbaum.
19.
KatzM. L.JamesA. S.PignoneM. P.HudsonM. A.JacksonE.OatesV.. (2004). Colorectal cancer screening among African American church members: A qualitative and quantitative study of patient-provider communication. BMC Public Health, 4, 62.
20.
KlabundeC. N.VernonS. W.NadelM. R.BreenN.SeeffL. C.BrownM. L. (2005). Barriers to colorectal cancer screening: A comparison of reports from primary care physicians and average-risk adults. Medical Care, 43, 939-944.
21.
LafataJ. E.DivineG.MoonC.WilliamsL. K. (2006). Patient-physician colorectal cancer screening discussions and screening use. American Journal of Preventive Medicine, 31, 202-209.
22.
LevinB.SmithR. A.FeldmanG. E.ColditzG. A.FletcherR. H.NadelM.RothenbergerD. A.. (2002). Promoting early detection tests for colorectal carcinoma and adenomatous polyps: A framework for action: the strategic plan of the National Colorectal Cancer Roundtable. Cancer, 95, 1618-1628.
23.
Ohio Department of Health, Center for Public Health Data and Statistics. (2000). 1998 Ohio Family Health Survey and Ohio Small Area Estimation Survey. Retrieved December 7, 2009, from http://www.odh.ohio.gov/healthStats/survey/ofhsanalysis.aspx
24.
Ohio State Medical Board. (2002). Registered physicians with the board as of December 31, 2002. Retrieved December 7, 2009, from http://www.med.ohio.gov/
25.
PignoneM.RichM.TeutschS. M.BergA. O.LohrK. N. (2002). Screening for colorectal cancer in adults at average-risk: A summary of the evidence for the U.S.Preventive Services Task Force. Annals of Internal Medicine, 137, 132-141.
26.
RuddR. E.ComingsJ. P. (1994). Learner developed materials: An empowering product. Health Education Quarterly, 21, 313-327.
27.
SchroyP. C.3rdGlickJ. T.RobinsonP. A.LydotesM. A.EvansS. R.EmmonsK. M. (2008). Has the surge in media attention increased public awareness about colorectal cancer and screening?Journal of Community Health, 33, 1-9.
28.
SmithR. A.CokkinidesV.EyreH. J. (2007). Cancer screening in the United States, 2007: A review of current guidelines, practices, and prospects. CA: A Cancer Journal of Clinicians, 57, 90-104.
29.
SouthwellB. G.BarmadaC. H.HornikR. C.MaklanD. M. (2002). Can we measure encoded exposure? Validation evidence from a national campaign. Journal of Health Communication, 7, 445-453.
VernonS. W. (1997). Participation in colorectal cancer screening: A review. Journal of the National Cancer Institute, 89, 1406-1422.
32.
VernonS. W.MeissnerH.KlabundeC.RimerB. K.AhnenD. J.BastaniR.. (2004). Measures for ascertaining use of colorectal cancer screening in behavioral, health services, and epidemiologic research. Cancer Epidemiology, Biomarkers & Prevention, 13, 898-905.
33.
ViswanathK. (2005). Science and society. The communications revolution and cancer control. Nature Reviews: Cancer, 5, 828-835.
34.
WinawerS.FletcherR.RexD.BondJ.BurtR.FerrucciJ.. (2003). Colorectal cancer screening and surveillance: Clinical guidelines and rationale—Update based on new evidence. Gastroenterology, 124, 544-560.
35.
YanceyA. K.TanjasiriS. P.KleinM.TunderJ. (1995). Increased cancer screening behavior in women of color by culturally sensitive video exposure. Preventive Medicine, 24, 142-148.
