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Hua J, Jackson K. A Systematic Review of Interventions to Promote Cervical Cancer Screening among Immigrant Vietnamese Women. J Community Health 2024:10.1007/s10900-024-01395-w. [PMID: 39187725 DOI: 10.1007/s10900-024-01395-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 08/28/2024]
Abstract
Vietnamese women have a higher incidence rate of cervical cancer and are less likely to have ever been screened for cervical cancer than their White counterparts in the US. This review synthesizes findings from published interventions to promote cervical cancer screening in this vulnerable population. Articles were identified through a systematic search of PsycInfo, Embase, Pubmed, Web of Science, and the Cochrane Register of Controlled Trials in October 2022. Articles were included if they were published in a peer-reviewed journal, written in English, included one or more interventions promoting cervical cancer screening, assessed at least one outcome relevant to screening, and included a sample of ≥ 70% Vietnamese participants. Quality assessment scores were computed using the Downs and Black Checklist. Fifteen articles met review inclusion criteria. Studies were, on average, of good quality. Most studies were conducted in the US (n = 12), used a quasi-experimental design (n = 9), and employed multiple intervention strategies (n = 12). Intervention strategies included educational sessions, lay health worker (LHW) outreach, small media, mass media, patient navigation, and community or healthcare-based strategies. The most common study outcomes were screening intention and receipt. All but two studies reported improved cervical cancer screening outcomes following intervention. Findings support the effectiveness of multicomponent culturally tailored interventions to improve cervical cancer screening outcomes in immigrant Vietnamese women. Further research is needed to determine whether these interventions will be as successful in non-US countries and to address broader community- and healthcare-based factors in screening.
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Affiliation(s)
- Jacqueline Hua
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD, 20850, USA.
- School of Public Health, University of California, Berkeley, CA, USA.
| | - Kristopher Jackson
- Center for AIDS Prevention Studies (CAPS), University of California, San Francisco, CA, USA
- School of Public Health, University of California, Berkeley, CA, USA
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Rauch JI, Daniels J, Robillard A, Joseph RP. Breast Cancer Screening among African Immigrants in the United States: An Integrative Review of Barriers, Facilitators, and Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1004. [PMID: 39200613 PMCID: PMC11353535 DOI: 10.3390/ijerph21081004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 09/02/2024]
Abstract
The purpose of this review was to synthesize the available literature on breast cancer-screening barriers, facilitators, and interventions among U.S. African immigrants. Following the integrative review framework and PRISMA guidelines for reporting systemic reviews, five electronic databases were searched: PubMed, CINAHL, PsycINFO, Medline, and Google Scholar. Studies were included if they were published in English language journals after 1 January 2000 and reported data on breast cancer-screening barriers, facilitators, or interventions among U.S. African immigrants. Barriers and facilitators reported by studies were descriptively examined and synthesized by two authors and classified as aligning with one of the three levels of influences based on the social-ecological model (intrapersonal, interpersonal, and community). Interventions promoting breast cancer screening were narratively summarized. Search procedures retrieved 1011 articles, with 12 meeting the criteria for inclusion in the review (6 qualitative and 6 quantitative). Intrapersonal barriers included limited awareness, fear of pain, language barriers, health concerns, transportation issues, costs, and negative past experiences. Interpersonal barriers involved modesty, spiritual beliefs, and lack of support, while community-level barriers included provider and healthcare-system challenges. Regarding facilitators, past screening experiences and health insurance were the most commonly reported intrapersonal facilitators. The only interpersonal facilitator identified was observing other women experience a breast cancer diagnosis and undergo treatment. Community-level facilitators included appointment reminders, scheduling assistance, culturally congruent interpreters, transportation to screening facilities, and patient navigators. Three articles reported outcomes of breast cancer-screening interventions. All three were pilot studies and reported increased knowledge and attitudes regarding breast cancer screening following the respective interventions. One study examined the uptake of breast cancer screening following the intervention, with results indicating an increase in screening. Findings provide a comprehensive synthesis of factors influencing breast cancer screening among African immigrants and highlight the need for future research on the topic. This review was registered with Prospero (CRD42024502826) before the initiation of search procedures.
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Affiliation(s)
- Julian I. Rauch
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St., Phoenix, AZ 85004, USA (R.P.J.)
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Sun J, Frick KD, Liang H, Chow CM, Aronowitz S, Shi L. Examining cancer screening disparities by race/ethnicity and insurance groups: A comparison of 2008 and 2018 National Health Interview Survey (NHIS) data in the United States. PLoS One 2024; 19:e0290105. [PMID: 38416784 PMCID: PMC10901319 DOI: 10.1371/journal.pone.0290105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/01/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Pervasive differences in cancer screening among race/ethnicity and insurance groups presents a challenge to achieving equitable healthcare access and health outcomes. However, the change in the magnitude of cancer screening disparities over time has not been thoroughly examined using recent public health survey data. METHODS A retrospective cross-sectional analysis of the 2008 and 2018 National Health Interview Survey (NHIS) database focused on breast, cervical, and colorectal cancer screening rates among race/ethnicity and insurance groups. Multivariable logistic regression models were used to assess the relationship between cancer screening rates, race/ethnicity, and insurance coverage, and to quantify the changes in disparities in 2008 and 2018, adjusting for potential confounders. RESULTS Colorectal cancer screening rates increased for all groups, but cervical and mammogram rates remained stagnant for specific groups. Non-Hispanic Asians continued to report consistently lower odds of receiving cervical tests (OR: 0.42, 95% CI: 0.32-0.55, p<0.001) and colorectal cancer screening (OR: 0.55, 95% CI: 0.42-0.72, p<0.001) compared to non-Hispanic Whites in 2018, despite significant improvements since 2008. Non-Hispanic Blacks continued to report higher odds of recent cervical cancer screening (OR: 1.98, 95% CI: 1.47-2.68, p<0.001) and mammograms (OR: 1.32, 95% CI: 1.02-1.71, p<0.05) than non-Hispanic Whites in 2018, consistent with higher odds observed in 2008. Hispanic individuals reported improved colorectal cancer screening over time, with no significant difference compared to non-Hispanics Whites in 2018, despite reporting lower odds in 2008. The uninsured status was associated with significantly lower odds of cancer screening than private insurance for all three cancers in 2008 and 2018. CONCLUSION Despite an overall increase in breast and colorectal cancer screening rates between 2008 and 2018, persistent racial/ethnic and insurance disparities exist among race/ethnicity and insurance groups. These findings highlight the importance of addressing underlying factors contributing to disparities among underserved populations and developing corresponding interventions.
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Affiliation(s)
- Jingjing Sun
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Kevin D Frick
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
- Carey Business School, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Hailun Liang
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
- School of Administration and Policy, Renmin University of China, Beijing, China
| | - Clifton M Chow
- Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sofia Aronowitz
- Independent Researcher, Albany, New York, United States of America
| | - Leiyu Shi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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Kue J, Tate J, Szalacha LA, Menon U. A randomized controlled trial of a tailored navigation intervention to promote breast and cervical cancer screening among intergenerational Southeast Asian women. Contemp Clin Trials Commun 2024; 37:101248. [PMID: 38234710 PMCID: PMC10792624 DOI: 10.1016/j.conctc.2023.101248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 12/03/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024] Open
Abstract
Background Cancer is the leading cause of death for Southeast Asian women in the U.S. Southeast Asian women have significantly high rates of breast and cervical cancers, yet are least likely to obtain regular mammography and Pap testing of all racial/ethnic groups in the U.S. Objectives The purpose of this study is to compare a tailored navigation intervention delivered by bilingual and bicultural Community Health Advisors to information and reminder only to increase age-appropriate breast and cervical cancer screening completion among Southeast Asian women. Methods The Southeast Asian Women's Health Project study will enroll 232 Cambodian, Filipino, Lao, and Vietnamese women who are not up to date with their breast and cervical cancer screenings. Women randomized to navigation will receive the intervention for 10 weeks. Women in the information group will be mailed information on mammography and Pap testing only. All participants will be contacted post-enrollment to assess screening completion. Discussion We will examine intervention efficacy, predictors of each intervention group, and the influence of intergenerational exchange of breast and cervical cancer screening information between mothers and daughters. We will disseminate study results locally to the community, nationally at conferences, and through peer-reviewed journals.
