Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Translational Behavioral Medicine
Published in: Translational Behavioral Medicine 1/2013

01-03-2013 | Original Research

“It’s up to you and God”: understanding health behavior change in older African American survivors of colorectal cancer

Authors: Felicity W K Harper, PhD, Andrea Nevedal, PhD, Susan Eggly, PhD, Carie Francis, BA, Kendra Schwartz, MD, MSPH, Terrance L Albrecht, PhD

Published in: Translational Behavioral Medicine | Issue 1/2013

Login to get access

ABSTRACT

This study investigated the beliefs and attitudes of older African American colorectal cancer (CRC) survivors that may influence health behavior changes after treatment. Drawing from existing theories of health behavior change and cultural beliefs about health, a semi-structured interview guide was developed to elicit survivors’ perspectives. Qualitative focus groups and interviews were conducted with 17 survivors identified through the Detroit Surveillance Epidemiology and End Results registry. Using verbatim transcripts from the sessions and NVivo software, thematic analysis was conducted to analyze patterns of responses. Transcripts were coded for seven categories (health behaviors, who/what motivates change, self-efficacy, fatalism, religion/spirituality, beliefs about cancer, race/ethnicity). Five themes emerged from the data (personal responsibility, resilience, desire for information, intentions to change, beliefs in divine control). Findings support the relevance of existing theories of health behavior change to older African American CRC survivors. Cultural considerations are suggested to improve interventions seeking to maximize changes in diet and exercise among this group of survivors.
Literature
1.
2.
Horner M, Ries L, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2006. Bethesda, MD: National Cancer Institute; 2009.
3.
Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2008. Bethesda, MD: National Cancer Institute; 2011.
4.
Schwartz K, Crossley-May H, Vigneau F, Brown K, Bannerjee M. Race, ses, and stage at diagnosis for five common malignancies. Cancer Causes Control. 2003; 14:761-766.PubMedCrossRef
5.
Yan B, Noone A, Yee C, Bannerjee M, Schwartz K, Simon M. Racial differences in colorectal cancer survival in the detroit metropolitan area. Cancer. 2009; 115:3791-3800.PubMedCrossRef
6.
Rock CL, Demark-Wahnefried W. Nutrition and survival after the diagnosis of breast cancer: a review of the evidence. J Clin Oncol. 2002; 20:3302-3316.PubMedCrossRef
7.
Pinto BM, Eakin E, Maruyama NC. Health behavior changes after a cancer diagnosis: what do we know and where do we go from here? Ann Behav Med. 2000; 22:38-52.PubMedCrossRef
8.
Meyerhardt JA, Giovannucci EL, Holmes MD, et al. Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol. 2006; 24:3527-3534.PubMedCrossRef
9.
Hewitt M, Rowland J, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol. 2003; 58:82-91.CrossRef
10.
Yabroff K, Lawrence W, Clauser S, Davis W, Brown M. Burden of illness in cancer survivors: findings from a population-based national sample. J Natl Cancer Inst. 2004; 96:1322-1330.PubMedCrossRef
11.
Keating N, Norredam M, Landrum M, Huskamp H, Meara E. Physical and mental health status of older long-term cancer survivors. J Am Geriatr Soc. 2005; 53:2145-2152.PubMedCrossRef
12.
Dehal AN, Newton CC, Jacobs EJ, Patel AV, Gapstur SM, Campbell PT. Impact of diabetes mellitus and insulin use on survival after colorectal cancer diagnosis: the Cancer Prevention Study-II Nutrition Cohort. J Clin Oncol. 2012; 30:53-59.PubMedCrossRef
13.
Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM. Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol. 2005; 23:5814-5830.PubMedCrossRef
14.
