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Although social and cultural contexts act on each level of the multilevel ecologic model to affect cancer risk, health behavior, and cancer screening and promotion in health behavior research, people have yet to develop theories that sufficiently integrate the social and environmental context with group and individual behavior. The "Behavioral Constructs and Culture in Cancer Screening" (3Cs) articles in this issue move this effort forward and argue that the specific social context structures the culture-specific factors that uniquely modify commonly used constructs in health behavior theories for particular populations and that these constructs are not universal as currently accepted. The 3Cs articles raise the important issues related to social context and question the completeness and appropriateness of theoretical constructs commonly used to develop interventions. This paper highlights the approaches of three researchers, whose work also investigates cultural differences, to demonstrate the different but parallel approaches to explain health behavior and cancer screening. Each researcher addresses behavior change; however, their attempts to integrate culture into existing behavior change theory varies by degree of focus and success (Kumanyika, 2003).

Interviewed adult African Americans regarding four parameters of racial identification (psychological, physical, cultural, and sociopolitical). Results indicated generally high levels of racial identification across participants, though scores varied across parameters. The highest level of racial identification was obtained on the cultural parameter. Only 15 percent of participants demonstrated consistent levels of racial identification across parameters. (SM)

Reports a study of racial identification that provides empirical support for a multidimensional approach. The study involves interviews with 162 African Americans (62 males and 100 females) over 18 years. Results confirm the psychological, physical, and sociocultural parameters of racial identification and thus the multidimensional approach to racial identification. (JB)

Human papillomavirus (HPV) vaccination rates remain low, but college student vaccination could offset this trend. This study identifies characteristics that could enhance HPV vaccination among U.S. college students. Data were from the National College Health Assessment II survey (fall 2012, N = 18,919). Univariate and logistic regression analyses were used to examine associations among demographic characteristics, college region and size, health status, receipt of health services, sexual health information, and HPV vaccination status. Among women, ethnic minorities, students attending schools in the South, those not receiving routine gynecological care in the past 12 months, and those unsure of when they last received gynecological care were less likely to report HPV vaccination. Among men, African Americans, students attending schools in the South and West, and those receiving sexually transmitted infection information were more likely to report vaccination. Data suggest that college health education can help to improve U.S. HPV vaccination rates. Campus health practitioners providing sexual health information and referrals are positioned to assist in this effort. [ABSTRACT FROM AUTHOR]

Background This paper reports on an effort to identify a streamlined set of issues important for colorectal cancer communication and interventions with older African Americans. Methods African American (N = 1,021), 683 women and 338 men, 50 to 75 years completed a telephone survey addressing demographics, colorectal cancer screening, cancer attitudes, and cancer related cultural attitudes. Several data analytics methods were applied and evaluated. Among them, results from associative data mining identified key variables and logistic regression was used to confirm associations to screening adherence. Results Sets of co-occurring variables identified by associative data mining methods are extracted to further study differences between adherent and non-adherent groups. Logistic regressions suggested four variables were significantly associated with adherence: healthcare provider colonoscopy recommendation, prevention services at the place health care is usually sought, a history of colitis, and a history of polyps. Conclusions The findings suggest a streamlined set of issues and concerns that may be used by providers advising patients or developing colorectal cancer intervention strategies for older African Americans. The data suggest the continued importance of healthcare provider recommendation to screen. It is important that providers give a clear recommendation to screen regardless of the test ultimately selected and should advise all patients that family history and the absence of symptoms or colitis do not eliminate the value of screening. [ABSTRACT FROM AUTHOR]