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Affiliation(s)
- Jennifer Kue
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Judith Tate
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Laura A. Szalacha
- College of Nursing, University of South Florida, Tampa, FL, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Usha Menon
- College of Nursing, University of South Florida, Tampa, FL, USA
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Khan MMM, Waqar U, Munir MM, Woldesenbet S, Mavani P, Endo Y, Katayama E, Rawicz-Pruszyński K, Agnese DM, Obeng-Gyasi S, Pawlik TM. Disparities in Breast Cancer Screening Rates Among Adults With and Without Intellectual and Developmental Disabilities. Ann Surg Oncol 2024; 31:911-919. [PMID: 37857986 DOI: 10.1245/s10434-023-14425-z] [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: 06/22/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Individuals with intellectual and developmental disabilities may face barriers in accessing healthcare, including cancer screening and detection services. We sought to assess the association of intellectual and developmental disabilities (IDD) with breast cancer screening rates. METHODS Data from 2018 to 2020 was used to identify screening-eligible individuals from Medicare Standard Analytic Files. Adults aged 65-79 years who did not have a previous diagnosis of breast cancer were included. Multivariable regression was used to analyze the differences in breast cancer screening rates among individuals with and without IDD. RESULTS Among 9,383,349 Medicare beneficiaries, 11,265 (0.1%) individuals met the criteria for IDD. Of note, individuals with IDD were more likely to be non-Hispanic White (90.5% vs. 87.3%), have a Charlson Comorbidity Index score ≤ 2 (66.2% vs. 85.5%), and reside in a low social vulnerability index neighborhood (35.7% vs. 34.4%). IDD was associated with reduced odds of undergoing breast cancer screening (odds ratio (OR) 0.77, 95% confidence interval (CI) 0.74-0.80; p < 0.001). Breast cancer screening rates in individuals with IDD were further influenced by social vulnerability and belonging to a racial/ethnic minority. CONCLUSIONS Individuals with IDD may face additional barriers to breast cancer screening. The combination of IDD and social vulnerability placed patients at particularly high risk of not being screened for breast cancer.
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Affiliation(s)
- Muhammad Muntazir Mehdi Khan
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Usama Waqar
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Muhammad Musaab Munir
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Selamawit Woldesenbet
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Parit Mavani
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Yutaka Endo
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Erryk Katayama
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Karol Rawicz-Pruszyński
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
| | - Doreen M Agnese
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Samilia Obeng-Gyasi
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Timothy M Pawlik
- Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
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Satagopan JM, Dharamdasani T, Mathur S, Kohler RE, Bandera EV, Kinney AY. Experiences and lessons learned from community-engaged recruitment for the South Asian breast cancer study in New Jersey during the COVID-19 pandemic. PLoS One 2023; 18:e0294170. [PMID: 37956167 PMCID: PMC10642833 DOI: 10.1371/journal.pone.0294170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND South Asians are a rapidly growing population in the United States. Breast cancer is a major concern among South Asian American women, who are an understudied population. We established the South Asian Breast Cancer (SABCa) study in New Jersey during early 2020 to gain insights into their breast cancer-related health attitudes. Shortly after we started planning for the study, the COVID-19 disease spread throughout the world. In this paper, we describe our experiences and lessons learned from recruiting study participants by partnering with New Jersey's community organizations during the COVID-19 pandemic. METHODS We used a cross-sectional design. We contacted 12 community organizations and 7 (58%) disseminated our study information. However, these organizations became considerably busy with pandemic-related needs. Therefore, we had to pivot to alternative recruitment strategies through community radio, Rutgers Cancer Institute of New Jersey's Community Outreach and Engagement Program, and Rutgers Cooperative Extension's community health programs. We recruited participants through these alternative strategies, obtained written informed consent, and collected demographic information using a structured survey. RESULTS Twenty five women expressed interest in the study, of which 22 (88%) participated. Nine (41%) participants learned about the study through the radio, 5 (23%) through these participants, 1 (4.5%) through a non-radio community organization, and 7 (32%) through community health programs. Two (9%) participants heard about the study from their spouse. All participants were born outside the US, their average age was 52.4 years (range: 39-72 years), and they have lived in the US for an average of 26 years (range: 5-51 years). CONCLUSION Pivoting to alternative strategies were crucial for successful recruitment. Findings suggest the significant potential of broadcast media for community-based recruitment. Family dynamics and the community's trust in our partners also encouraged participation. Such strategies must be considered when working with understudied populations.
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Affiliation(s)
- Jaya M. Satagopan
- Department of Biostatistics and Epidemiology, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Tina Dharamdasani
- Department of Biostatistics and Epidemiology, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Shailja Mathur
- Department of Family and Community Health Sciences, Cooperative Extension, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Racquel E. Kohler
- Department of Health Behavior, Society & Policy, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Elisa V. Bandera
- Cancer Epidemiology and Health Outcomes, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Anita Y. Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
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Xiong S, Ghebre R, Kulasingam S, Mason SM, Pratt RJ, Lazovich D. Exploring factors associated with preferences for human papillomavirus (HPV) self-sampling among racially- and ethnically-diverse women in Minnesota: A cross-sectional study. Prev Med Rep 2023; 34:102243. [PMID: 37234567 PMCID: PMC10206196 DOI: 10.1016/j.pmedr.2023.102243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Pap tests are still underutilized by minority women due to limited awareness of cervical cancer screening (CCS), inadequate health care access, and cultural or religious beliefs. Human papillomavirus (HPV) self-sampling, a new CCS tool, has demonstrated potential to overcome some of these barriers. In 2021, women aged 30-65 years old were recruited across Minnesota to complete an online survey. The survey assessed five outcome measures related to HPV self-sampling: (1) awareness of test; (2) self-efficacy to conduct test; (3) location preference of test (clinic vs. home); 4) collector preference (self vs. clinician); and (5) preference of CCS strategy (HPV self-sampling vs. Pap test). Modified Poisson regressions tested associations between sociodemographic variables and outcomes. A total of 420 women completed the survey, of which 32.4% identified as Non-Hispanic white, 22.2% as Hispanic, 12.6% as Black/African-American, 28.3% as Asian, 1.9% as American Indian/Alaskan Native, and 1.4% as more than two races. Few women had heard of HPV self-sampling (6.5%), but a majority reported high self-efficacy to perform self-sampling (75.3%). Women also reported higher preferences for completing an HPV test in the clinic (52.2%) and for performing a self-collected HPV test themselves (58.7%), yet would choose a traditional Pap test over HPV self-sampling (56.0%). The low level of HPV self-sampling awareness, across all racial/ethnic groups, suggests a strong opportunity to promote widespread educational efforts around this new tool. Future HPV self-sampling research efforts should examine educational interventions targeted at healthcare providers to educate and encourage women on the importance of self-collection options.
