Cancer Screening in African American Men, Research Paper Example

Introduction

Colorectal cancer (CRC) in the USA is the second leading cause of death associated to cancer (Winterich et.al, 2011). According to the American Cancer Society, ACS, 52, 000 deaths in America in the year 2009 is associated to colorectal cancer. Males and females life span has been impacted by colorectal cancer yet it is a preventable cancer. Furthermore, this has been of particular challenge to the diagnosis of African American males as they experience higher mortality rates compared to other groups. The incidence of colorectal cancer in African American males is 71/100,000 as compared to that of the White males, which is at 59/100,000. The mortality rate of the African American males is estimated to be at 32/100,000.

On a national level, colorectal cancer affects women and men equally. However, compared to the females, males have a higher mortality and incidence rates. Colorectal cancer screening is difficult because of the existence of significant disparities in the use of screening tools for males from the African American group and culture. Among the African American males, diagnosis of colorectal cancer is done at a later stage since they are proximately located. Hence, this has made identification of colorectal cancer to be difficult. As a result, practitioners play a significant role in trying to improve screening practices for African American males with colorectal cancer.

This discussion will aim at identifying and exploring colorectal cancer perceptions among the African American males as elaborated by different authors. This integrative literature review looks at the essential aspects of colorectal cancer and observes the self-reported CRC screening behaviors among the African American males. As a result, the literature review looks at colorectal cancer and colorectal cancer screening from different angles and settings. This has enabled researchers and nurse practitioners explore and comprehend more on the health issue (Gwede et.al, 2010). In this review, the target populations are the African American males of age 50 and above.

This assignment is relevant to evidence-based practice because it promotes cost-effective outcomes for patients, health care providers, families, quality and the health system. From the selected articles, it is evident that the information evolves from integration of best research evidence with the help of clinical expertise and patients values and needs. As a result, empirical knowledge is generated from the articles in order to synthesize on quality study findings in order to address the health issue of colorectal cancer among African American males. This means that the health professionals will use the best research evidence synthesized in order to develop standardized guidelines for use in the clinical setting and practice. Moreover, the needs and values of the patients, in this case, gives focus to the promotion of health, chronic illness management, illness prevention and or rehabilitation. In terms of patient’s value, unique preferences, cultural beliefs, and concerns to the clinical encounter are observed. Therefore, evidence-based practice for both patients and their families is a source of encouragement that motivates them have an active role in the management of their health. This literature review will look into the search strategy applied and integrated discussion of studies. In the integrated review section, the purpose of the study is elaborated, research designs, theoretical frameworks, methods, major findings, strengths and weaknesses associated to the study. Furthermore, the conclusion gives a summary of the information in regards to the major themes reviewed, the specific questions for researchers to follow-up on, knowledge application to future practices among other items. All of this review takes into consideration colorectal cancer in African American males.

Search Strategy

In the course of the study, the keywords used encompass health surveys, colorectal cancer, and attitude to health, mass screening, health literacy, colorectal cancer screening, preventive health services, and African American males. For this study, the National Health Services, JAMA, PubMed, and NCHS Data Brief among other journals were used. A total of ten articles are used for this review, and recent articles were chosen for this study. The search strategies for this study are identified under the preliminary sources, which include the indexes and databases. These articles contain an abstract and full text articles with wide topic ranges accessible in print and online editions. Therefore, the criterion used in selecting the right peer reviewed article to use is on the basis of the key words used. Furthermore, the Guide to Clinical Preventive Services; focused MEDLINE searches of the literature from 2010 through to 2013; systematic reviews and hand searches of key articles.

Integrated Discussion of Studies

Study purposes

The study’s major part looks into colorectal cancer and screening among the African American males. The articles used in this review look at low-income earners in the U.S.A. regarding their knowledge on colorectal cancer. African American males experience low health literacy levels concerning colorectal cancer, and this has led to poor health outcomes among this target group. African American males have negative health outcomes and perceptions on the methods used by health practitioners in handling cancer patients. Nevertheless, a comparison of colorectal cancer screening use includes changes over time and characteristics of demographics. Literature investigated show that increased risks of negative outcomes are ascribed to the underserved populations. This is due to their different screening beliefs that have led to increased rates of disparity among the African American male population. In addition, financial and accessibility barriers towards screening and testing of colorectal cancer is concerned with high discrimination rates. Therefore, the purpose is to identify the attitudes associated with CSR screening. Thereby, informs on future developments of interventions to be prepared with the aim of improving the rates of screening (James, Daley & Greiner, 2011).

