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The research problem was informed by the fact that despite there being a correlation between early screening, diagnoses, treatment and reduction in mortality incidences related to colorectal cancer and survival rates, most U.S adults are still reluctant to go for such screenings (James, Daley & Greiner, 2011). There was thus need to find out the knowledge and attitude of the target population towards such screenings.

The healthcare administrators are interested in this study since its findings will inform future designs for intervention against colorectal cancer especially through increased screening rates and early diagnoses. This is possible if the barriers are dealt with. Addressing the negative attitude is likely to increase the rate of voluntary screening initiatives and help reduce mortality rates related to colorectal cancer (James et al, 2011).

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The prime purpose of the study was to find out the levels of knowledge, prominent barriers and attitude of the respondents-African Americans aged 45 years and older-towards colorectal cancer screening (James et al, 2011). The research question that guided this study is not expressly indicated.  However, one can deduce the main research question to be as follows: What is the knowledge levels and attitude of African Americans towards screening services for colorectal cancer offered at community health centers that serve low-income and uninsured patients?

One can find the study hypothesis in the article, although it is not stated expressly. For example, from the objective of the study, the various hypotheses can be drawn. These include the hypothesis that negative attitude towards colorectal cancer screening is likely to contribute to the low rates of screening. The study could also be designed based on the hypothesis that low levels of knowledge of colorectal cancer have direct relationship with low rates of screening for the disease. The independent variables in the study include level of knowledge and attitude towards screening for colorectal cancer. The dependent variable was screening for colorectal cancer. These variables guided the study design in almost all its stages.

The conceptual framework or theoretical framework is not expressly identified in the study. The reader of the article has to gather the pieces from the various sections of the study and use this to design the conceptual or theoretical framework of the study.

From literature review, it is possible to justify the need and rationale for the study. For example, the researchers have indicated that only a small proportion of published literature about underserved population exists in relation to screening for colorectal cancer. There is thus need to find out if this vulnerable population have some beliefs, attitudes, and other reasons that hinder their participation in screening activities. Most studies have indicated that 90% of people who attend screening sessions and are diagnosed with colorectal cancer have high chances of living longer than those who are diagnosed in the advanced stages of the disease (James et al, 2011).

The study followed qualitative design. Focus group and semi-structured interviews were conducted. Pre-focus group surveys were conducted as well. Non-probability sampling was used to pick the respondents who suited the criteria. Snow ball sampling, in particular, was used in this study. Data was transcribed, coded according the key thematic areas and analyzed using standard text analysis. The study sampled 52 respondents of different gender, economic status and level of education (James et al, 2011). The study focused mainly on the community health centers that served the uninsured low class African Americans. The community health centers were thus the target organizations for this study. The length of the study is not indicated in the article.

In conclusion, the article is very informative especially in terms of the details it gives about the procedures involved in qualitative research design. It also expounds on the importance of early screening for colorectal cancer and perceived barriers to such screenings.

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