Colorectal cancer (CRC) is the second most common cancer among African American women and the third most common cancer for African American men. The mortality rate from CRC is highest among African Americans compared to any other racial or ethnic group. Much of the disparity in mortality is likely due to diagnosis at later stages of the disease, which could result from unequal access to screening. The purpose of this study is to determine the impact of race and insurance status on CRC outcomes among CRC patients. Data were drawn from the Surveillance, Epidemiology, and End Results database. Logistic regressions models were used to examine the odds of receiving treatment after adjusting for insurance, race, and other variables. Cox proportional hazard models were used to measure the risk of CRC death after adjusting for sociodemographic and tumor characteristics when associating race and insurance with CRC-related death. Blacks were diagnosed at more advanced stages of disease than whites and had an increased risk of death from both colon and rectal cancers. Lacking insurance was associated with an increase in CRC related-deaths. Findings from this study could help profile and target patients with the greatest disparities in CRC health outcomes.

Purpose To evaluate the applicability of an evidence-based video intervention to promote informed decision making for prostate cancer (CaP) screening among African-American men with different levels of health literacy. Methods Forty nine African-American men participated in interviewer-administered, pretest-posttest interviews between January and March 2008. Health literacy status was assessed with the Test of Functional Health Literacy in Adults (TOFHLA). Repeated measures analysis of covariance (ANCOVA), McNemar or binomial distributions were computed to assess pretest/posttest differences in knowledge. Descriptive statistics were produced to describe participants’ perceptions of the information presented in the video. Results Results indicated that men with functional health literacy had higher mean levels of CaP screening knowledge at baseline than men with inadequate health literacy. The between group (F2,44 = 4.84; p = .013) and within group (F1,44 = 5.16; p = .028) test results from repeated measures ANCOVA indicated that preexisting group differences in CaP knowledge had lessened after intervention exposure. Nearly all men rated the information presented in the video as credible (98%), trustworthy (96%), interesting (100%), understandable (94%), and complete (96%). Conclusions Result from this exploratory study suggests that the video intervention is suitable for use with African-American men with different health literacy characteristics in two counties in the Greater Florida Panhandle Region. More research is recommended to evaluate the impact of the intervention on mens’ intentions to undergo screening and actual screening behavior.

B13 Initiatives to promote informed decision making for prostate cancer (CaP) screening and early detection have grown significantly in recent years. However, several subpopulations of men throughout the United States remain underserved. Systematic reviews of the CaP control literature point to a need for more research to enhance African American mens’ knowledge of CaP screening issues and research that can increase their levels of participation in CaP screening decision-making discussions with physicians. Evidenced-based tools exist that can achieve both of these objectives. However, many of these tools have not been evaluated for use with African American men nor with consideration given to participants’ abilities to comprehend health messages as measured by health literacy status. The current research study was conducted in response to national calls for more type II translation research--research aimed at increasing the adoption of effective practices into communities--with vulnerable and high risk populations. The goal was to evaluate the applicability of a video intervention-The PSA Test for Prostate Cancer: Is it Right for Me?--for use with African American men in the Greater Florida Panhandle Region. The specific aims were (1) to assess acceptability of the intervention, (2) to evaluate the impact of the intervention on knowledge about screening-related issues, and (3) to assess the impact of the intervention on intentions to become involved in decision-making discussions across participants’ demographic and health literacy characteristics. Fifty African American men participated in interviewer-administered pretest/posttest interviews during January and February 2008. Health literacy status was determined with the test of functional health literacy in adults (TOFHLA). Six research hypotheses related to changes in CaP knowledge, intentions to engage in PSA screening decision-making discussions, and intentions to undergo PSA testing were tested. Results from bivariate analyses [F(2,46) = 6.54, p = .003] indicated that men with functional health literacy (M = 7.29) had higher mean levels of CaP knowledge at baseline than men with inadequate health literacy (M = 5.50). No baseline differences were noted regarding participants’ intentions to have PSA discussions with physicians in the next 12 months or their intentions to have a PSA test in the next 12 months. The between group and within group test results from repeated measures analysis of covariance indicated that the group differences in CaP knowledge that existed at pretest had lessened after intervention exposure. No changes were found regarding participants’ intentions to have a PSA discussion with a physician in the next 12 month or their intentions to have a PSA test. Participants’ perceptions of the information presented in the video were overwhelmingly favorably. Nearly all (98%) believed the information was credible. Ninety percent stated that the information was trustworthy. All men thought the information was interesting. Most (91%) stated that the information was understandable. Nearly all (96%) thought the information presented was complete. Results from the current study provide preliminary support for the use of an evidenced-based intervention with diverse African American men and support more dissemination research with the intervention within the African American community. Citation Information: Cancer Prev Res 2008;1(7 Suppl):B13.

Minorities with diabetes are at an increased risk for low quality care and access to resource utilization, specifically health insurance coverage which often determines access to health care. The purpose of the study was to examine the relationship between insurance coverage and diabetes preventive care after adjusting for patient, physician care, and contextual characteristics. Study used data from the 2010 Medical Expenditure Panel Survey (MEPS). Patients represented a weighted total of 20,741,963 (n=2,182). The dependent variables included five measures of the recommended components of diabetes preventive care: receipt of A1C test, retinal eye exam, foot care, blood cholesterol check, and flu vaccination. The independent variables consisted of sociodemographic, physician care, and contextual characteristics. Receipt of each of the diabetes quality and preventive care measures was strongly associated with insurance coverage. Insured individuals were more likely to receive treatment than uninsured. However, the impact of insurance coverage was attenuated after adjusting for individual, physician care, and contextual characteristics. Physician care was the strongest predictor of diabetes preventive care. Our study identified the importance of health insurance coverage on diabetes preventive care. Physician care and contextual factors made a significant impact in receipt of diabetes preventive care.

Minorities with diabetes are at an increased risk for low quality care and access to resource utilization, specifically health insurance coverage which often determines access to health care. The purpose of the study was to examine the relationship between insurance coverage and diabetes preventive care after adjusting for patient, physician care, and contextual characteristics. Study used data from the 2010 Medical Expenditure Panel Survey (MEPS). Patients represented a weighted total of 20,741,963 (n=2,182). The dependent variables included five measures of the recommended components of diabetes preventive care: receipt of A1C test, retinal eye exam, foot care, blood cholesterol check, and flu vaccination. The independent variables consisted of sociodemographic, physician care, and contextual characteristics. Receipt of each of the diabetes quality and preventive care measures was strongly associated with insurance coverage. Insured individuals were more likely to receive treatment than uninsured. However, the impact of insurance coverage was attenuated after adjusting for individual, physician care, and contextual characteristics. Physician care was the strongest predictor of diabetes preventive care. Our study identified the importance of health insurance coverage on diabetes preventive care. Physician care and contextual factors made a significant impact in receipt of diabetes preventive care.