the 2011 iowa dialogue on colorectal cancer iowa colorectal cancer focus groups: what we learned...
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The 2011 Iowa Dialogue on Colorectal Cancer
Iowa Colorectal Cancer Focus Groups: What We Learned
Iowa Dialogue on Colorectal CancerSeptember 16, 2011
Lorrie Graaf, American Cancer Society
The 2011 Iowa Dialogue on Colorectal Cancer
ACKNOWLEDGEMENT
Focus groups were conducted and the final reportwas prepared by:
Kellee Thorburn McCrory, MPHProject Director
National Resource Center for Family Centered PracticeUniversity of Iowa School of Social Work
The 2011 Iowa Dialogue on Colorectal Cancer
Research Question
Why are people who havehealth insurance and access tocare not getting screened for colorectal cancer?
The 2011 Iowa Dialogue on Colorectal Cancer
Project OverviewReceived University of Iowa IRB approval Determined participant eligibility criteriaRecruited and screened potential participants
Focus Group Participation by SiteSite Total recruited Total participated
Garner, IA 6 5Des Moines, IA 10 6Iowa City, IA 10 3Iowa City 7 5Total 31 19
The 2011 Iowa Dialogue on Colorectal Cancer
About the Participants
Age – Mean age 55 yearsPlace of residence – Majority suburbanEducation – Majority; college at some level Employment – 89% employed full or part-timeRace/ethnicity – Caucasian and Asian
The 2011 Iowa Dialogue on Colorectal Cancer
Focus Group Questions• What do you think of when you think about
colorectal cancer (CRC) screening?• When it comes to getting screened for CRC, who
do you trust to give you the most up-to-date information about the available screening tests?
• Have your family or friends talked about getting a CRC screening?
• What would help you make the decision to get screened for CRC?
The 2011 Iowa Dialogue on Colorectal Cancer
What Participants Said:Thinking About CRC Screening
• Prep• Time off work• Considered self healthy• Colonoscopy limitations
NO ONE mentioned any of the other tests available for CRC Screening. All references were to Colonoscopy.
“Also, my doctor has said it is not foolproof. That it can give you false readings that there is something there and can also not catch if there is something there”
“I’ve been wanting to do it, but just to get the time and I think a lot of it is the fear factor, as far as might find”
The 2011 Iowa Dialogue on Colorectal Cancer
What Participants SaidTrust Information and Barriers
Sources• Physician• Internet websitesBarriers• High deductibles• Physician had not “pushed screening hard
enough”
“And so I’ve just been waiting for the doctor to ask again, but they never,
they never mention it”
The 2011 Iowa Dialogue on Colorectal Cancer
What Participants Said:Talked With Family or Friends
• Stories that influenced opinionPrep, several days off work, transporting,colonoscopy complications
• Peer or spouse pressure
The 2011 Iowa Dialogue on Colorectal Cancer
What Participants Said:Decision to be Screened
Eventually might be screened• Reasonable cost/insurance covers cost• Type of prep• Physician “pushing” screening• Symptoms
Not interested in being screened• Cost• Current health status and behaviors• Perceived test reliability
The 2011 Iowa Dialogue on Colorectal Cancer
Survey Questions: Screening and Awareness
Question Yes No Can’tRecall
Has your doctor ever talked to you about colorectal screening?
42.1 52.6 5.3
Have you declined an opportunity to be screened for colorectal cancer?
15.8 78.9 5.3
Have you ever seen any advertising about colorectal cancer screening?
68.4 26.3 5.3
The 2011 Iowa Dialogue on Colorectal Cancer
Conclusions• Knowledge of need to be screened.• Health insurance not a “green light”.• Prep continues to be an issue.• Repeated screening message from
physician.• Advertising provides the screening
message, but it is not a motivator.