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Alsaad LN, Sreedharan J. Practice of colorectal cancer screening in the United Arab Emirates and factors associated - a cross-sectional study. BMC Public Health 2023; 23:2015. [PMID: 37845665 PMCID: PMC10580662 DOI: 10.1186/s12889-023-16951-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Colorectal cancer is a significant public health concern globally, with high incidence and mortality rates. Despite the implementation of CRC screening guidelines, the uptake of screening among adults in the UAE remains low. This study aimed to assess the practice, factors associated, barriers, and knowledge gaps among adults in the UAE. MATERIALS AND METHODS 2100 residents of the UAE, aged > = 40 years, participated in the study. A validated questionnaire was used to collect data. Data was collected through online platforms and face-to-face interviews in healthcare settings. Chi-Square test and binary logistic regression were used for data analysis. RESULTS The study revealed a low CRC screening rate of 9.1%. Factors analyzed included age groups, health insurance coverage, regular physician checkups, family history of CRC, awareness of CRC, and knowledge levels about CRC and its signs and symptoms. Participants in the 50-59 age group showed a slightly higher likelihood of CRC screening, but the difference was not statistically significant. However, individuals in the 60-69 and > = 70 age groups were more likely to undergo screening. Regular physician checkups, family history of CRC, prior knowledge of CRC, and knowledge about the disease and its signs and symptoms were associated with a higher likelihood of screening, with statistically significant OR. CONCLUSION A low CRC screening rate of 9.1% among adults. Barriers to screening included not being offered a test by physicians, fear of positive results, discomfort with the screening process, perception of pain, and lack of knowledge. Identifying particulate barriers and developing targeted measures requires larger-scale research.
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Keller KG, Toriola AT, Schneider JK. The relationship between cancer fatalism and education. Cancer Causes Control 2021; 32:109-118. [PMID: 33151430 PMCID: PMC8284073 DOI: 10.1007/s10552-020-01363-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 10/24/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Fatalism is defined by feelings of pessimism, hopelessness, and powerlessness regarding cancer outcomes. Early researchers reported associations between race and cancer fatalism. Yet current evidence suggests that social determinants of health are better predictors of cancer fatalism than race. Therefore, the aim of this study was to examine the association between age, race, education, and cancer fatalism. METHODS Three hundred ninety (n = 390) women who attended a screening mammogram at the Joanne Knight Breast Health Center at Siteman Cancer Center at Washington University School of Medicine (St. Louis, MO) completed the Powe Fatalism Inventory (PFI), a 15-item self-report instrument used to operationalize cancer fatalism. We used Pearson's correlation, independent samples t-tests, one-way ANOVA with post hoc tests, and linear regression to analyze the relationships between PFI total scores and age, race, and education. RESULTS There were no differences between the mean PFI scores for Non-Hispanic Whites (1.89, SD 0.55) and African Americans (2.02, SD 0.76, p = 0.092, 95% CI 0.27 to 0.02). We found significant differences between the mean PFI scores across levels of education. Women who attained a high school degree or less (n = 72) reported higher PFI scores (2.24, SD 0.77) than women who attended some college or post-high school vocational training (n = 111; 1.95, SD 0.61) and women with a college or postgraduate degree (n = 206; 1.83, SD 0.57). When PFI score was regressed onto age, race, and education, only education significantly explained fatalism (B = -0.19, p < 0.001). CONCLUSIONS In this study, cancer fatalism did not differ between Non-Hispanic White and African American women attending a screening mammogram. However, lower educational levels were associated with higher cancer fatalism. The previously observed associations between race and cancer fatalism may be explained by racial disparities in social determinants of health, such as education. Importantly, study findings indicate that the people with the greatest need for cancer fatalism interventions are those with lower educational levels.
