# Colorectal screening fear-reduction and racially-targeted norm messaging entreaties to increase colorectal cancer screening rates among African Americans

> **NIH NIH R21** · WAYNE STATE UNIVERSITY · 2021 · $20,005

## Abstract

Summary Abstract
 Colorectal cancer (CRC) is one of the leading causes of cancer mortality in the United States, and African
Americans (AfAms) still fare worse in CRC incidence and mortality compared to European Americans
(EuAms).Interventions to increase CRC screening rates among AfAms are instrumental to address the
disparities in CRC incidence and mortality. Despite literature indicating that AfAms’ fears (e.g., of colonoscopy
procedures or cancer diagnosis) serve as barriers to CRC screening, no interventions have used theory-guided
methods to directly target fear-based beliefs. Additionally, no research has examined the extent to which racial
identity moderates the effects of racially targeted messaging, despite the ubiquity of using targeted health
messaging entreaties among minority groups. This is particularly relevant given our work showing that racially-
targeted screening entreaties increased CRC screening intentions among AfAms who identified less strongly,
but depressed those intentions among AfAms who identified more strongly with their racial group. Lack of
focus on other salient CRC screening barriers may have been off-putting to highly identified African Americans.
We propose to examine whether combining both fear-reduction and racially-targeted norm-based messages
will increase at-home stool-based CRC screening receptivity and uptake for all African American regardless of
level of racial identity. Given low return rates of at-home screening kits, we will also explore whether making an
explicit commitment to return screening kits is associated with increased kit returns.
 Aim 1: To develop and refine a fear-reduction intervention guided by the theory of planned behavior and by
published literature, in conjunction with AfAm community experts.
 Aim 2: To examine whether the fear-reduction entreaty increases receptivity to, and uptake of at-home
CRC screening when coupled with racially-targeted norm-based messages.
 Aim 3: To examine the moderating roles of racial identity and perceived CRC risk on the effects of fear-
reduction and racially-targeted norm-based messaging entreaties.
 Aim 4: We will explore whether participants who make explicit commitments to return FIT Kits return them
at a higher rate compared to those who do not make such commitments.
 This proposed study is significant because it directly addresses documented CRC screening deficits
among an underserved population, and is innovative given its design of a theory-based and literature
informed intervention to address previously unaddressed barriers to CRC screening among AfAms.

## Key facts

- **NIH application ID:** 10288102
- **Project number:** 1R21MD016506-01
- **Recipient organization:** WAYNE STATE UNIVERSITY
- **Principal Investigator:** MARK A MANNING
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $20,005
- **Award type:** 1
- **Project period:** 2021-09-25 → 2021-09-26

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10288102

## Citation

> US National Institutes of Health, RePORTER application 10288102, Colorectal screening fear-reduction and racially-targeted norm messaging entreaties to increase colorectal cancer screening rates among African Americans (1R21MD016506-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10288102. Licensed CC0.

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