Mullens A, McCaul K, Erickson S, Sandgren A. Coping after cancer: risk perceptions, worry and health behaviors among colorectal cancer survivors. Psychooncology. 2004; 13:367-376.PubMedCrossRef
15.
Satia J, Campbell M, Galanko J, James A, Carr C, Sandler R. Longitudinal changes in lifestyle behaviors and health status in colon cancer survivors. Cancer Epidemiol Biomarkers Prev. 2004; 13:1022-1031.PubMed
16.
17.
McBride CM, Emmons KM, Lipkus IM. Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res. 2003; 18:156-170.PubMedCrossRef
18.
Aziz N. Cancer survivorship research: challenge and opportunity. J Nutr. 2002; 132(11 Suppl):3494S-3503S.PubMed
19.
Aziz N, Rowland J. Trends and advances in cancer surivorship research: challenge and opportunity. Semin Radiat Oncol. 2003; 13:246-266.CrossRef
20.
Umezawa Y, Lu Q, You J, Kagawa-Singer M, Leake B, Maly R. Belief in divine control, coping, and race/ethnicity among older women with breast cancer. Ann Behav Med. 2012; 44:21-32.PubMedCrossRef
21.
Schulz E, Holt CL, Caplan L, et al. Role of spirituality in cancer coping among African Americans: a qualitative examination. J Cancer Surviv. 2008; 2:104-114.PubMedCrossRef
22.
Taylor RJ, Chatters LM. Importance of religion and spirituality in the lives of African Americans, Carribean blacks and non-Hispanic whites. J Negro Educ. 2010; 79:280-294.
23.
Peek ME, Sayad JV, Markwardt R. Fear, fatalism and breast cancer screening in low-income African American women: the role of clinicians and the health care system. J Gen Intern Med. 2008; 23:1847-1857.PubMedCrossRef
24.
Powe BD. Cancer fatalism among elderly Caucasians and African Americans. Oncol Nurs Forum. 1995; 22:1355-1359.PubMed
25.
Phillips J, Cohen M, Moses G. Breast cancer screening and African American women: fear, fatalism, and silence. Oncol Nurs. 1999; 26:561-571.
26.
Thompson H, Valdimarsdottir H, Winkel G, Jandorf L, Redd W. The group-based medical mistrust scale: psychometric properties and association with breast cancer screening. Prev Med. 2004; 38:208-218.CrossRef
27.
Peek ME, Odoms-Young A, Quinn MT, Gorawara-Bhat R, Wilson SC, Chin MH. Race and shared decision-making: perspectives of African-Americans with diabetes. Soc Sci Med. 2010; 71:1-9.PubMedCrossRef
28.
Halbert CH, Weathers B, Delmoor E, et al. Racial differences in medical mistrust among men diagnosed with prostate cancer. Cancer. 2009; 115:2553-2561.PubMedCrossRef
29.
Park CL, Gaffey AE. Relationships between psychosocial factors and health behavior change in cancer survivors: an integrative review. Ann Behav Med. 2007; 34:115-134.PubMedCrossRef
30.
Harper FWK, Schmidt JE, Beacham AO, et al. The role of social cognitive processing theory and optimism in positive psychosocial and physical behavior change after cancer diagnosis and treatment. Psychooncology. 2007; 16:79-91.CrossRef
31.
Andrykowski MA, Beacham AO, Schmidt JE, Harper FWK. Application of the theory of planned behavior to understand intentions to engage in physical and psychosocial health behaviors after cancer diagnosis. Psychooncology. 2006; 15:759-771.PubMedCrossRef
32.
Ajzen I. The theory of planned behavior. Organ Behav Hum Decis. 1991; 50:179-211.CrossRef
33.
Ajzen I. From intentions to action: a theory of planned behavior. In: Kuhl J, Beckman J, eds. Action Control: From Cognitions to Behavior. New York: Springer; 1985:11-39.
34.
Armitage C, Conner M. Efficacy of the theory of planned behavior: a meta-analytic review. Br J Soc Psychol. 2001; 40:471-499.PubMedCrossRef
35.
Conner M, Sparks P. The theory of planned behaviour and health behaviours. In: Conner M, Norman P, eds. Predicting health behavior. Buckingham: Open University Press; 1996:121-162.
36.
Godin G, Kok G. The theory of planned behavior: a review of its applications to health-related behaviors. Am J Health Promot. 1996; 11:87-98.PubMedCrossRef
37.