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Liu D, Schuchard H, Burston B, Yamashita T, Albert S. Interventions to Reduce Healthcare Disparities in Cancer Screening Among Minority Adults: a Systematic Review. J Racial Ethn Health Disparities 2021; 8:107-126. [PMID: 32415578 DOI: 10.1007/s40615-020-00763-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 12/16/2019] [Accepted: 04/14/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Racial minority populations face an increased burden relative to cancer interventions. Compared with Caucasians, the cancer screening rate is substantially lower among African American, Asian American, Latinx American, and American Indian/Alaska Native populations. Barriers such as low health literacy, lack of health insurance, and miscommunication between patients and providers have been identified as important factors that result in low screening rates among minority adults. This study was designed to identify interventions targeting racial minority adults 40 years of age or older that were effective in increasing cancer screening uptake rates. METHODS A systematic review of articles published in and after January 2009 was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Twenty-six published studies of cancer screening intervention tested with minority adults were identified through the searches of CINAHL, Global Health, PsycINFO, PubMed, and Scopus databases. RESULTS Thirteen (50%) of the studies utilized lay community health workers to increase cancer awareness and knowledge and to encourage screening. These methods took place over the telephone, at community education sessions, or within the context of personalized patient navigation support. The intervention programs utilized culturally relevant materials as well as spoken and written information in the targeted population's native language. Various intervention designs resulted in statistically significant increases in cancer screening adherence. However, we found no intervention that consistently elevated cancer screening rates across all racial/ethnic minority adults. CONCLUSIONS The finding suggests that highly segmented interventions are needed in order to improve cancer screening among various racial/ethnic minority adults.
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Affiliation(s)
- Darren Liu
- Department of Public Health, Des Moines University, 3200 Grand Avenue, Des Moines, IA, 50312, USA.
| | - Hayley Schuchard
- College of Osteopathic Medicine, Des Moines University, Des Moines, IA, USA
| | - Betty Burston
- Department of Health Care Administration and Policy, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Takashi Yamashita
- Department of Sociology, Anthropology, and Health Administration and Policy, University of Maryland, Baltimore County, Baltimore, MD, USA
| | - Steven Albert
- Department of Behavioral & Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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Jin SW, Yoon YJ. Barriers and facilitators to colorectal cancer screening among older Korean Americans: A focus group study. SOCIAL WORK IN HEALTH CARE 2020; 59:668-680. [PMID: 33232203 PMCID: PMC7752819 DOI: 10.1080/00981389.2020.1852359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 04/24/2020] [Accepted: 11/12/2020] [Indexed: 06/11/2023]
Abstract
A qualitative study was undertaken to explore the barriers and facilitators to colorectal cancer (CRC) screening among older Korean Americans (KAs). Four focus groups with 25 male and female KA participants and one focus group comprising five KA health professionals were conducted in the Atlanta Metropolitan area. Interpretive analyses of the interview data revealed barriers regarding CRC screening for KAs included a lack of CRC knowledge, embarrassment during the screening tests, CRC-related fatalism, and modesty, no perceived need for the screening, poor English proficiency, and mistrust of the American healthcare system. The results also indicated that doctors' screening recommendations and access to Korean doctors positively influence KAs' decision to participate in CRC screening. Public health social workers should consider integrating age- and gender-specific cultural contexts when developing interventions and programs for CRC screening targeted to older KAs.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis , Memphis, Tennessee, USA
| | - Young Ji Yoon
- School of Social Work, University of Minnesota-Twin Cities , Paul, Minnesota, USA
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Lee SY, Lee EE, Rhee YS, Yang EY, Shin JH, Lee S. Adaptation and validation of the health belief model scale for colorectal cancer screening. Nurs Health Sci 2019; 22:355-363. [PMID: 31625669 DOI: 10.1111/nhs.12656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 12/01/2022]
Abstract
Korea has the second highest incidence of colorectal cancer in the world. Instruments that are culturally and contextually sensitive, as well as valid and reliable, for determining health beliefs regarding colorectal cancer screening are essential for obtaining accurate information. The purpose of this study was to adapt and validate the health belief model scale for Koreans regarding colorectal cancer and fecal occult blood test utilization. Individual and cognitive interviews (also known as cognitive debriefing) with 33 Koreans, expert reviews with seven nursing practitioners and professors, and a pilot test with 18 Koreans were conducted to make the existing health belief model scale culturally and contextually sensitive. Subsequently, a cross-sectional survey with 728 Koreans aged >50 years was conducted. Exploratory and confirmatory factor analyses of the construct validity and internal consistency reliability supported the adapted health belief model scale. The adapted and validated health belief model scale in this study could contribute to the assessment of health beliefs regarding the fecal occult blood test among Koreans with a greater degree of accuracy with respect to Korean culture and context.
