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The Gerontologist 46:545-550 (2006)
© 2006 The Gerontological Society of America

Enhancing Adherence Among Older African American Men Enrolled in a Longitudinal Cancer Screening Trial

Marvella E. Ford, PhD1,, Suzanne Havstad, MA2, Sally W. Vernon, PhD3, Shawna D. Davis, MA4, David Kroll4, Lois Lamerato, PhD5 and G. Marie Swanson, PhD6

Correspondence: Address correspondence to Dr. Marvella E. Ford, Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, 135 Cannon Street, Suite 303, P.O. Box 250835, Charleston, SC 29425. E-mail: fordmar{at}musc.edu

Purpose: The purpose of this study was to enhance adherence among older (aged 55 years and older) African American men enrolled in a cancer screening trial for prostate, lung, and colorectal cancer. For this study, we defined adherence as completing the trial screenings. Design and Methods: We used a randomized trial design. Case managers contacted intervention group participants (n = 352) at least monthly by telephone and provided information and referral services. The control group included 351 participants. Results: Among participants with low income, those in the intervention group had higher screening adherence rates than did participants in the control group for (a) prostate-specific antigen test for prostate cancer (74.3% vs 53.0%, p =.001), (b) digital rectal exam for prostate cancer (66.2% vs 46.1%, p =.011), and (c) chest x-ray for lung cancer (70.9% vs 51.3%, p =.012). We found no statistically significant differences in adherence rates for flexible sigmoidoscopy screening for colorectal cancer. In contrast, among participants with moderate-to-high income, we found no statistically significant differences in adherence rates between intervention and control group participants for any of the screening tests. Implications: The case management intervention was effective in enhancing adherence among participants with the lowest income, who in many studies are the most difficult to retain.

Key Words: Case management • Cancer screening • African American men






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