Date of Award
Spring 2026
Document Type
Open Access Dissertation
Department
College of Nursing
First Advisor
Karen K. McDonnell
Abstract
Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality in the United States despite the availability of effective screening. Persistent disparities in screening participation exist among immigrant populations, particularly those from Eastern Europe and the former Soviet Union (FSU), who experience delayed diagnosis and elevated cancer mortality. Russian-speaking immigrants represent an understudied population whose preventive health behaviors are shaped by legacies of paternalistic healthcare systems, limited emphasis on prevention, linguistic barriers, and enduring mistrust of medical institutions. In Upstate South Carolina—where CRC incidence and late-stage diagnosis rates exceed state and national averages—understanding screening behaviors within this growing community is critical.
This multi-method dissertation examined individual, cultural, relational, and structural determinants of CRC screening among Russian-speaking immigrants residing in Upstate South Carolina. Guided by the Health Belief Model and Social Cognitive Theory, the program of research included a scoping review of cancer screening literature among Eastern European immigrants, a cross-sectional survey (N = 167) assessing correlates of CRC-related health beliefs, and qualitative semi-structured interviews (n = 41) analyzed using reflexive thematic analysis.
Quantitative findings identified perceived benefits, barriers, and self-efficacy as key modifiable determinants of screening beliefs, with education, marital status, and cultural background influencing perceived barriers and susceptibility. Qualitative findings demonstrated that screening was often understood as conditional and symptom-driven, relational and authority-guided, and shaped by migration-informed mistrust and system navigation challenges. Collectively, evidence across study components indicated that CRC screening behaviors were embedded within relational, cultural, and structural contexts rather than driven by individual risk perception alone.
These findings informed development of the RESTORE Framework (Relational Engagement and System-Trust Oriented Response for Early Screening), a culturally responsive, theory-informed intervention model emphasizing provider-initiated recommendation, bilingual nurse navigation, culturally aligned education, relational reinforcement, and structural access support. This work advances immigrant health equity by offering empirically grounded, culturally responsive strategies to improve CRC screening adherence and contributes to the advancement of nursing science focused on underserved communities.
Rights
© 2026, Vera Bratnichenko
Recommended Citation
Bratnichenko, V.(2026). Colorectal Cancer Screening Beliefs and Practices Among Russian-Speaking Immigrants in the Upstate of South Carolina: A Multi-Method Study Grounded in the Health Belief Model and Informed by Social Cognitive Theory. (Doctoral dissertation). Retrieved from https://scholarcommons.sc.edu/etd/8937