P0364 - African-Americans in Focus Group Compared to Health Care Learners More Frequently Identified Racial Disparity in Care, Physician Respect Toward Patients and Receiving Information as Barriers in Colon Cancer Screening

Ankit Patel, MD¹, Valeria Martinez Lebron, MD², Ana Pabalan, MD³, Samuel A. Schueler, MD⁴, Jehan El-Bayoumi, MD⁵, Chavon Onumah, MD, MEd, MPH⁶, Marie L. Borum, MD, EdD, MPH^7
1George Washington University, Washington, DC; ²George Washington University School of Medicine and Health Sciences, Washington, DC; ³George Washington Medical Faculty Associates, Ashburn, VA; ⁴George Washington University Hospital, Washington, DC; ⁵Georgetown University School of Medicine, Washington, DC; ⁶George Washington School of Medicine and Health Sciences, Washington, DC; ⁷George Washington University Medical Center, Washington, DC

Introduction: African-Americans (AA) have the highest rate of colorectal cancer (CRC) deaths. Adherence to CRC screening guidelines can improve outcomes. This study evaluated physician trust and barriers to screening by focus group participants, comparing church member (CM) and health care learners’ (HCL) responses.

Methods: A focus group discussion facilitated by university faculty physicians, included Washington, D.C. church members (CM) and university health care learners (HCL; medical students, post-graduate trainees), evaluated physician trust, CRC screening knowledge and identified CRC screening barriers. Audio recording was transcribed with thematic analysis. A post-focus group survey confirmed barriers to CRC screening identified during the focus group discussion. Statistical analysis comparing CM and HCL responses using Fisher’s Exact test (significant p< 0.05) was performed. The validated Wake Forest Physician Trust Scale (WFPTS) and a colon cancer screening knowledge (CRCSK) survey were administered prior to the focus group.

Results: The focus group of 18 participants (7 AA church members (CM), age range 65-84; 11 non-AA health care learners (HCL); age range 27-36), completed the pre-discussion surveys. The WFPTS found that 83% (86% CM, 82% HCL; p=1.0) strongly agree/agree that their physician would advocate and do what is best for their health. 77% (86% CM, 73% HCL; p=1.0) strongly agree/agree that they have complete trust in their physician. The CRCSK survey revealed that 100% recognized that CRC screening is recommended.

There was a significant difference between CM and HLM perception of racial disparity in health care (CM 57% v HCL 1%; p=0.0474), physician respect toward patients (CM 71% v HCL 1%; p=0.0128) and physician discussions with patients (CM 100% v HCL 1%; p=0.0006) as barriers to screening. There was no significant difference in CM and HCL identification of other screening barriers, including access, insurance coverage, physician trust, time constraints, transportation, bowel prep, CRC awareness and fear of colonoscopy.

Discussion: Recognizing and addressing barriers to CRC screening can improve clinical outcomes. This study identified differences in AA focus group members compared to health care learners’ perceptions of potential screening barriers. Additional research related to disparity in care, physician respect toward patients and providing information to patients may be necessary to improve CRC screening and clinical outcomes in African-Americans.


Disclosures:


Ankit Patel, MD¹, Valeria Martinez Lebron, MD², Ana Pabalan, MD³, Samuel A. Schueler, MD⁴, Jehan El-Bayoumi, MD⁵, Chavon Onumah, MD, MEd, MPH⁶, Marie L. Borum, MD, EdD, MPH⁷. P0364 - African-Americans in Focus Group Compared to Health Care Learners More Frequently Identified Racial Disparity in Care, Physician Respect Toward Patients and Receiving Information as Barriers in Colon Cancer Screening, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.