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Affiliation(s)
- Serena Xiong
- Department of Surgery, Washington University in St. Louis School of Medicine, 600 S Taylor Avenue, St. Louis, MO 63110, United States
| | - Rahel Ghebre
- Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455, United States
- Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455, United States
| | - Shalini Kulasingam
- Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455, United States
- Department of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd Suite 300, Minneapolis, MN 55454, United States
| | - Susan M. Mason
- Department of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd Suite 300, Minneapolis, MN 55454, United States
| | - Rebekah J. Pratt
- Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455, United States
- Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414, United States
| | - DeAnn Lazovich
- Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455, United States
- Department of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd Suite 300, Minneapolis, MN 55454, United States
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Martínez AD, Ruelas-Thompson L. Acceptability, feasibility, and ethics of saliva collection in community-based research with Mexican-origin mixed-status families during high immigration enforcement. BMC Public Health 2022; 22:1685. [PMID: 36064334 PMCID: PMC9446519 DOI: 10.1186/s12889-022-13903-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background There are concerns about the representation of vulnerable and underrepresented racial-ethnic minorities in biomedical and public health research, particularly when the research requires the collection of biospecimens. The current paper reports on the acceptability, feasibility, and ethics of saliva collection in a study examining the relationship between chronic stressors among mostly mixed-status, Latinx families (N = 30) during high immigration enforcement. Methods Data for this study included anthropometric measures and salivary biospecimens from each family member (N = 110) and a household survey. Data for this analysis are from ethnographic field notes, which were analyzed using a bricolage of critical ethnography and case study analysis techniques. Results We discuss the feasibility, aversions, acceptability, and ethical implications of integrating salivary biomarkers with Mexican-origin mixed-status families living in an area with restrictive immigration enforcement policies. We present the recruitment and data collection strategies used by the research team to gain participants’ trust, retain families, and maintain confidentiality. Conclusion We recommend that researchers who obtain biospecimens from Latinx, Mexican-origin, and/or immigrant populations answer the participants’ questions honestly and without fear that they will not understand the science to obtain voluntary assent and consent. We recommend that researchers be knowledgeable of the sociopolitical context that the Latinx, immigrant, and in particular, mixed-status families inhabit so that they are prepared to provide informational resources. Finally, we think it is imperative that the study team in the field be bilingual, multicultural Latinx persons who identify with the community.
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Affiliation(s)
- Airín Denise Martínez
- School of Public Health and Health Sciences, Department of Health Promotion and Policy, University of Massachusetts-Amherst, 715 N. Pleasant Street, Arnold House 333, 01003, Amherst, MB, USA.
| | - Lillian Ruelas-Thompson
- College of Liberal Arts & Sciences, ASU Advance,, Knowledge Exchange for Resilience, Arizona State University, Box 5302, Tempe, AZ, 85281, USA
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Paranjpe A, Zheng C, Chagpar AB. Disparities in Breast Cancer Screening Between Caucasian and Asian American Women. J Surg Res 2022; 277:110-115. [PMID: 35489215 DOI: 10.1016/j.jss.2022.03.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/22/2022] [Accepted: 03/30/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Asian American women have lower breast cancer incidence and mortality than their non-Hispanic White (NHW) counterparts. We sought to determine whether differences in screening practices could explain, in part, the variation in breast cancer detection rate. METHODS The 2015 National Health Interview Survey, an annual survey that is representative of the civilian, noninstitutionalized American population, was used to determine whether mammography usage was different between Asian and NHW women. Women ≥40 y of age who identified as either Asian or NHW were included. RESULTS A total of 7990 women ≥40 y of age (6.12% Asian, 93.88% NHW), representing 53,275,420 women in the population, were included in our cohort of interest; 71.49% of Asian and 74.46% of NHW women reported having had a mammogram within the past 2 y (P = 0.324). Controlling for education, insurance, family income, marital status, and whether they were born in the United States, Asians were less likely to have had a mammogram within the past 2 y than their NHW counterparts (odds ratio = 0.68; 95% confidence interval: 0.46-0.99, P = 0.047). Of patients who had an abnormal mammogram, there was no difference in the biopsy rate (20.35% versus 25.97%, P = 0.4935) nor in the rate of cancer diagnosis among those who had a biopsy (7.70% versus 12.86%, P = 0.211) between Asian and NHW women, respectively. CONCLUSIONS Our findings suggest that the lower breast cancer incidence among the Asian population may, in part, be explained by a lower screening mammography rate in this population.
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Affiliation(s)
- Ashwini Paranjpe
- Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Caiwei Zheng
- Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Anees B Chagpar
- Department of Surgery, Yale University, New Haven, Connecticut.
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Xie H, Li Y, Theodoropoulos N, Wang Q. Mammography Screening Disparities in Asian American Women: Findings From the California Health Interview Survey 2015-2016. Am J Health Promot 2021; 36:248-258. [PMID: 34814756 DOI: 10.1177/08901171211048136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To identify mammography screening prevalence and predictors in Asian American women, focusing on the potential disparities in race and its influence on screening behaviors. DESIGN A secondary analysis utilized the California Health Interview Survey (CHIS) 2015-2016. SETTING California, U.S. SAMPLE Cisgender women who were non-Hispanic (NH) White, Chinese, Filipino, Vietnamese, Japanese, Korean, or "other Asian", aged 40 or above (unweighted N=13 451). MEASURES Socioeconomics, chronic health conditions, and preventive care utilization were mesuared as potential risk factors, where up-to-date mammography screening as the outcome variable. ANALYSIS Multivariable adjusted logistic regressions were generalized to identify the up-to-date mammography screening behaviors in relation to potential factors, stratified by race and ethnicity. RESULTS The prevalence for up-to-date mammography screening in NH-White and Asian American women were 68.06% and 65.97%, respectively. In NH-White women, receiving an up-to-date mammogram was associated with age, birthplace, smoking status, diabetes, hypertension, health insurance coverage, and a preventive care visit in the past 12 months, whereas only age and a preventive care visit were significant predictors in Asian women. CONCLUSIONS The findings indicate that utilization disparities exist in mammogram in relation to socioeconomics, chronic health conditions, preventive care utilization, when comparing between race and ethnicity. Asian American women with borderline hypertension and no preventive care visits may require more public health outreach and cancer education.
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Affiliation(s)
- Hui Xie
- Joseph J. Zilber School of Public Health, 14751University of Wisconsin-Milwaukee Milwaukee, WI, USA
| | - Yannan Li
- Dapartment of Medicine, 5925Icahn School of Medicine at Mount Sinai Morningside and West, New York, NY, USA
| | - Nickolas Theodoropoulos
- Dapartment of Medicine, 5925Icahn School of Medicine at Mount Sinai Morningside and West, New York, NY, USA
| | - Qian Wang
- Division of Hematology and Medical Oncology, Department of Medicine, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
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De Jesus M, Ramachandra S, De Silva A, Liu S, Dubnansky E, Iyawe K, Jimenez A, Logie L, Jackson MC. A Mobile Health Breast Cancer Educational and Screening Intervention Tailored for Low-Income, Uninsured Latina Immigrants. WOMEN'S HEALTH REPORTS 2021; 2:325-336. [PMID: 34476415 PMCID: PMC8409237 DOI: 10.1089/whr.2020.0112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 12/20/2022]
Abstract
Objective: To investigate the efficacy of mobile health (mHealth) intervention strategies that delivered either personalized, culturally, and linguistically tailored cell phone voice messages or text messages related to breast cancer and prevention, compared to the control group, to determine which strategy is more likely to increase breast cancer knowledge and screening mammography among low-income Latina immigrants. Methods: This randomized controlled trial assigned 256 Latina immigrants 40 years of age or older to one of three groups: an automated cell phone voice message group, an automated text message group, or the control group (mail). The mHealth intervention employed a comprehensive approach that included breast cancer and prevention education and free mammography screening. Outcome measures included knowledge of breast cancer and breast cancer prevention, and adherence to screening mammography. Results: There was a general increase in breast cancer knowledge after the educational intervention for all the groups [p = 0.01, t(199) = 3.996]. Knowledge increase and mammography adherence did not differ based on group. Conclusion: More important than the actual method of communication is how breast cancer and prevention messages are constructed, who the messenger is, and the enabling factors that facilitate screening adherence. A breast cancer preventive intervention program that is personalized, culturally and linguistically tailored, and offers a free or low-cost mammogram holds promise to be an effective method in reaching an underserved Latina population with a high breast cancer burden.