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Affiliation(s)
- Shin-Young Lee
- Department of Nursing, Chosun University, Gwangju, Korea
| | - Eunice E Lee
- School of Nursing, University of California, Los Angeles, California, USA
| | - Young Sun Rhee
- Department of Administration and Social welfare, Chosun University, Gwangju, Korea
| | - Eun Young Yang
- Department of Nursing, Chosun University, Gwangju, Korea
| | - Jeong Ha Shin
- Department of Nursing, Chunnam Techno University, Gokseong-gun, Korea
| | - Seonah Lee
- College of Nursing, Chonnam National University, Gwangju, Korea
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Jin SW, Lee Y, Dia DA. Analyzing paths from online health information seeking to colorectal cancer screening using health literacy skills frame and cognitive mediation model. PATIENT EDUCATION AND COUNSELING 2019; 102:416-423. [PMID: 30448041 DOI: 10.1016/j.pec.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/19/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To test the hypothesized paths for Online Health Information Seeking (OHIS) behaviors in developing health literacy, leading to colorectal cancer (CRC) screening among Korean Americans (KAs) using Health Literacy Skills Frameworks (HLSF) and Cognitive Mediation Model (CMM). METHODS A total of 433 KAs aged 50 through 75 in a metropolitan area in the Southeastern U.S. completed a cross-sectional survey regarding sociodemographics, OHIS behaviors, information overload, health literacy, decisional balance, and CRC screening history. Path analyses were implemented to assess the hypothesized causal models by examining the relationships among these variables. RESULTS OHIS was positively associated with information overload and health literacy; information overload was negatively associated with health literacy. Health literacy was positively associated with decisional balance; decisional balance was positively associated with uptake of sigmoidoscopy and colonoscopy. CONCLUSION The findings supported both theoretical frameworks, HLSF and CMM, for OHIS to develop health literacy, leading to CRC screening. These findings highlight the significant roles of information overload and attitudes and beliefs about screening in enhancing health literacy and CRC screening among KAs. PRACTICE IMPLICATIONS Practice efforts for facilitating CRC screening among medically underserved older KAs should target improving access to and use of OHIS and culturally-tailored health information delivery.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis, 226 McCord Hall, Memphis, TN 38152, USA.
| | - Yeonggeul Lee
- Department of Social Welfare, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-gu, Seoul 02504, South Korea.
| | - David A Dia
- School of Social Work, The University of Memphis, 226 McCord Hall, Memphis, TN 38152, USA.
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Lee SY. Factor structure and internal reliability of cultural belief scales about colorectal cancer screening among Koreans in the Republic of Korea. BMC Public Health 2018; 18:1328. [PMID: 30497422 PMCID: PMC6267900 DOI: 10.1186/s12889-018-6240-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 11/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Culturally sensitive, reliable and valid cultural belief scales for colorectal cancer (CRC) screening in Koreans in the Republic of Korea are not available in the literature. The purpose of this study was to adapt and validate existing cultural belief scales for CRC screening in Koreans. METHODS Individual interviews, expert reviews, and a pilot test were conducted for instrument adaptation, and a cross-sectional survey with 884 Koreans was conducted for instrument validation. Construct validity using exploratory and confirmatory factor analyses and reliability of the Korean version of the instruments were examined. RESULTS Exploratory factor analysis using c four factors that accounted for 48.12% of the variance. The validity and reliability of the cultural belief scales were supported by confirmatory factor analysis and Cronbach's alpha. CONCLUSIONS The results of the present study showed that the four-factor cultural belief scales were culturally sensitive, reliable and valid in Koreans. The final cultural belief scales could be used to identify cultural beliefs more accurately and specifically, as well as to develop effective interventions to increase CRC screening in Koreans in the Republic of Korea.
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Affiliation(s)
- Shin-Young Lee
- Department of Nursing at Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-759, Republic of Korea.