Research designs

The review of literature utilized varied systematic reviews and individual studies. Four of the studies used qualitative in getting deeper understanding of the health problem (Glenn et.al, 2011; Griffith, Passmore, Smith & Wenzel, 2012; James, Daley & Greiner, 2011; Winterich et.al, 2011). Descriptive, cross-sectional designs are another design used by three articles (Brittain et.al, 2012; BeLue et.al, 2011; Gwede et.al, 2010). Two other articles used explanatory research, which gave focus to questionnaires (Aghoa et.al, 2012; Consedine et.al, 2011). The last article used randomized controlled trial (Shires et.al, 2011).

Theoretical frameworks

This research was supported by the Preventive Health Model (PHM). This model proposes on both internal and external factors influencing preventive health behaviors, which are reflective of an individual’s self-esteem. Also, PHM suggests that an individual forms an intention to act, for example, to be screened or not to be screened. This is based on the self-system of individuals when they are faced with health problems (Brittain et.al, 2012). The action plan is implemented and modified by their decision-making process (beliefs, costs, demographic and sociocultural characteristics, and benefits), alternative behavioral selection and preference clarification. The Health Belief Model (HBM), a psychological model, posits that perceived severity, susceptibility, barriers, benefits, and cues to action are related to the preparedness of a person to act on the health behavior. In the past studies, assess to HBM has been used by African Americans for CRC screening behaviors (BeLue et.al, 2011).

Major Components of Interventions

In this review, the range of studied procedures is from interviews, questionnaires, health measurements, screening tests. However, the most predominant intervention procedures are questionnaires and interviews (Glenn et.al, 2011; Griffith, Passmore, Smith & Wenzel, 2012; James, Daley & Greiner, 2011; Winterich et.al, 2011; Aghoa et.al, 2012; Consedine et.al, 2011). These intervention procedures aimed at collecting data on perceptions of demographics and health care providers among African American older males. Additionally, an increase in health costs has forced many African American males not to subscribe to screening procedures due to their harsh economic status that fails to accommodate the budgets of subscribing to a good health institution with screening facilities. Survey and population studies conducted were used in evaluating the number of African American males facing CSR and the mortality risks of these adults.

Major findings

From the assessment, it is evident that men have low knowledge levels concerning sigmoidoscopy, colon, and rectum, regardless of education, screening status, and race (Winterich et.al, 2011). Fear and pain of screening tests have resulted in an increasing number of colorectal cancer patients among the African American males in the United States (Shires et.al, 2011). Another finding is that low health literacy is a public health issue that is critical. This is because individuals with low health literacy do not participate in health promotion and diverse programs for preventing colorectal cancer. Therefore, many of the African American males are faced with the difficulty in reading appointment slips, hospital signs, learning medical conditions since they have difficulty in reading and understanding written instructions (Aghoa et.al, 2012). Race and ethnicity are the causal factors related to the increased numbers of illiterate people in the nation among the African Americans. Male adults are the most affected group experiencing colorectal cancer within the African Americans and have left them looking for ways of reducing the numbers. Furthermore, these findings helped health care providers in looking for permanent solutions related to screening perceptions and fears (Glenn et.al, 2011).

Strengths and weaknesses of studies

The strengths of the study encompassed the active participation of participants from different parts of America. Furthermore, other organizations like the faith-based organizations collaborated with researchers in identifying the risk associated with colorectal cancer and what needs to be done in order to promote screening among African American males with colorectal cancer. Additionally, the range of cultural or ethnic group(s), controlled randomized trials, systematic reviews, and the level of significance nurses gave the study. Moreover, the weaknesses established included the lack of generalizability, low response rates, deficient ethnic groups ranges, and clinical trials lacked intervention procedures. As such, a literature review is provided in the research because it gives essential information collected for future use in combating the health problem. In addition, evidence is provided on the study’s importance and the strengths and weaknesses exist because they help researchers redefine their study’s purpose. Reliability of data and bias levels are evident due to the evidence-based practice, which have decreased. However, the significance level of colorectal cancer among African American males in the US has given researchers a clear picture on the absence of screening and early detection of the problem.

Conclusion

Major themes of review

Colorectal cancer among African American males aged 50 years and above is the study conducted in this review. Articles used displayed varied information on why it is essential to have a test done at early stages in order to reduce the high rates of cancer levels. Colorectal cancer is the leading cause of cancer deaths and low income has contributed to his health problem. Furthermore, health outcomes and perceptions have increased the rates of colorectal cancer among African American males.

