S627 Identifying Barriers and Recommendations for Colon Cancer Screening in an Immigrant Community: Lessons From Focus Groups

Introduction: Immigrants in the United States undergo colorectal cancer (CRC) screening at significant lower rates than those born in the US. Hispanic adults have reported screening rates of 52%, with adults speaking only Spanish having rates as low as 32%. Multiple factors have been reported to contribute to suboptimal screening. However, it is important to understand community-specific issues. This study evaluated findings of a focus group addressing CRC screening in a predominantly Hispanic immigrant community. Methods: University health care providers and administrators at an urban community center available for Spanish-speaking immigrants collaboratively planned a health fair to improve CRC awareness. Two focus groups were conducted to identify barriers and obtain community recommendations for CRC screening. The focus groups were led by a Spanish-speaking facilitator. Discussions were recorded with verbatim transcription. Thematic analysis was conducted through an iterative process by 2 investigators. Qualitative and quantitative assessment was conducted. Quantitative analysis was performed using a t-test with significance set at P < 0.05. Results: Two focus groups had 10 self-identified Hispanic participants (first with 5 men, 2 women; second with 1 man, 2 women). Primary barriers impacting CRC screening included lack of knowledge about CRC (70%), fear of procedures or diagnosis (70%), job security concerns (50%), access to care and cost (40%), preference for seeking care for illness rather than prevention with tendency for home remedies (30%). There was no significant difference between genders regarding knowledge (P = 1.000), fear (P = 0.50), job security (P = 0.50), access to care (P = 0.40) and preference for illness seeking care (P = 0.50). Recommendations to increase CRC screening included increased community outreach (50%), enhanced provider trust (30%), improvement in educational material (30%) and use of social media (40%). There was no significant difference between genders recommending outreach (P = 1.00), enhanced provider trust (P = 0.47), improvement in educational material (P = 0.47) and use of social media (P = 0.57). Conclusion: This study offers insight into a Hispanic immigrant community’s perspectives about CRC screening. Tendency for illness-seeking care and reliance on natural remedies are issues that may be under-recognized. It is important to identify community-specific concerns when developing programs to improve CRC screening.