Graduation Year


Document Type




Degree Granting Department

Community and Family Health

Major Professor

Julie A. Baldwin, Ph.D.

Co-Major Professor

Carol Bryant, Ph.D.

Committee Member

Martha L. Coulter, Dr.P.H.

Committee Member

Clement K. Gwede, Ph.D.

Committee Member

H. Roy Kaplan, Ph.D.


African Americans, colorectal cancer, disease disclosure, family secrets, social support


Colorectal cancer (CRC) is the second leading cancer killer in the United States and the third most common cancer in African American men and women. Though the overall death rates have declined, this reduction in mortality is smaller for African Americans than for Whites. Factors that are protective against colorectal cancer include occupational or recreational physical activity, a diet high in fruits and vegetables, and colorectal cancer screening with removal of polyps (polypectomy) before they progress to cancer. Compliance with CRC screening recommendations requires people to know if a first-degree relative (parent, sibling, and child) or second-degree relative (aunt, uncle, niece, nephew, and grandparent) has been diagnosed with colorectal cancer. Little is known about how patients disclose this information to their relatives and what type of information is disclosed when disclosure takes place. The role of the family has long been overlooked in research on African American health screening behavior despite the fact that family interventions have been known to produce favorable outcomes in diet, nutrition, and exercise. This qualitative study explored the disclosure process among African American colorectal cancer survivors and FDRs with whom they shared their diagnosis. Of special interest was the role of social support in the disclosure process and the criteria used to decide which relatives to tell. Findings from this study will be used to advance the knowledge about the dynamics of CRC disclosure to first-degree relatives in African American families and ultimately increase CRC screening in relatives.