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Affiliation(s)
- Maria De Jesus
- Center on Health, Risk, and Society, School of International Service, American University, Washington, District of Columbia, USA
| | - Shalini Ramachandra
- Department of Mathematics and Statistics, American University, Washington, District of Columbia, USA
| | - Alexis De Silva
- Department of Mathematics and Statistics, American University, Washington, District of Columbia, USA
| | - Shirley Liu
- Department of Mathematics and Statistics, American University, Washington, District of Columbia, USA
| | - Ethan Dubnansky
- Department of Mathematics and Statistics, Connecticut College, New London, Connecticut, USA
| | - Kingsley Iyawe
- Department of Mathematics and Statistics, American University, Washington, District of Columbia, USA
| | | | | | - M C Jackson
- Department of Mathematics and Statistics, American University, Washington, District of Columbia, USA
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Chan TKC, Tan LWL, van Dam RM, Seow WJ. Cancer Screening Knowledge and Behavior in a Multi-Ethnic Asian Population: The Singapore Community Health Study. Front Oncol 2021; 11:684917. [PMID: 34476210 PMCID: PMC8406849 DOI: 10.3389/fonc.2021.684917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/07/2021] [Indexed: 12/24/2022] Open
Abstract
Background Cancer has become the leading cause of mortality in Singapore and among other Asian populations worldwide. Despite the presence of National Cancer Screening programmes in Singapore, less than half of the population has had timely screening according to guidelines. The underlying factors of poor cancer screening rates and health outcomes among Asian ethnic groups remain poorly understood. We therefore examined cancer screening participation rates and screening behavior in a multi-ethnic Singapore population. Methods We collected data from 7,125 respondents of the 2015–2016 Singapore Community Health Study. Factors associated with cervical, breast, and colorectal cancer screening were evaluated using modified Poisson regression. Adjusted prevalence ratios were computed with 95% confidence intervals after adjusting for confounders. Results The mean age of the respondents was 57.7 ± 10.9 years; 58.9% were female and were predominately Chinese (73.0%), followed by Malay (14.2%), and Indian (10.9%). Less than half of the respondents in the recommended age groups had undergone cancer screening (cervical, 43%; breast, 35.1%; colorectal, 27.3%). Malay respondents were significantly less likely to screen as recommended for cervical (aPR = 0.75, CI = 0.65–0.86, p < 0.001), breast (aPR = 0.83, CI = 0.68–0.99, p = 0.045), and colorectal cancer (aPR = 0.55, CI = 0.44–0.68, p < 0.001), as compared to Chinese respondents. Respondents who had obtained lower secondary level education were 42% more likely to screen for cervical cancer (aPR = 1.42, CI = 1.23–1.64, p < 0.001), and 22% more likely to screen for breast cancer (aPR = 1.22, CI = 1.02–1.46, p = 0.032), compared to those with primary level education and below. Respondents with a household income ≥S$10,000/month were 71% more likely to screen for breast cancer (aPR = 1.71, CI = 1.37–2.13, p < 0.001), as compared with <$2,000/month. Conclusions Ethnicity and socio-economic status were significantly associated with lower uptake of cancer screening tests in Singapore. To improve the screening uptake among disadvantaged groups, a multi-faceted approach is needed that addresses the barriers to screening such as the adequacy of subsidy schemes and ethnic differences.
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Affiliation(s)
| | - Linda Wei Lin Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Wei Jie Seow
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
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13
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Medina HN, Callahan KE, Morris CR, Thompson CA, Siweya A, Pinheiro PS. Cancer Mortality Disparities among Asian American and Native Hawaiian/Pacific Islander Populations in California. Cancer Epidemiol Biomarkers Prev 2021; 30:1387-1396. [PMID: 33879454 PMCID: PMC8254771 DOI: 10.1158/1055-9965.epi-20-1528] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/03/2021] [Accepted: 04/13/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Asian American and Native Hawaiian/Pacific Islanders (AANHPI) are the fastest growing minority in the United States. Cancer is the leading cause of death for AANHPIs, despite relatively lower cancer morbidity and mortality. Their recent demographic growth facilitates a detailed identification of AANHPI populations with higher cancer risk. METHODS Age-adjusted, sex-stratified, site-specific cancer mortality rates from California for 2012 to 2017 were computed for AANHPI groups: Chinese, Filipino, South Asian, Vietnamese, Korean, Japanese, Southeast Asian (i.e., Cambodian, Hmong, Laotian, Thai), and Native Hawaiian and Other Pacific Islander (NHOPI). Regression-derived mortality rate ratios (MRR) were used to compare each AANHPI group to non-Hispanic whites (NHW). RESULTS AANHPI men and women (total 40,740 deaths) had lower all-sites-combined cancer mortality rates (128.3 and 92.4 per 100,000, respectively) than NHWs (185.3 and 140.6) but higher mortality for nasopharynx, stomach, and liver cancers. Among AANHPIs, both NHOPIs and Southeast Asians had the highest overall rates including for colorectal, lung (men only), and cervical cancers; South Asians had the lowest. NHOPI women had 41% higher overall mortality than NHWs (MRR = 1.41; 95% CI, 1.25-1.58), including for breast (MRR = 1.33; 95% CI, 1.08-1.65) and markedly higher for endometrial cancer (MRR = 3.34; 95% CI, 2.53-4.42). CONCLUSIONS AANHPI populations present with considerable heterogeneous cancer mortality patterns. Heightened mortality for infection, obesity, and tobacco-related cancers in Southeast Asians and NHOPI populations highlight the need for differentiated priorities and public health interventions among specific AANHPI populations. IMPACT Not all AANHPIs have favorable cancer profiles. It is imperative to expand the focus on the currently understudied populations that bear a disproportionate cancer burden.
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Affiliation(s)
- Heidy N Medina
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
| | - Karen E Callahan
- School of Public Health, University of Nevada, Las Vegas, Nevada
| | - Cyllene R Morris
- California Cancer Reporting and Epidemiologic Surveillance Program, UC Davis Comprehensive Cancer Center/UC Davis Health, Davis, California
| | - Caroline A Thompson
- School of Public Health, San Diego State University, Sutter Health Palo Alto Medical Foundation Research Institute, University of California San Diego School of Medicine, San Diego, California
| | - Adugna Siweya
- School of Public Health, University of Nevada, Las Vegas, Nevada
| | - Paulo S Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
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14
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Nelson M, Patton A, Robb K, Weller D, Sheikh A, Ragupathy K, Morrison D, Campbell C. Experiences of cervical screening participation and non-participation in women from minority ethnic populations in Scotland. Health Expect 2021; 24:1459-1472. [PMID: 34137135 PMCID: PMC8369098 DOI: 10.1111/hex.13287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/21/2021] [Accepted: 05/09/2021] [Indexed: 11/29/2022] Open
Abstract
Background The introduction of screening in the UK and other high‐income countries led to a significant decrease in the incidence of cervical cancer and increase in survival rates. Minority ethnic groups are often underrepresented in screening participation for reasons that are poorly understood. Objective To explore experiences of cervical screening participation and non‐participation of women from minority ethnic populations in Scotland and gain insights to support the development of interventions that could potentially support screening participation and thereby reduce inequalities. Design Qualitative comparison group study using in‐depth, semi‐structured individual interviews that were thematically analysed. Setting and participants This study took place in Scotland. Fifty women were purposively sampled from four ethnic minority groups: South Asian; East European; Chinese; and Black African or Caribbean. White Scottish women were also interviewed. Results Many experiences described were common regardless of ethnicity, such as difficulties managing competing priorities, including work and care responsibilities. However, important differences existed across the groups. These included going abroad for more frequent screening, delayed introduction to screening and not accessing primary care services, language difficulties in health‐care settings despite proficiency in English and not being sexually active at screening commencement. Experiences of racism, ignorance and feeling shamed were also reported. Conclusions Key differences exist in the experience of minority ethnic groups in Scotland. These offer potential opportunities to reduce disparity and support screening participation including maximizing co‐incidental interactions and developing outreach work.
