Date of Conferral





Public Health


Weng-Hung Kuo


Screening plays an essential role in reducing colorectal cancer (CRC) incidence and mortality rates, yet CRC screening use remains low in Maryland and lower in some age and racial/ethnic groups with limited resources to participate in CRC screening programs. The purpose of this quantitative, cross-sectional study is to investigate whether age group, sex, race/ethnicity, education level, income level, health insurance coverage, and access to health care professional can predict an individual, 50–75 years of age, in Maryland to take action to fully meet the United States Preventive Services Task Force CRC screening test recommendation within the recommended time interval. The health belief model and the fundamental cause theory provided the framework for this study. Secondary data of 2014, 2016, and 2018, from 3134 respondents in the Behavioral Risk Factor Surveillance Systems database, were analyzed using the Pearson chi-square test of independence and multiple logistic regression techniques. Stratified random sampling was used to select cases. The results revealed statistically significant (p < .05) association between age, race/ethnicity, education level, access to health care professional, and CRC screening use. However, non-significant (p >.05) association was found between income level, health insurance plan, and CRC screening use. Age group and race/ethnicity were confounders on the association, but sex had no effect on the odds ratios. By identifying the predictors of CRC screening use, findings from this research could have positive social change and guide policy decisions by informing public health practitioners on the design and implementation of tailored CRC screening programs with modalities that target groups with lower CRC screening use.