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Jin SW, Lee J, Lee S. Analyzing Factors Associated With Decisional Stage of Adoption for Colorectal Cancer Screening Among Older Korean Americans Using Precaution Adoption Process Model. J Transcult Nurs 2018; 30:461-470. [PMID: 30428784 DOI: 10.1177/1043659618811910] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Introduction: For Korean Americans (KAs), colorectal cancer (CRC) screening rates remain lower than the national target. This study aimed to examine factors predicting decisional stage of CRC screening adoption among older KAs using the precaution adoption process model. Method: Convenience sampling was employed to recruit KAs aged 50 to 75 years from the Atlanta metropolitan area in the United States. A total of 433 KAs completed a cross-sectional survey that collects information on sociodemographics, CRC screening history, a physician's recommendation, knowledge, self-efficacy, and decisional balance pertaining CRC screening, and precaution adoption process model stage. Results: Higher scores of decisional balance (odds ratio [OR] = 1.34), having a physician's recommendation (OR = 8.61), and having regular annual medical checkups (OR = 4.44) were significantly associated with higher decisional stage compared with lower stage, controlling for other variables. Discussion: Intervention research should incorporate consideration of individuals' decisional stage to move KAs forward from not engaging the screening to maintaining regular participation in CRC screening.
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Affiliation(s)
| | | | - Sohye Lee
- 1 The University of Memphis, Memphis, TN, USA
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Lee SY. Koreans’ Awareness and Preventive Behaviors Regarding Colorectal Cancer Screening. Asian Pac J Cancer Prev 2018; 19:2657-2664. [PMID: 30256565 PMCID: PMC6249469 DOI: 10.22034/apjcp.2018.19.9.2657] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Koreans in the Republic of Korea had high incidence and mortality rates of colorectal cancer (CRC), late stage of CRC diagnosis, and low CRC screening. The purpose of this study was to gain a more thorough understanding of CRC awareness, preventive behaviors, and preferred strategies to improve CRC screening behaviors among Koreans. Methods: Individual interviews with 33 Koreans aged 50 and older were conducted using semi-structured, open-ended questions. All interview data were recorded and analyzed using direct content analysis. Results: To prevent CRC, all participants focused on primary prevention including healthy lifestyle more than secondary prevention such as screening. Motivators of CRC screening were (a) symptoms, (b) being scared by acquaintances with CRC, (c) being healthy for the family, (d) others’ recommendations, and (f) annual fecal occult blood test (FOBT) in the National Cancer Screening Program. Barriers to CRC screening were (a) no symptom, (b) discomfort on test procedure, (c) lack of knowledge, (d) low perceived risk of developing CRC, (e) mistrust in CRC screening tests or health care providers, (f) fear of CRC diagnosis, (g) embarrassment, and (h) colonoscopy was a follow-up test in the National Cancer Screening Program. Participants suggested preferred strategies using various information delivery methods. Conclusions: This study suggests that we should provide accurate knowledge, emphasize importance of secondary prevention, enhance motivators and decrease barriers, and use multilevel approach incorporating preferred strategies to improve CRC screening behaviors among Koreans.
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Affiliation(s)
- Shin-Young Lee
- Department of Nursing, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-759 Republic of Korea
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10
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Lee SY, Lee EE. Access to Health Care, Beliefs, and Behaviors about Colorectal Cancer Screening among Korean Americans. Asian Pac J Cancer Prev 2018; 19:2021-2027. [PMID: 30051703 PMCID: PMC6165655 DOI: 10.22034/apjcp.2018.19.7.2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/30/2018] [Indexed: 01/25/2023] Open
Abstract
Background: Colorectal cancer (CRC) is one of the most common cancers among Korean Americans (KAs) and their CRC screening rates are low. To raise the rates of CRC screening among KAs, it is necessary to improve our understanding of factors that influence their CRC screening behaviors. This study examined socio-demographics, access to health care, health and cultural beliefs, and behaviors about the fecal occult blood test (FOBT) for CRC screening among KAs aged 50 and older. Methods: Based on the health belief model, the cultural assessment model for health, and the Powe fatalism model, this study measured socio-demographics (age, gender, years in the U.S., marital status, education, employment, income, and acculturation), health care access (health insurance, having a regular doctor, physician recommendation, and trust in doctor), health beliefs (susceptibility, severity, benefits, barriers, and self-efficacy), and cultural beliefs (physical space, health temporal orientation, personal control, and fatalism) and FOBT. A cross-sectional survey (n=202) was conducted. Data analysis was conducted using descriptive analysis, Pearson correlation, and multivariate logistic regression. Results: This study found that physician recommendation was the strongest factor in lifetime FOBT utilization in KAs. The results also revealed a positive association among health temporal orientation, health fatalism, and lifetime FOBT among KAs, while previous research found a negative association between fatalism and cancer screening. Years in the U.S., employment, and having a regular doctor were significantly associated with having had a FOBT in the previous year. Conclusion: Study results suggested the need for public education programs to increase physician recommendation among KAs. Furthermore, the positive relationships among health temporal orientation, health fatalism, and FOBT utilization in KAs suggests that KAs have a desire to maintain health and find cancer early despite their fatalistic view on health.