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Affiliation(s)
- Mia Nelson
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Andrea Patton
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Katie Robb
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - David Weller
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - David Morrison
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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15
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Milani SA, Swain M, Otufowora A, Cottler LB, Striley CW. Willingness to Participate in Health Research Among Community-Dwelling Middle-Aged and Older Adults: Does Race/Ethnicity Matter? J Racial Ethn Health Disparities 2021; 8:773-782. [PMID: 32808194 PMCID: PMC7431111 DOI: 10.1007/s40615-020-00839-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Older adults, including racial and ethnic minorities, are underrepresented in research. As the US population ages, the number of older racial and ethnic minority individuals will increase. Including these individuals in research is an important step towards reducing health disparities. METHODS We used data from HealthStreet, a University of Florida community engagement program which uses community health workers to assess the health of the community, to assess willingness to participate in different types of health research by race/ethnicity. Descriptive statistics and logistic regression models were used to assess willingness to participate among adults aged 50 and older, by race/ethnicity (n = 4694). RESULTS Our sample was 42.0% non-Hispanic White, 52.8% non-Hispanic Black, and 5.2% Hispanic. Non-Hispanic White participants reported more past research participation than non-Hispanic Black and Hispanic participants (28.7% vs. 19.0% and 19.2%, respectively). Compared with non-Hispanic White participants, non-Hispanic Black participants were less willing to participate in most types of studies, while Hispanic participants were less willing to participate in studies that might be seen as invasive (required blood sample, genetic sample, or participants to take medicine, or use of medical equipment). CONCLUSIONS Our study provides investigators with a general profile of research preferences by race/ethnicity; compared with non-Hispanic White individuals, non-Hispanic Black individuals are less willing to participate in most studies, while Hispanic individuals are less willing to participate in studies that may be seen as invasive or demanding. It is imperative to include diverse older adults in health research. By tailoring research based on preferences we can improve recruitment in underrepresented populations.
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Affiliation(s)
- Sadaf Arefi Milani
- Sealy Center on Aging, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0177, USA.
| | - Michael Swain
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ayodeji Otufowora
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
| | - Catherine W Striley
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
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Christie-de Jong F, Reilly S. Barriers and facilitators to cervical screening for Filipino women – a narrative literature review. INTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE 2021. [DOI: 10.1108/ijmhsc-04-2019-0043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Purpose
Mortality rates of cervical cancer are high amongst Filipino women; however, uptake of cervical screening is low. The purpose of this paper is to identify known barriers and facilitators to cervical screening for Filipino migrant women.
Design/methodology/approach
A systematic approach was adopted for the search, data extraction, critical appraisal and synthesis processes of this review. Eight electronic databases were searched. Studies published in peer review journals in English between 1995 and 2019 were reviewed.
Findings
In total, 20 relevant studies were identified. Studies were heterogeneous in design and focus and mostly conducted in the USA. A complex multifactorial picture of barriers to cervical screening was identified, which included: demographic, cognitive, access, health-care provider and cultural factors. None of the studies incorporated all factors.
Practical implications
This review demonstrates the complexity and multifactorial characteristic of cervical screening for Filipino migrant women. To increase uptake of screening, barriers to cervical screening for Filipino migrant women need to be fully understood. Future research should be conducted in different locations, focussing on multiple factors.
Originality/value
Aggregation of barriers and facilitators for Asian women combined tends to ignore cultural differences between groups. This review synthesises the existing but scarce literature to identify known barriers and facilitators to cervical screening for this specific population of Filipino migrant women.
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17
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Jun J. Cancer/health communication and breast/cervical cancer screening among Asian Americans and five Asian ethnic groups. ETHNICITY & HEALTH 2020; 25:960-981. [PMID: 29792075 DOI: 10.1080/13557858.2018.1478952] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 05/03/2018] [Indexed: 06/08/2023]
Abstract
Objectives: This paper is an examination of cancer/health communication factors (i.e. cancer/health information seeking, patient-provider communication (PPC), cancer screening information from providers) and screening for breast and cervical cancer among Asian Americans and five Asian ethnic groups (Chinese, Filipinos, Japanese, Koreans, Vietnamese) in comparison to Whites. Additionally, the relationship between cancer/health communication disparity and cancer screening gaps between Asian Americans and Whites was investigated. Design: Data comes from a nationally representative sample of 2011-2014 Health Information National Trends Surveys (HINTS). Results: Asian Americans and most Asian ethnic-groups reported significantly lower rates of cancer/health information seeking and lower evaluations for PPC as compared to Whites, though differences within Asian ethnic groups were observed (Koreans' greater cancer/health information seeking, Japanese' higher PPC evaluation). When the cancer/health communication factors were controlled, Asian Americans' odds of cancer screening were increased. Especially, Asian Americans' odds of adhering to the breast cancer screening guideline became nearly 1.4 times greater than Whites. Conclusion: This research demonstrates that health organizations, providers, and Asian American patients' collaborative efforts to increase the access to quality cancer information, to make culturally competent but straightforward screening recommendations, and to practice effective communication in medical encounters will contribute to diminishing cancer disparities among Asian Americans.
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Affiliation(s)
- Jungmi Jun
- The School of Journalism and Mass Communications, University of South Carolina, Columbia, SC, USA
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Özkan İ, Taylan S. Barriers to women’s breast cancer screening behaviors in several countries: A meta-synthesis study. Health Care Women Int 2020; 42:1013-1043. [DOI: 10.1080/07399332.2020.1814777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- İlknur Özkan
- Kumluca Faculty of Health Sciences, İnternal Medicine Nursing Department, Akdeniz University, Kumluca, Antalya, Turkey
| | - Seçil Taylan
- Kumluca Faculty of Health Sciences, Surgical Nursing Department, Akdeniz University, Kumluca, Antalya, Turkey
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Hepatitis B Virus Screening and Vaccination in First-generation African Immigrants: A Pilot Study. J Community Health 2020; 44:1037-1043. [PMID: 31123877 DOI: 10.1007/s10900-019-00668-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Foreign-born African immigrants bear a large burden of hepatitis B virus (HBV)-related liver disease in the U.S. However, HBV awareness and knowledge of HBV screening and vaccination among this population is limited. This study aimed to provide a better understanding of HBV burden in this vulnerable population and to identify risk factors for the implementation of more effective prevention and treatment programs. We conducted a cross-sectional survey among 71 first-generation African Americans in New York City. Participants' sociodemographic characteristics, HBV screening and vaccination history, knowledge of HBV transmission, and other related issues were asked. The study sample included 46 men and 23 women, with an average age of 32.75. Of the sample, 87.50% participants migrated from sub-Saharan Africa and 79.10% had lived in the U.S. for 10 or fewer years. Almost half of participants never underwent HBV screening (44.29%) or HBV vaccination (49.23%). About two-thirds (60.87%) of participants never received any HBV screening or vaccination recommendation from doctors. Multivariable analysis results showed that having a college degree and being currently married were significantly associated with HBV screening, while having health insurance was significantly associated with HBV vaccination. Survey data further indicated that first-generation African immigrants had very limited knowledge of HBV transmission, suggesting that this population would benefit from greater awareness of HBV risk factors and modes of transmission. The influence of education, marriage and spousal support, and access to health insurance on HBV screening and vaccination should be noted and further examined in future public health interventions and research.
