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Health Education Research Advance Access originally published online on April 24, 2009
Health Education Research 2009 24(5):876-889; doi:10.1093/her/cyp024
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© The Author 2009. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Use of focus group data to develop recommendations for demographically segmented colorectal cancer educational strategies

Cheryl L. Holt1,*, Michele Shipp2, Mohamad Eloubeidi3, Kimberly S. Clay4, Mary Ann Smith-Janas5, Michael John Janas6, Kristi Britt7, Maria Norena8 and Mona N. Fouad9

1 Department of Public and Community Health, School of Public Health, University of Maryland, 2369 Public Health Building (255), College Park, MD 20742, USA
2 School of Public Health, The Ohio State University, Cunz Hall Room 456, 1841 Neil Avenue, Columbus, OH 43210, USA
3 Department of Gastroenterology and Hepatology, School of Medicine, University of Alabama at Birmingham, 408 Lyons Harrison Research Building, 701 19th Street South, Birmingham, AL 35294-0007, USA
4 Department of Social Work, University of Georgia, 210 Tucker Hall, Athens, GA 30602, USA
5 Marketry, Inc., 1630 29th Court South, Birmingham, AL 35209, USA
6 Samford University, 800 Lakeshore Drive, Birmingham, AL 35229, USA
7 Sanofi-Aventis, 409 13th Terrace NW, Birmingham, AL 35215, USA
8 Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, MT 512F, 1530 3rd Avenue South, Birmingham, AL 35294-4410, USA
9 Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, MT 618, 1530 3rd Avenue South, Birmingham, AL 35294-4410, USA

* Correspondence to: C. L. Holt. E-mail: cholt14{at}umd.edu

Screening is available and effective in colorectal cancer (CRC) control, but underutilized. The purpose of this study was to use focus group data to develop recommendations for the development of educational interventions to increase CRC screening, using an audience segmentation strategy. Demographic segments were based on urban–rural residence, race (African-American, White) and sex. One hundred and sixty-five participants age 50+, with no history of CRC participated in 17 focus groups in Alabama urban and rural communities. Transcripts were examined by independent coders. Knowledge among participants was limited regarding age to begin screening, insurance coverage and risk factors for CRC. Perceived barriers to screening included lack of physician recommendation, cost/lack of insurance coverage, pain/discomfort and embarrassment. African-American men reported postponement in seeing their physicians. White women were proactive at initiating discussion of CRC screening with their providers while African-American women felt that providers should drive the process. No urban–rural differences were identified. This study identified cultural and gender characteristics and perceptions that can be used in the development of demographically segmented health communication interventions to increase CRC awareness and screening.

Received on April 9, 2008; accepted on March 9, 2009


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