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Affiliation(s)
- Shin Young Lee
- Department of Nursing, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-759 Republic of Korea.
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11
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Instrument Adaptation, Modification, and Validation for Cultural Beliefs About Colorectal Cancer Screening Among Korean Americans. Cancer Nurs 2018; 41:E38-E48. [DOI: 10.1097/ncc.0000000000000523] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tran MT, Jeong MB, Nguyen VV, Sharp MT, Yu EP, Yu F, Tong EK, Kagawa-Singer M, Cuaresma CF, Sy AU, Tsoh JY, Gildengorin GL, Stewart SL, Nguyen TT. Colorectal cancer beliefs, knowledge, and screening among Filipino, Hmong, and Korean Americans. Cancer 2018; 124 Suppl 7:1552-1559. [PMID: 29578600 PMCID: PMC5875724 DOI: 10.1002/cncr.31216] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/22/2017] [Accepted: 12/13/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND To the authors' knowledge, there are few studies to date regarding colorectal cancer (CRC) beliefs, knowledge, and screening among multiple Asian American populations, who are reported to have lower CRC screening rates compared with white individuals. The current study was performed to assess knowledge and beliefs regarding the causes of CRC, its prevention, and factors associated with CRC screening among 3 Asian American groups. METHODS The authors conducted an in-language survey with Filipino (Honolulu, Hawaii), Hmong (Sacramento, California), and Korean (Los Angeles, California) Americans aged 50 to 75 years who were sampled through social networks. Bivariate and multivariable analyses were conducted to assess factors associated with CRC screening. RESULTS The sample of 981 participants was 78.3% female and 73.8% reported limited proficiency in English. Few of the participants were aware that age (17.7%) or family history (36.3%) were risk factors for CRC; 6.2% believed fate caused CRC. Only 46.4% of participants knew that screening prevented CRC (74.3% of Filipino, 10.6% of Hmong, and 55.8% of Korean participants; P<.001). Approximately two-thirds of participants reported ever having undergone CRC screening (76.0% of Filipino, 72.0% of Hmong, and 51.4% of Korean participants; P<.001) and 48.6% were up to date for screening (62.2% of Filipino, 43.8% of Hmong, and 41.4% of Korean participants; P<.001). Factors found to be significantly associated with ever screening were being Korean (compared with Filipino), having a family history of CRC, having health insurance or a regular source of health care, and knowing that a fatty diet caused CRC. Believing that fate caused CRC and that praying prevented it were found to be negatively associated with ever screening. Factors associated with being up to date for CRC screening included being born in the United States, having a family history of CRC, and having access to health care. CONCLUSIONS Knowledge regarding the causes of CRC and its prevention among Filipino, Hmong, and Korean individuals is low. However, health care access, not knowledge or beliefs, was found to be a key determinant of CRC screening. Cancer 2018;124:1552-9. © 2018 American Cancer Society.