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Lee HY, Beltran R, Kim NK, Lee DK. Racial Disparities in Cervical Cancer Screening: Implications for Relieving Cervical Cancer Burden in Asian American Pacific Islander Women. Cancer Nurs 2020; 42:458-467. [PMID: 30624249 DOI: 10.1097/ncc.0000000000000642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND While cervical cancer is considered preventable and the overall Papanicolaou (Pap) test utilization rate has gradually increased in the United States, certain Asian American Pacific Islander (AAPI) women consistently rate lower in Pap test receipt compared with non-Latina whites (NLWs), leading to a higher cervical cancer mortality rate for various AAPI women. Few studies, however, have focused on female AAPI college students' cervical cancer screening behavior in comparison with NLW students. OBJECTIVE This study aimed to investigate cervical cancer screening behaviors among college-aged females by (1) determining AAPIs' and NLWs' screening rates, (2) assessing their knowledge about Pap tests, and (3) discovering factors associated with Pap test receipt. Andersen's Health Behavioral Model was used as a theoretical framework. METHODS Using a simple random sampling strategy, 2270 female students (15% AAPIs, 85% NLWs) completed an online health survey. RESULTS Results indicate AAPI students had significantly lower Pap test knowledge and Pap test receipt rate compared with NLW students. Age, nativity, human papillomavirus vaccination completion, frequency of obstetrician/gynecologist (OB/GYN) visits, and the number of sexual partners were associated with AAPI students' lower rate of Pap test receipt, whereas the Pap test receipt rate for NLW students was influenced by the same factors with the addition of having increased prior knowledge about Pap tests. CONCLUSION Results show the importance of OB/GYN visits in obtaining Pap tests for AAPI and NLW students. IMPLICATION FOR PRACTICE Health practitioners should pay attention to students' race/ethnicity in their practice and provide corresponding ethnic group-specific preventive care.
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Affiliation(s)
- Hee Yun Lee
- Author Affiliations: School of Social Work, University of Alabama, Tuscaloosa (Dr Lee); and School of Social Work (Ms Beltran), Department of Educational Psychology (Mr Kim), and School of Medicine (Mr Lee), University of Minnesota, Twin Cities
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21
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Huang YC, Garcia AA. Culturally-tailored interventions for chronic disease self-management among Chinese Americans: a systematic review. ETHNICITY & HEALTH 2020; 25:465-484. [PMID: 29385815 DOI: 10.1080/13557858.2018.1432752] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/21/2017] [Indexed: 06/07/2023]
Abstract
Objectives: Literature review evaluating the effectiveness and cultural surface and deep structures of interventions designed to improve Chinese Americans' chronic disease self-management.Method: PubMed, PsycINFO, CINAHL, and Health Source databases were searched for research conducted from 1990 to 2016 on self-management interventions for Chinese Americans with chronic disease.Results: Ten articles comprised eight interventions, which each addressed a dimension of cultural surface structure, all providing linguistically appropriate messages delivered via bilingual staff. Five interventions also addressed cultural deep structure dimensions by providing culturally congruent counsellors or educators, or incorporating Chinese cultural values and social customs. Six interventions resulted in significant improvements in major outcome variables. Participants also reported high satisfaction and retention rates were high.Conclusion: Culturally-tailored interventions that incorporate surface and deep structural elements of culture are sensitive and generally effective for Chinese Americans to improve access to health care, disease awareness, social environment, and participants' ability to practice self-management skills.
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Affiliation(s)
- Ya-Ching Huang
- The School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Alexandra A Garcia
- Dell Medical School, The School of Nursing, The University of Texas at Austin, Austin, TX, USA
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Shon EJ, Townsend AL. Predictors of never having a mammogram among Chinese, Vietnamese, and Korean immigrant women in the U.S. PLoS One 2019; 14:e0224505. [PMID: 31693678 PMCID: PMC6834271 DOI: 10.1371/journal.pone.0224505] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/15/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer among Asian women in the U.S. The first objective was to investigate predictors (including ethnicity) of never having a mammogram in middle-aged and older Chinese, Vietnamese, and Korean immigrant women (main effects). The second objective was to explore whether relationships between predictors and never having a mammogram varied across the three groups (moderation effects of ethnicity). METHODS Merged (2005-2007-2009-2011) California Health Interview Survey data were utilized. Unweighted sample was 3,710 Asian women ages 40 years and older (Chinese = 1,389; Vietnamese = 1,094; Korean = 1,227). Replicate weighted total sample size was 1,710,233 (Chinese = 940,000; Vietnamese = 410,000; Korean = 360,000). Replicate-weighted multivariate logistic regression was applied. Interaction effects (moderator role of ethnicity) were also examined, using multivariate logistic regression, for the second objective. RESULTS For the first objective, odds of never having a mammogram were higher for women who were Korean (Ref = Vietnamese), unmarried, or a non-U.S. citizen. Odds were lower in women ages 50-59 or 60-69 (Ref = 70-85). Regarding the second objective, only for Chinese women, odds of never having a mammogram were lower as the number of physician visits got higher. CONCLUSION Culturally-sensitive outreach and services should be developed to target higher-risk groups. Patient-centered healthcare strategies tailored for the three groups could be effective. For Chinese women, in particular, regular information sessions or education programs could be provided for enhancing their physician visits.
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Affiliation(s)
- En-Jung Shon
- Department of Family Science and Social Work, Miami University, Oxford, OH, United States of America
| | - Aloen Louise Townsend
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States of America
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23
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Lee MH, Schwartz AJ. Barriers to Breast Cancer Screening and Coping Strategies in Korean American Women. J Transcult Nurs 2019; 32:6-13. [PMID: 31603031 DOI: 10.1177/1043659619881482] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: To develop more culturally appropriate and effective intervention strategies, this qualitative study explored Korean American women's barriers to mammography and their coping strategies within their sociocultural context. Methodology: Semistructured individual interviews were conducted with 30 Korean American women in 2016. Thematic analysis was used to analyze the data and identify themes. Results: Four themes and their associated subthemes emerged from the data: (1) barriers to accessing mammography (cost, time consuming and complicated procedure, and language barriers), (2) psychosocial concerns related to mammography (pain, discomfort and embarrassment, and exposure to radiation), (3) strategies to access mammography (identifying ways to get a cost-free mammogram and having procedure done in home country), and (4) ways to deal with psychosocial concerns (being positive and avoiding or postponing the procedures). Discussion: Health professionals should account for cultural differences including, but not limited to, patients' concerns, access to care, and beliefs surrounding screening processes.
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Affiliation(s)
- Mi Hwa Lee
- East Carolina University, Greenville, NC, USA
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Predictors of Cervical Cancer Screening Awareness and Literacy Among Korean-American Women. J Racial Ethn Health Disparities 2019; 7:1-9. [PMID: 31410785 DOI: 10.1007/s40615-019-00628-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/02/2019] [Accepted: 08/04/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Korean-American women experience a higher incidence of cervical cancer than non-Hispanic White women as well as other Asian-American women. A prominent cause of such a disproportional health risk among Korean-American women is a lack of awareness and knowledge of cervical cancer screening. Identifying factors related to cervical cancer screening awareness and literacy is critical for increasing cervical cancer screening among this population. METHODS Researchers surveyed 230 Korean-American women in a metro area in a Southeastern state, USA. Based on Anderson's Behavioral Model of Health Services Use, predisposing, enabling, and need factors were explored to predict cervical cancer screening awareness and literacy. RESULTS Monthly income, education, English proficiency, and annual checkups had significantly positive associations with cervical cancer screening awareness. Having an acquaintance giving support and receiving an annual checkup had significantly positive relationships with cervical cancer screening literacy. DISCUSSION This study recommends culture specific guidelines to promote annual checkups through primary care physicians and the transfer of information about cervical cancer screening through acquaintances giving support.
