Date of Award

January 2015

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Psychological Sciences

First Advisor

Catherine E Mosher

Committee Member 1

Susan M Rawl

Committee Member 2

David A Haggstrom

Committee Member 3

Kevin L Rand


Colorectal cancer (CRC) is the third most common cancer diagnosed and the third most common cause of cancer deaths among men in the United States. Although CRC screening tests can reduce CRC incidence and mortality, men’s current rates of CRC screening fall below screening objectives. Results from qualitative studies have suggested masculinity to be a potential barrier to CRC screening as some men may find endoscopic screening procedures to breach masculinity norms. In prior studies, masculinity beliefs have been associated with preventive health behaviors as well as risk behaviors among men. However, to the author’s knowledge, no other quantitative studies have examined the relationship between masculinity and CRC screening adherence. The current study aimed to understand the relationship between three aspects of masculinity (i.e., self-reliance, risk-taking, and heterosexual self-presentation), health beliefs, participant characteristics, and CRC screening adherence. It was hypothesized that the three aspects of masculinity would be inversely associated with CRC screening adherence. Data were collected from 350 men aged 51-75 at average risk for CRC who were accessing primary care services at a Veterans Affairs Medical Center. Of the 350 consenting individuals, data from 327 participants were included in study analyses. Of those 327 participants, 213 individuals were adherent to CRC screening guidelines and the remaining 114 were non-adherent. Correlational and logistic regression analyses were utilized to examine associations between aspects of masculinity and CRC screening adherence. Conditional process analyses were used to examine whether health belief variables (i.e., trust in physician and cancer fear) mediated the relationships between certain aspects of masculinity and CRC screening adherence. Next, participant characteristics (i.e., race, age, and length of relationship between the patient and his primary care provider) were examined as potential moderators of certain relationships in the models utilizing conditional process analyses. In addition, a hierarchical logistic regression analysis was utilized to examine whether the three aspects of masculinity predicted CRC screening adherence above and beyond the predictive value of variables that have predicted CRC screening adherence in prior studies (i.e., race, age, education, physician recommending CRC screening, and family/friend recommending CRC screening). Furthermore, logistic regression analyses were used to examine the extent to which the three aspects of masculinity predicted the receipt of stool blood testing and endoscopic screening. Results suggested that none of the three masculinity variables were significantly associated with CRC screening adherence. In addition, health beliefs did not mediate the proposed relationships between aspects of masculinity and CRC screening adherence, and participant characteristics did not moderate relations between certain mediators and outcome variables. Potential explanations for study results and future directions are discussed. Prospective and longitudinal research studies that recruit participants from diverse backgrounds are required to better understand relationships among study variables.