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Affiliation(s)
- Mi T Tran
- Division of General Internal Medicine, University of California at San Francisco, San Francisco, California
| | - Matthew B Jeong
- Division of General Internal Medicine, University of California at San Francisco, San Francisco, California
| | - Vickie V Nguyen
- Division of General Internal Medicine, University of California at San Francisco, San Francisco, California
| | - Michael T Sharp
- Division of General Internal Medicine, University of California at San Francisco, San Francisco, California
| | - Edgar P Yu
- Division of General Internal Medicine, University of California at San Francisco, San Francisco, California
| | - Filmer Yu
- Division of General Internal Medicine, University of California at San Francisco, San Francisco, California
| | - Elisa K Tong
- Department of General Internal Medicine, University of California at Davis, Davis, California
| | - Marjorie Kagawa-Singer
- Department of Community Health Sciences, Los Angeles Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California
| | - Charlene F Cuaresma
- Department of Public Health, University of Hawai'i at Manoa, Honolulu, Hawaii
| | - Angela U Sy
- Department of Public Health, University of Hawai'i at Manoa, Honolulu, Hawaii
| | - Janice Y Tsoh
- Department of Psychiatry, University of California at San Francisco, San Francisco, California
| | - Ginny L Gildengorin
- Division of General Internal Medicine, University of California at San Francisco, San Francisco, California
| | - Susan L Stewart
- Department of Public Health Sciences, University of California at Davis, Davis, California
| | - Tung T Nguyen
- Division of General Internal Medicine, University of California at San Francisco, San Francisco, California
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Lee SY, Lee EE. Cancer screening in Koreans: a focus group approach. BMC Public Health 2018; 18:254. [PMID: 29444640 PMCID: PMC5813376 DOI: 10.1186/s12889-018-5147-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 02/02/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Cancer is the greatest disease burden in Korea. Cancer screening can reduce the burden of cancer but cancer screening rates among Koreans remain low. The purposes of this study were to a) understand Koreans' beliefs and knowledge about cancer screening, and b) explore preferred strategies for increasing cancer screening utilization. METHODS We conducted a descriptive, qualitative study using eight face-to-face focus groups with a total of 64 Koreans aged 40 and over. Participants answered semi-structured, open-ended questions assessing their experiences with, and beliefs, knowledge, and opinions about, cancer screening. All interview data were recorded and analyzed in the context of the health belief model (HBM). RESULTS The most important themes that emerged from the focus group data were (a) perceived susceptibility (most of the participants believed they were not susceptible to cancer; those who perceived themselves susceptible to cancer were reluctant to express it); (b) perceived benefits (early detection and feelings of relief after cancer screening were benefits; participants had screening because they wanted to take advantage of the Korean government's Medical Payment Support program for cancer patients who have participated in the National Cancer Screening program); (c) perceived barriers (no symptoms; self-care when having symptoms; widespread distrust of tests, doctors, and hospitals; unkind health care providers; the financial burdens of advanced cancer screening tests; and the discomfort during cancer screening); and (d) knowledge of the causes of cancer (incorrect knowledge including beliefs that stress, personality, and body overuse cause cancer). Almost all of the participants were very knowledgeable about the seriousness of cancer and were confident that they were able to have cancer screening. Participants preferred strategies of cancer screening using group interventions with family or friends; various information delivery methods; information emphasizing the importance of cancer prevention; convenient, free, or inexpensive services; and kind health care providers. CONCLUSIONS This HBM-based research suggests that beliefs in low susceptibility to cancer, many barriers to cancer screening, and incorrect knowledge should be the foci for increasing cancer screening rates in Koreans. Interventions could change individual cultural beliefs and increase knowledge as well as the quality of health care for Koreans.
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Affiliation(s)
- Shin-Young Lee
- Department of Nursing, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-759 Republic of Korea
| | - Eunice E. Lee
- School of Nursing, University of California, Los Angeles, CA USA
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Bulduk S, Dinçer Y, Usta E. Identification of Colorectal Cancer Risks of Individuals Aged over Fifty and Their Beliefs towards Having Fecal Occult Blood Test. KONURALP TIP DERGISI 2017. [DOI: 10.18521/ktd.306651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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15
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Cultural Factors relevant to Korean Americans in Health Research: A Systematic Review. J Community Health 2017; 43:421-432. [PMID: 28905156 DOI: 10.1007/s10900-017-0418-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To eliminate health disparities in the United States, identifying cultural contexts salient to the target populations in an intervention study is critical; however, little research has been conducted on the identification of cultural contexts among Korean Americans who have significant risk factors for chronic diseases. This systematic review identifies critical cultural contexts central to the literature discussed in health research on Korean Americans. We examined 14 research reports of 801 potentially eligible articles published between 2000 and 2016 and analyzed their contribution to cultural contexts among Korean Americans based on the PEN-3 model. This review highlights how cultural contexts impact health and health behaviors of Korean Americans, and may contribute to health disparities in the United States. The key cultural contexts highlighted in this review include social support/social network, family, gender role expectations, and a holistic view of health and illness. These cultural contexts should be incorporated in designing culturally relevant, effective, and sustainable health interventions for Korean Americans, which will contribute to eliminating health disparities for this ethnic group who experience great obstacles to healthcare access and healthy behaviors.