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Feinglass J, Cooper JM, Rydland K, Tom LS, Simon MA. Using Public Claims Data for Neighborhood Level Epidemiologie Surveillance of Breast Cancer Screening: Findings from Evaluating a Patient Navigation Program in Chicago's Chinatown. Prog Community Health Partnersh 2019; 13:95-102. [PMID: 31378739 DOI: 10.1353/cpr.2019.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This study was designed to evaluate a patient navigation program undertaken with our community partners in Chicago's Chinatown. Inadvertently, the study collected data on two biannual mammography screening cycles that coincided almost exactly with implementation of the Affordable Care Act (ACA) in Illinois. METHODS The study uses claims data to profile mammography screening rates for residents of an 18 zip code, 398 census tract area on Chicago's near south and southwest side. Patient addresses were geocoded from biannual (August 2011 to July 2103 and August 2103 to July 2015) Illinois Medicaid and Illinois Breast and Cervical Cancer Program (IBCCP) claims. Screening rates are presented separately for low-income women ages 40 to 49 and 50 to 64 years. We compare change between 16 tracts with greater than 20% Chinese ancestry, 85 tracts with 1% to 20% Chinese ancestry, and 297 tracts with less than 1% Chinese ancestry. RESULTS There were more than 65,000 low-income women age 40 to 64 in the study area (mammogram patients were 63% Black, 23% Hispanic, 10% White, 2.5% Asian, and 2.5% other/unknown race and ethnicity). The increase in screening was greatest in Chinatown, although mean rates were not significantly different across the three areas (p = .07). DISCUSSION Our results demonstrate large increases in mammography screening after ACA implementation in 20132014. The greatest increase occurred in the Chinatown patient navigation program area. The study provides a template for programs aimed at using public community-area data to evaluate programs for improving access to care and health equity.
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Freund KM, Reisinger SA, LeClair AM, Yoon GH, Al-Najar SM, Young GS, González ET, Oliveri JM, Paskett ED. Insurance Stability and Cancer Screening Behaviors. Health Equity 2019; 3:177-182. [PMID: 31289777 PMCID: PMC6608696 DOI: 10.1089/heq.2018.0093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: Disparities in rates of cancer screening are observed in underserved populations. Lack of stable health insurance may contribute to these disparities. The goal of this study was to examine the association between insurance stability and up-to-date cancer screening in underserved populations. Methods and Findings: We enrolled 333 community participants aged 40–74 years across four different sites in three states: Chinese Americans in Boston, Massachusetts; Hispanics in Columbus, Ohio; Appalachian populations from Ohio's Appalachian counties; and Blacks and African Americans in Philadelphia, Pennsylvania. Self-reported screening rates were 77.9% for breast cancer, 71.1% for cervical cancer, and 67.7% for colorectal cancer (CRC). Screening rates fell short of Health People 2020 targets for breast, colorectal, and cervical cancer screenings. Being currently insured was associated with current CRC screenings (69.7% among insured vs. 30.7% among uninsured, p=0.0055), but not with breast or cervical cancer screenings. Stable 12-month insurance coverage was not statistically associated with up-to-date screenings. Conclusion: Having current insurance was associated with CRC screening; stability of insurance was not associated with cancer screening. Insurance coverage alone is not the main driver of cancer screening.
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Affiliation(s)
- Karen M Freund
- Institute of Clinical Research and Health Policy Studies, Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts
| | - Sarah A Reisinger
- Department of Population Sciences, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
| | - Amy M LeClair
- Institute of Clinical Research and Health Policy Studies, Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts
| | - Grace H Yoon
- Institute of Clinical Research and Health Policy Studies, Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | | | - Gregory S Young
- Center for Biostatistics, Department of Biomedical Informatics, Ohio State University, Columbus, Ohio
| | - Evelyn T González
- Fox Chase Cancer Center, Office of Community Outreach, Philadelphia, Pennsylvania
| | - Jill M Oliveri
- Department of Population Sciences, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
| | - Electra D Paskett
- Department of Internal Medicine, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
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Assari S, Khoshpouri P, Chalian H. Combined Effects of Race and Socioeconomic Status on Cancer Beliefs, Cognitions, and Emotions. Healthcare (Basel) 2019; 7:E17. [PMID: 30682822 PMCID: PMC6473681 DOI: 10.3390/healthcare7010017] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 12/24/2022] Open
Abstract
AIM To determine whether socioeconomic status (SES; educational attainment and income) explains the racial gap in cancer beliefs, cognitions, and emotions in a national sample of American adults. METHODS For this cross-sectional study, data came from the Health Information National Trends Survey (HINTS) 2017, which included a nationally representative sample of American adults. The study enrolled 2277 adults who were either non-Hispanic Black (n = 409) or non-Hispanic White (n = 1868). Race, demographic factors (age and gender), SES (i.e., educational attainment and income), health access (insurance status, usual source of care), family history of cancer, fatalistic cancer beliefs, perceived risk of cancer, and cancer worries were measured. We ran structural equation models (SEMs) for data analysis. RESULTS Race and SES were associated with perceived risk of cancer, cancer worries, and fatalistic cancer beliefs, suggesting that non-Hispanic Blacks, low educational attainment and low income were associated with higher fatalistic cancer beliefs, lower perceived risk of cancer, and less cancer worries. Educational attainment and income only partially mediated the effects of race on cancer beliefs, emotions, and cognitions. Race was directly associated with fatalistic cancer beliefs, perceived risk of cancer, and cancer worries, net of SES. CONCLUSIONS Racial gap in SES is not the only reason behind racial gap in cancer beliefs, cognitions, and emotions. Racial gap in cancer related beliefs, emotions, and cognitions is the result of race and SES rather than race or SES. Elimination of racial gap in socioeconomic status will not be enough for elimination of racial disparities in cancer beliefs, cognitions, and emotions in the United States.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| | - Pegah Khoshpouri
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
| | - Hamid Chalian
- Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
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Desire for Continued Pessary Use Among Women of Hispanic and Non-Hispanic Ethnic Backgrounds for Pelvic Floor Disorders. Female Pelvic Med Reconstr Surg 2019; 25:172-177. [PMID: 30807423 PMCID: PMC9969967 DOI: 10.1097/spv.0000000000000652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to describe the association between patient ethnicity/race and desire to continue using a pessary for the treatment of pelvic floor disorders. METHODS We performed a secondary analysis of a randomized trial among women presenting for pessary fitting. The primary outcome was the desire to continue using a pessary at 3 months. Bacterial vaginosis by Nugent score and vaginal symptoms (discharge, itching, pain, sores) were also evaluated. Logistic or multiple linear regression was performed with correction for body mass index, education level, parity, Charlson Comorbidity Index, and randomization to TrimoSan gel. RESULTS One hundred fourteen women (41 Hispanic and 73 non-Hispanic) were eligible for this analysis. Women self-identified as white (65/114; 57%), Hispanic (41/114, 36%), Asian (3/114; 2.6%), Native American (4/114; 3.5%), and "other" (1/114, 0.9%) race, with no self-identified African American women (0/114) meeting the inclusion criteria. No significant difference in desire to continue pessary use was found between Hispanic and non-Hispanic women (58.5% vs 63%; P = 0.69; corrected odds ratio [cOR], 1.11; 95% confidence interval [CI], 0.43-2.90) or across races (P = 0.89). Hispanic women had significantly higher risk of bacterial vaginosis (34% vs 16%; P = 0.04; cOR, 2.91; 95% CI, 1.01-8.39), higher Nugent scores (5.4 ± 2.3 vs 4.3 ± 2.3; P = 0.02; corrected coefficient, 1.10; 95% CI, 0.10-2.10), and more vaginal pain (17.1% vs 2.8%; P = 0.01; cOR, 9.14; 95% CI, 1.37-61.17) at 3 months. CONCLUSIONS Despite increased vaginal pain and vaginal microbiome disturbances in Hispanic women using a pessary, no significant differences in the desire to continue using the pessary existed.
