Introduction: Breast cancer mortality rates among African American (AA) women are at 29.2 deaths per 100,000 persons compared with 20.6 deaths per 100,000 persons among Caucasian women. Regular mammography screening may significantly reduce breast cancer mortality and narrow this disparity. This study guided by PEN-3 model aims to explore the relationships and expectations domain and identify perceptions, enablers, and nurturers of regular mammography among AA women. Method: As part of an intervention study, in-depth interviews were conducted with 39 AA women recruited from the emergency department of a public university hospital. Results: Women’s perceptions included fear and limited knowledge. Enablers identified were cost, socioeconomic, and race-related discrimination, and health care previous experiences. Nurturers identified included observation of family experiences and lack of health-related social support. Discussion: Findings underscore the need to develop culturally tailored interventions to address the issues salient to this population.

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Although social support as it measured in this study does not show significant associations with screening patterns, it is important to understand how social network structures may influence screening patterns. Familial and social roles/responsibilities that result in reported social support may also be the barrier to cancer screening and other prevention health behaviors.

Background: Appalachian Kentucky residents suffer significant colorectal cancer (CRC) disparity, in part related to low utilization of CRC screening. Reducing or removing potential barriers to CRC screening uptake may increase utilization of CRC screening in this population. The purpose of this study was to identify barriers to CRC screening in adults aged 50 years and older in rural Appalachian Kentucky. Methods: This study reports the analysis of baseline data from a randomized controlled trial designed to promote CRC screening in rural Appalachian Kentucky among individuals who have not been screened for CRC recruited from two Emergency Departments at St. Claire Regional Medical Center in Morehead, Kentucky, and Appalachian Regional Healthcare in Hazard, Kentucky. The survey used for this study assessed CRC screening status, barriers, susceptibility, and benefits related to CRC screening, sociodemographic characteristics, and other health-related information such as health care utilization including the reason for ED visit, insurance coverage, and health care access. Descriptive and bivariate analyses are reported. Results: Questionnaires were completed by 191 adults aged 50 and over, waiting for nonurgent care or with a family member in the ED of rural Appalachian hospitals. Participants were mostly Caucasian (98%), female (57%), aged 58 ± 8 years, who had household income < $20,000 (56%), and 95% had never undergone CRC screening. Fear of CRC result (51%), perceived pain (50%), and cost (49%) were the most salient barriers to CRC screening test. The following four demographic variables were significantly associated with barriers to CRC screening; education, marital status, income, and age. Conclusions: Rural Appalachian Kentucky residents do not screen for CRC according to guidelines, partly due to perceived barriers to CRC screening. Education and income level were associated with the perception of painful and costly CRC screening in this population, suggesting that they do not have adequate knowledge or access to CRC screening resources available in the communities. Considering the cultural norms peculiar to Appalachian Kentucky, this population will benefit from a community health worker-led educational intervention to promote CRC screening through short video messages about the CRC screening process, other less invasive screening options, and benefits of CRC screening. This intervention may be able to address the barriers identified in this group, including the perception of painful screening procedure and the fear of screening result. Additionally, appropriate navigation program to affordable and accessible CRC screening resources within the local community would be beneficial to addressing the dismal use of screening resources among individuals in this population. Citation Format: Adaeze Aroh, Adebola Adegboyega, Jennifer Hatcher. Reported barriers to colorectal cancer screening in Appalachian Kentucky [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B100.

Background: Sub-Saharan African immigrant (SSAI) women in the United States suffer cervical cancer screening disparities despite known benefits of cervical cancer screening. The disparity in uptake of cervical cancer screening among this group is concerning given that sub-Saharan Africa has the highest estimated rates of cervical cancer globally. Without routine screening, SSAI women may miss the opportunity for early detection contributing to later stage diagnosis and mortality. Immigrants’ adaptation to a new environment and navigating through the complexities of the healthcare to promote preventive health utilization is enhanced by social support. Specifically, a growing body of evidence suggests that social support influences cancer screening behaviors. Understanding the relationship between social support and Pap screening behaviors can provide important insights into designing appropriate culturally relevant interventions to promote and facilitate Pap screening use among SSAI women. Methods: For this study, we conducted a secondary analysis of data from a cross-sectional study conducted with 107 English speaking SSAI women aged 21 and above. Using purposive and snowball sampling, participants were recruited from Central Kentucky between October 2016 and January 2017. Participants completed a questionnaire that included sociodemographic information, Pap screening history, and the Medical Outcomes Study (MOS) Social Support Survey. Analysis of Variance (ANOVA) was used to examine associations between Pap screening and each of the four MOS social support subscales (emotional, tangible, affection, and positive interaction) and the overall social support index. Results: Among the 107 women, the Pap screening test uptake was 65.7%, History of Pap screening was significantly associated with the affection (F < sub > 1,106 < /sub > = 6.64, P= 0.011) and positive social interactions subscales (F < sub > 1,106 < /sub > = 5.50, P= 0.021), and overall social support (F < sub > 1,106 < /sub> = 3.94, p=0.050). Compared to women who had not had Pap screening, those who had been screened experienced greater support through affection (M = 12.6: SD = 3.0 vs. M = 10.8: SD = 3.9, respectively) and positive interactions (M =12.2: SD =2.9 vs. M = 10.9: SD = 3.8, respectively) as well as greater overall social support (M= 66.8; SD =16.7 vs. M=73.1; SD=15.0, respectively). Conclusions: The finding that SSAI women who had a history of Pap screening had greater overall support compared to SSAI women who had not had screening suggests that interventions that increase social support might improve cervical cancer screening uptake in this population. At the same time, improved understanding of the influences of the various subtypes of social support on screening uptake is needed to better guide intervention development. Citation Format: Adebola Adegboyega, Adaeze Aroh, Gia Mudd-Martin. Social support and Pap test uptake among sub-Saharan African immigrant women in the United States [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C094.