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Wu TY, Park Y. Demographic Predictors and Cancer Screening Among Asian Americans in Michigan: Role of Refugee Status. J Racial Ethn Health Disparities 2017. [PMID: 28643271 DOI: 10.1007/s40615-017-0397-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Although the Asian American population has steadily increased since 1980s, there remains a paucity of literature on cancer screening utilization on this population. The purpose of this study was to evaluate preventive health and screening practices by examining demographic predictors of health and screening behaviors among 217 Asian Americans living in state of Michigan. Several demographic and acculturation-related factors were found to be associated with "ever screened" status in the bivariate analyses. This included the examination of the relationships among refugee status and cancer screening practices among Asian Americans. After adjusting for other demographic correlates, Asian Americans in the refugee group had lower screening rates in colorectal and breast cancer. Our findings emphasize the need for effective interventions to increase cancer screening rates in this vulnerable population.
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Affiliation(s)
- Tsu-Yin Wu
- Eastern Michigan University School of Nursing, 311 Everett L. Marshall Building, Ypsilanti, MI, 48197, USA.
| | - Yeyun Park
- University of Michigan, Literature, Science and Arts, Ann Arbor, MI, USA
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Lee SY. Cultural Factors Associated with Breast and Cervical Cancer Screening in Korean American Women in the US: An Integrative Literature Review. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:81-90. [PMID: 26160234 DOI: 10.1016/j.anr.2015.05.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 11/16/2022] Open
Abstract
PURPOSE This study examined current research theories and methods, cultural factors, and culturally relevant interventions associated with breast and cervical cancer screening in Korean American (KA) women. METHODS Based on Ganong's guidelines, the literature on cultural factors associated with breast and cervical cancer screening in KA women was searched using MEDLINE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Sixty-eight articles on breast cancer screening and 66 articles on cervical cancer screening were retrieved from both databases, and a total of 22 articles were included in the literature review based on the selection criteria. RESULTS Of the 22 studies reviewed, 14 (63.6%) were descriptive and 8 (36.4%) were interventional. Many studies have used individual focused cognitive theories such as health belief model and different types of operationalization for measures of cultural beliefs. Cultural factors associated with breast and cervical cancer screening in KA women that were identified in descriptive quantitative and qualitative studies included family, embarrassment, preventive health orientation, fatalism, and acculturation. Most culturally relevant interventional studies used education programs, and all education was conducted by bilingual and bicultural health educators at sociocultural sites for KA women. CONCLUSIONS Theories focusing on interpersonal relationships and standardized, reliable, and valid instruments to measure cultural concepts are needed to breast and cervical cancer screening research in KA women. Traditional cultural factors associated with cancer screening should be considered for practical implications and future research with KA women.
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Affiliation(s)
- Shin-Young Lee
- Department of Nursing, Chosun University, Gwangju, South Korea.
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18
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Lee SY, Lee EE. Cross-cultural Validation of Instruments Measuring Health Beliefs about Colorectal Cancer Screening among Korean Americans. J Korean Acad Nurs 2015; 45:129. [DOI: 10.4040/jkan.2015.45.1.129] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 09/24/2014] [Accepted: 11/20/2014] [Indexed: 08/30/2023]
Affiliation(s)
- Shin-Young Lee
- Department of Nursing, Chosun University, Gwangju, Korea
| | - Eunice E. Lee
- School of Nursing, University of California, Los Angeles, LA, USA
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19
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Oh PJ, Jang ES. Effects of Psychosocial Interventions on Cortisol and Immune Parameters in Patients with Cancer: A Meta-analysis. J Korean Acad Nurs 2014; 44:446-57. [DOI: 10.4040/jkan.2014.44.4.446] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Pok Ja Oh
- Department of Nursing, Sahmyook University, Seoul, Korea
| | - Eun-su Jang
- Department of Nursing, Graduate School, Sahmyook University, Seoul, Korea
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