Bandura A. Self-Efficacy: The Exercise of Control. New York: Freeman; 1997.
38.
Lev E, Owen S. Counseling women with breast cancer using principles developed by Albert Bandura. Perspect Psychiatr Care. 2000; 36:131-138.PubMedCrossRef
39.
Merluzzi T, Martinez Sanchez M. Psychological perspectives on life threatening illness: cancer and aids. In: Roth-Roemer S, Robinson-Kurpius S, Carmin C, eds. The Emerging Role of Counseling Psychology in Health Care. New York: W.W. Norton; 1998:157-190.
40.
Peek M, Wilson S, Gorawara-Bhat R, Odoms-Young A, Quinn M, Chin M. Barriers and facilitators to shared decision-making among African-Americans with diabetes. J Gen Intern Med. 2009; 24:1135-1139.PubMedCrossRef
41.
Boehm S, Coleman-Burns P, Schlenk EA, Funnell MM, Parzuchowski J, Powell IJ. Prostate cancer in African American men: increasing knowledge and self-efficacy. J Community Health Nurs. 1995; 12:161-169.PubMedCrossRef
42.
Adderley-Kelly B, Green PM. Breast cancer education, self-efficacy, and screening in older African American women. J Natl Black Nurses Assoc: JNBNA. 1997; 9:45.PubMed
43.
Lawson E. A narrative analysis: a black women’s perceptions of breast cancer risks and early breast cancer detection. Cancer Nurs. 1998; 21:421-429.PubMedCrossRef
44.
Matthews H, Lannin D, Mitchell J. Coming to terms with advanced breast cancer: black women’s narratives from eastern North Carolina. Soc Sci Med. 1994; 38:789-800.CrossRef
45.
Ashing-Giwa K. Health behavior change models and their socio-cultural relevance for breast cancer screening in African American women. Women Health. 1999; 28:53-71.PubMedCrossRef
46.
Russell K, Swenson M, Skelton A, Shedd-Steele R. The meaning of health in mammography screening for African American women. Health Care of Women Int. 2003; 24:27-39.
47.
Matthews D, McCullough M, Larson D, Koenig H, Swyers J, Milano M. Religious commitment and health status: a review of the research and implications for family medicine. Arch Fam Med. 1998; 7:118-124.PubMedCrossRef
48.
Smedley B, Stith A, Nelson A. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Acadamies Press; 2003.
49.
Hill PC, Pargament KI. Advances in the conceptualization and measurement of religion and spirituality. Implications for physical and mental health research. Am Psychol. 2003; 58:64-74.PubMedCrossRef
50.
51.
Francis JJ, Johnston M, Robertson C, et al. What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychol Health. 2009; 25:1229-1245.CrossRef
52.
Scheermesser M, Bachmann S, Schamann A, Oesch P, Kool J. A qualitative study on the role of cultural background in patients' perspectives on rehabilitation. BMC Musculoskelet Disord. 2012; 13:5.PubMed
53.
54.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007; 19:349-357.PubMedCrossRef
55.
QSR International Pty Ltd. (1999). Nvivo 9.
56.
Patton M. Qualitative Research & Evaluation Methods. 3rd ed. Thousand Oaks, CA: Sage; 2002.
57.
Bernard HR. Research Methods in Anthropology. 4th ed. Plymouth, UK: Alta Mira Press; 2005.
58.
Ryan GW (Personal communication, April 12, 2012).
59.
Saldaña J. The Coding Manual for Qualitative Researchers. Thousand Oaks, CA: Sage Publications; 2009.
60.
61.
Luborsky MR. The identification and analysis of themes and patterns. In: Gubrium J, Sankar A, eds. Qualitative Methods in Aging Research. Thousand Oaks: SAGE Publications; 1994:189-210.
62.
Masters K. If God is in control of my health, what should I do? The importance of religious, ethnic, and social culture: a comment on Umezawa et al. Ann Behav Med. 2012; 44:3-4.
63.
Reiser SJ. Responsibility for personal health: a historical perspective. J Med Philos. 1985; 10:7-17.
64.
Becker G, Beyene Y, Newsom EM, Rodgers DV. Knowledge and care of chronic illness in three ethnic minority groups. Fam Med. 1998; 30:173-178.PubMed
65.
