The colorectal cancer (CRC) mortality rate among African Americans is 45% higher than Caucasians and CRC screening rates among African Americans are lower than Caucasians (American Cancer Society, 2008). Informed decision-making may be a strategy to decreasing CRC disparities among African Americans. This study examined relationships between cultural identity, family support and influence, CRC beliefs, gender and an informed decision regarding CRC screening among older African Americans (N=129). Bivariate correlations indicated that perceived family support and CRC beliefs were related to making an informed decision regarding CRC screening (r=.24, p<.01; r=.29, p<.01, respectively). Path analysis indicated that CRC beliefs explained 9% of the variance in an informed decision and cultural identity, family support and influence explained 36% of the variance in CRC beliefs. The path analysis of the overall model did not fit the data well.

Gender differences among African American men and women were examined through bivariate correlations, t-tests and path analyses. Bivariate correlations indicated that among men, CRC and racial pride were related to an informed decision regarding CRC screening (r=.320, p=.006; r=.330, p=.005, respectively). Family support was related to CRC beliefs among men (r=.599; p=.000) and women (r=.447; p=.000). T-tests indicated that men were different than women in responses to certain cultural identity factors, CRC beliefs and family support (p=.05). Path analyses indicated that the gender covariate and male models did not fit the data well. However, the female model fit the data well (X²=5.10, 6df, p=.531, N=65, NFI=.905, CFI=1.00, RMSEA=.000). Explained variance for an informed decision was 6% for the female model and 10% for the gender covariate and male models.

Based on study results, older African Americans should be assessed for certain cultural factors, CRC beliefs and family support to increase informed decision making. Assessments and interventions should consider gender differences. Additional research is needed to understand the influences, supports and predictors of an informed decision to create efficacious CRC interventions and decision aids tailored for African Americans.