Term of Award

Summer 2014

Degree Name

Doctor of Public Health in Public Health Leadership (Dr.P.H.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)


Jiann-Ping Hsu College of Public Health

Committee Chair

Gerald Ledlow

Committee Member 1

Gulzar Shah

Committee Member 2

Hani Samawi


Background: The findings from previous studies on the socio-demographic and socio-economic factors associated with non-adherence to Colorectal Cancer Screening (CRCS) in populations of health disparities are inconsistent, and few studies have utilized an integrative approach to deliver a CRCS intervention to at-risk adults. Methods: A cross-sectional study was conducted using data from the 2009-2010 Southeast Georgia Cancer Alliance Integrative project survey to describe the rates of negative patient deviation (non-adherence) to CRCS. Results: Almost 70% of at-risk adult participants were non-adherent to CRCS. Participants under 45 years of age were 1.8 times as likely to report a negative deviation compared to participants 45 years of age and older. Males were 1.7 times as likely to be non-adherent to CRCS compared to females. Obese participants were 7.8 times as likely to be non-adherent to CRCS compared to underweight, normal weight and overweight participants. A strong correlation existed between county of residence and negative deviation to CRCS. The results of the study support that age, gender, BMI and county of residence were significant factors that showed strong associations to non-adherence to CRCS. Conclusion: The findings suggest, understanding the relationships that exist between non-adherence to CRCS and factors that determine health outcomes are essential to reducing the mortality and morbidity of CRC.

INDEX WORDS: Colorectal Cancer Screening, Colorectal Cancer, Non-adherence, Negative Patient Deviation, Southeast Georgia Cancer Alliance Integrative project, Populations/groups of health disparity, Colorectal Cancer prevention, Colonoscopy and FOBT