Becker G. Disrupted lives: how people create meaning in a chaotic world. Berkeley and Los Angeles: University of California Press; 1997.
66.
Peek ME, Quinn MT, Gorawara-Bhat R, Odoms-Young A, Wilson SC, Chin MH. How is shared decision-making defined among African-Americans with diabetes? Patient Educ Couns. 2008; 72:450-458.PubMedCrossRef
67.
Carver CS. Resilience and thriving: issues, models, linkages. J Soc Issues. 1998; 54(2):245-266.CrossRef
68.
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977; 84:191-215.PubMedCrossRef
69.
Rock CL, Doyle C, Denmark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012; 62:242-274.CrossRef
70.
Peek M, Harmon S, Scott S, et al. Culturally tailoring patient education and communication skills training to empower African-Americans with diabetes. Transl Behav Med. 2012; 2:296-308.CrossRef
71.
Peek ME, Cargill A, Huang ES. Diabetes health disparities: a systematic review of health care interventions. Med Care Res Rev. 2007; 64:101S-156S.PubMedCrossRef
72.
Garfield SA, Malozowski S, Chin MH, et al. Considerations for diabetes translational research in real-world settings. Diabetes Care. 2003; 26:2670-2674.PubMedCrossRef
73.
Gallagher KM, Updegraff JA. Health message framing effects on attitudes, intentions, and behavior: a meta-analytic review. Ann Behav Med. 2012; 43:101-116.PubMedCrossRef
74.
Rabin C, Pinto BM. Cancer-related beliefs and health behavior change among breast cancer survivors and their first-degreee relatives. Psychooncology. 2006; 15:701.PubMedCrossRef
75.
Lovasi GS, Hutson MA, Guerra M, Neckerman KM. Built environments and obesity in disadvantaged populations. Epidemiol Rev. 2009; 31:7-20.PubMedCrossRef
76.
Schuz B, Wurm S, Warner LM, Ziegelmann JP. Self-efficacy and multiple illness representations in older adults: a multilevel approach. Psychol Heal. 2012; 27:13-29.CrossRef
77.
Levin J, Chatters LM, Taylor RJ. Religion, health and medicine in African Americans: implications for physicians. J Natl Med Assoc. 2005; 97:237-249.PubMed
78.
Taylor RJ, Chatters LM, McKeever Bullard K, Wallace JM, Jackson JS. Organizational religious behavior among older African Americans: findings from the national survey of American life. Res Aging. 2009; 31:440-462.PubMedCrossRef
79.
Campbell MK, Hudson MA, Resnicow K, Blakeney N, Paxton A, Baskin M. Church-based health promotion interventions: evidence and lessons learned. Annu Rev Public Health. 2007; 28:213-234.PubMedCrossRef
80.
Tuskegee Syphilis Study Legacy Committee. Final report of the Tuskegee Syphilis Study Legacy Committee; 1996.
Metadata
Title
“It’s up to you and God”: understanding health behavior change in older African American survivors of colorectal cancer
Authors
Felicity W K Harper, PhD
Andrea Nevedal, PhD
Susan Eggly, PhD
Carie Francis, BA
Kendra Schwartz, MD, MSPH
Terrance L Albrecht, PhD
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Translational Behavioral Medicine / Issue 1/2013
Print ISSN: 1869-6716
Electronic ISSN: 1613-9860
DOI
https://doi.org/10.1007/s13142-012-0188-6

Other articles of this Issue 1/2013

Translational Behavioral Medicine 1/2013 Go to the issue

Policy Brief

Preventing substance abuse and increasing energy balance in middle school students: What works?

Original Research

Project MARS: design of a multi-behavior intervention trial for justice-involved youth

Editorial

Advances in multiple health behavior change research

Commentary

News from NIH: effective behavioral treatments for patients with multiple chronic conditions

Case Study

The challenges of translating an efficacious smoking cessation program, Commit to Quit, to the community setting of YMCAs

Synopsis

Multiple health behavior change: a synopsis and comment on “A review of multiple health behavior change interventions for primary prevention”