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Men had general knowledge about colorectal cancer (CRC).
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I think it would all go down to knowledge and awareness. ’Cause if you knew what could happen by not getting checked, then you’d be more motivated to get checked.
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Knowledge came from several sources.
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Well I don’t think it was educational stuff. It may have been just that you hear all the stories, you know that something has to happen when you’re 50.
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I don’t know if it was advertising or reading stories about who had died of cancer. And every time that you’d read a story about it there’d be something saying that if they caught it earlier.
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American Indian (AI) men felt that there were numerous barriers to screening.
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| Cost/insurance: Yeah, cost and no insurance would be the main thing I could see. From listening to some of the others, it sounds like access. It sounds like there’s nothing in this area for someone that don’t have insurance or anything to get it done.
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| Privacy/embarrassment: It would be embarrassing to have to go pull their pants down and let somebody do something like that to them. That in itself and their mentality… and believe me I’ve talked to them about it, they wouldn’t do that. . . . I mean I definitely think there’s an embarrassment factor there.
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| Fear: But a lot of them don’t know the procedure, don’t know nothing about it and they’re afraid to ask. So you have a lot of natives dying off because they’re afraid to go up there and ask somebody a question and we’ve got to figure out how to get this out to the public.
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There are negative perceptions of clinicians or systems that can affect willingness to get screened.
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| Vague information: They [providers] mentioned it but then, you know, they said, well, we’d like for you to have one [colonoscopy] sometime in the near future, but that’s, you know, the extent of what. . . . They never actually told me what it is, what it involves.
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| Dissatisfaction: If somebody’s dealt with a health center, Indian Health Service, and was not happy with whatever they were doing, then that would . . . make them less likely to be proactive. |
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The majority of participants had discussed CRC only with their health care providers.
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| Inadequate detail from providers: When you do hear [a doctor’s recommendation for screening] it’s just a slight mention. You know, like when I got my physical he says, you’re over 50, I would recommend a colonoscopy, you know. But why?
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| Reasons for talking about CRC: Yeah, that’s what killed my father-in-law. You know he got sick and didn’t go to the doctor, and when he got to the point where he went to the doctor, which was only 3 months too late. He lasted about a month.
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Traditional perspectives must be incorporated into intervention messages about CRC.
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There are hospitals, Indian Health Hospitals on reservations that are doing that, working with the traditional medicine... And it works good when they [traditional and Western medicine] get together. You know, you have both and the Western medicine doctors respect that and, you know, they work hand in hand.
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I still believe in traditional ways and I don’t turn down any traditional medicine or any healing ceremonies or anything like that, but I know that, you know, I can’t go to [a traditional healer] and get a colonoscopy.
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Participants stressed that education and prevention strategies for CRC should use multiple formats.
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| A suggested primary message was “you are at higher risk [for CRC] and these are the sources that are available to you.” |