Specific question for follow-up

In any research, the presence of gaps is evident and in this case, vast areas of colorectal cancer topics are investigated. The most daunting question is, are the African American males willing to have a different perception when it comes to their health? Secondly, what is the next step for African American males concerning CSR screening? How is it going to be possible to educate these groups of people on the importance of having early test that detect colorectal cancer? What are the measures taken by health practitioners in helping the illiterate African American males in combating the health problem? At this point in time, is the government doing anything to improve the screening procedures conducted? How are government interventions helping reduce the high costs associated with screening tests among cancer patients? Moreover, the aspect of financial barriers is a risk that needs to be addressed. What measures have been undertaken in handling the financial problems faced by the African American males? Many of the authors have stated that the male species are the most affected group. What have their female counterparts done to reduce their chances of having colorectal cancer? There are many questions concerning this topic and a few mentioned above are the most stringent ones that need to be addressed.

How your thinking about research in relation to practice

After conducting the review, my thinking on colorectal cancer has changed. The review has enabled me to look at the problem from a different angle. Therefore, I have the knowledge required in educating individuals facing colorectal cancer. I have the zeal and energy to persuade people from low income backgrounds with colorectal cancer to go for screening tests. It is a vital step that needs to be undertaken by cancer patients. This is vital because they will educate their family members on the importance of having done early cancer tests that would minimize the death rates. Furthermore, the review of literature enabled me comprehend on the need to have professional health practitioners because they will upgrade and enlighten the patients and family members. This is essential because it enables cancer patients reduce their chances of losing lives to the health problem. Lastly, it is apparent that colorectal cancer is preventable if detected at an early stage.

Application of knowledge to future practice

The knowledge obtained from the review of literature will enable me access the possibility of having reduced costs to health care facilities. This will enable health practitioners formulate programs and interventions that will cater for the needs of all people in a nation.

Relevance to Master’s essentials

For a Master’s prepared nurse, it is important to collaborate with multiple disciplines like teachers, counselors, dieticians, and parents in meeting the objective of the study. Disciplines collaborative approach utilized enables an advance practice nurse assist in coordinating adult aspects that improve on health outcomes.
References

Aghoa, A. O., Parkerb, S., Rivers, P. A., Mushi-Brunta, C., Verdund D., & Kozake M. A. (2012). Health literacy and colorectal cancer knowledge and awareness among African-American males. International Journal of Health Promotion and Education 50(1), 10–19.

BeLue, R., Menon, U., Kinney, A. Y., & Szalacha, L. A. (2011). Psychosocial risk profiles among black male veterans administration patients non-adherent with colorectal cancer screening. Psycho-Oncology 20, 1151–1160.

Brittain, K., Loveland-Cherry, C., Northouse, L., Caldwell, C. H., & Taylor, J. Y. (2012). Sociocultural Differences and Colorectal Cancer Screening Among African American Men and Women. Oncology Nursing Forum 39(1), 100-107.

Consedine, N. S., Reddig, M. K., Ladwig, I., & Broadbent, E. A. (2011). Gender and Ethnic Differences in Colorectal Cancer Screening Embarrassment and Physician Gender Preferences. Oncology Nursing Forum 38(6), E409-E417.

Glenn, B. A., Herrmann, A. K., Crespi, C. M., Mojica C. M., Chang, L. C., Maxwell, A. E., & Bastani, R. (2011). Changes in Risk Perceptions in Relation to Self-Reported Colorectal Cancer Screening Among First-Degree Relatives of Colorectal Cancer Cases Enrolled in a Randomized Trial. Health Psychology 30(4), 481–491.

Griffith, K. A., Passmore, S. R., Smith, D., & Wenzel, J. (2012). African Americans with a Family History of Colorectal Cancer: Barriers and Facilitators to Screening. Oncology Nursing Forum 39(3), 209-306.

Gwede, C. K., William, C. M., Thomas, K. B., Tarver, W. L., Quinn, G. P., Vadaparampil, S. T., Kim, J., Lee, J., & Meade, C. D. (2010). Exploring Disparities and Variability in Perceptions and Self-Reported Colorectal Cancer Screening Among Three Ethnic Subgroups of U.S. Blacks. Oncology Nursing Forum 37(5), 581-591.

James, A. S., Daley, C. M., & Greiner, K. A. (2011). Knowledge and Attitudes About Colon Cancer Screening Among African Americans. American Journal of Health Behavior 35(4), 393-401.

Shires, D. A., Divine, G., Schum, M., Gunter, M. J., Baumer, D. L., Kasprzyk, D., Montano, D. E., Smith, J. L., & Elston-Lafata, J. (2011). Colorectal Cancer Screening Use among Insured Primary Care Patients. The American Journal of Managed Care 17(7), 480-488.

Winterich, J. A., Quandt, S. A., Grzywacz, J. G., Clark, P., Dignan, M., Stewart IV, J. H., & Arcury, T. A. (2011). Men’s Knowledge and Beliefs About Colorectal Cancer and 3 Screenings: Education, Race, and Screening Status. American Journal of Health Behavior 35(5), 525-534.