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Lee J, Carvallo M, Lee E, Chung J, Shin C. Affective and Cognitive Attitudes on Cervical Health Behaviors Among Asian American Women. FAMILY & COMMUNITY HEALTH 2019; 42:123-132. [PMID: 30768477 DOI: 10.1097/fch.0000000000000216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Cervical cancer is a major cause of death for Vietnamese and Korean American women, yet their screening rates remain low. This study explored factors influencing cervical health behaviors of these populations, using a 2-dimensional model (ie, affect and cognition) of attitude structure approach. Semistructured interviews were conducted with 33 participants. A semantic content analysis was used to identify major codes and themes across the transcripts. Multiple aspects of both negative and positive affect and cognition, which led to 3 different cervical health behaviors (avoidance, ambivalence, and acceptance), emerged from the interviews. The clinical implications of these findings are discussed.
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Affiliation(s)
- Jongwon Lee
- College of Nursing, The University of New Mexico, Albuquerque (Dr J. Lee); Department of Psychology, University of Oklahoma, Norman (Dr Carvallo); UCLA School of Nursing (Dr E. Lee); Virginia Commonwealth University School of Nursing, Richmond (Dr Chung); and Arizona State University College of Nursing and Health Innovation, Phoenix (Dr Shin)
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Lee SY, Lee E, Natipagon-Shah B, Toyama J. Factors Associated with Breast Cancer Screening among Korean American Women in California: Results from the California Health Interview Survey 2015–2016. Asian Pac J Cancer Prev 2018; 19:3271-3277. [PMID: 30486631 PMCID: PMC6318411 DOI: 10.31557/apjcp.2018.19.11.3271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 10/19/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Few studies have examined preventive lifestyle behaviors and breast cancer (BC) screening behaviors simultaneously to determine whether BC screening behaviors are associated with preventive lifestyle behaviors. The purposes of this study are to (a) describe BC screening utilization and preventive lifestyle behaviors and (b) examine factors associated with BC utilization among Korean American (KA) women. Methods: Data from the 2015–2016 California Health Interview Survey were analyzed. Survey-weighted adjusted logistic regressions were used to determine whether preventive lifestyle behaviors and characteristics of KA women 50 years of age and older at the time of the survey were associated with obtaining mammograms. Results: Most participants were born outside of the US and had lived in the US for 15 years or more at the time of the survey. This study found that KA women who were 50–64 years old had 38 times greater odds of having ever had a mammogram and a 13 times greater odds of having a recent mammogram than those 65 and older. KA women who walked at least 10 minutes per week for transportation and leisure purposed were 61 times more likely to have ever had a mammogram than those who did not walk. Conclusion: This study provides important perspectives on associations of BC screening behaviors and preventive life-style behaviors, especially walking. Future research should be conducted to better understand the association between BC screening and preventive life-style behaviors and to develop feasible interventions to improve BC screening behaviors among KA women, particularly elderly and physically inactive ones.
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Affiliation(s)
- Shin-Young Lee
- Department of Nursing at Chosun University 309 Pilmun-daero, Dong-gu, Gwangju, Republic of Korea.
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Translation and Validation of the Korean Version of the Revised Health Care System Distrust Scale (HCSD-K) in Korean American Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091964. [PMID: 30205573 PMCID: PMC6163931 DOI: 10.3390/ijerph15091964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 08/31/2018] [Accepted: 09/08/2018] [Indexed: 01/26/2023]
Abstract
Background: Trust in the healthcare system is a major contributor for racial disparities in health and health care. We aimed to formally translate and cross-culturally adapt the Korean version of the Revised Health Care System Distrust (HCSD-K) scale with a sample of Korean American women and examine the psychometric properties of the HCSD-K scale. Methods: Ten Korean American women participated in the cognitive interview. A self-administered questionnaire was completed by 196 Korean American women aged 50–74 years. Instrument adaptation was performed using committee-based translation and cognitive interviewing. Construct validity, convergent validity, and internal consistency were examined to evaluate the psychometric properties of the HCSD-K scale. Results: The translated instrument was found to be semantically sound. A confirmatory factor analysis revealed a two-factor structure with an excellent fit. Convergent validity was supported by correlations between the HCSD-K scale and both the Perceived Discrimination in Health Care and Trust in Physician scales. Cronbach’s alpha for the total HCSD-K was 0.83. Conclusion: The nine-item HCSD-K scale demonstrated satisfactory reliability and validity. It is an appropriate instrument for measuring healthcare system distrust in Korean American women. Further study is needed to confirm the study results in a gender-mixed Korean population.
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Jun J, Nan X. Determinants of Cancer Screening Disparities Among Asian Americans: A Systematic Review of Public Health Surveys. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:757-768. [PMID: 28378200 DOI: 10.1007/s13187-017-1211-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We conducted a systematic analysis of 24 peer-reviewed literary works that examined Asian Americans' breast, cervical, and colon cancer screening, focusing on empirical findings from large-scale public health surveys (i.e., NHIS, CHIS, HINTS, BRFSS). We provide an overview of relevant research in terms of study characteristics, samples, predictor/covariate of cancer screenings, and key findings. Our analysis indicates that Asian Americans' cancer screening rates are lower than for non-Hispanic Whites for all cancer types in four large-scale public health surveys throughout 17 study years. Acculturation and healthcare access were two significant factors in explaining Asian Americans' cancer screening rates. Cancer fatalism and family cancer history emerged as potential factors that may account for more variances. However, the screening disparities between Asian Americans and whites persist even after adjusting all covariates, including SES, acculturation, healthcare access, health status, and health perception/literacy. More individual and cultural factors should be identified to address these disparities.
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Affiliation(s)
- Jungmi Jun
- The Department of Communication, University of Maryland, College Park, MD, USA.
| | - Xiaoli Nan
- The Department of Communication, University of Maryland, College Park, MD, USA
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Development and Evaluation of Culturally and Linguistically Tailored Mobile App to Promote Breast Cancer Screening. J Clin Med 2018; 7:jcm7080181. [PMID: 30042291 PMCID: PMC6111615 DOI: 10.3390/jcm7080181] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 12/02/2022] Open
Abstract
Background: While a significant breast cancer burden exists for Korean American immigrant women, their cancer screening behavior is strikingly poor, and few interventions have focused on this population. To promote breast cancer screening behavior in Korean American immigrant women, a mobile phone multimedia messaging intervention (mMammogram) was developed. Objective: The current study explores the impact of mMammogram on changes to study participants’ screening behavior and proposes suggestions for how the intervention can be improved for wide dissemination and implementation in the Korean American community. Material and Methods: Data were collected through qualitative research methods. Three focus groups were conducted with 14 Korean immigrant women who completed the mMammogram. Findings: Three themes emerged: (1) better understanding of breast cancer and screening through mMammogram (e.g., increased knowledge on breast cancer and screening methods, increased understanding of the importance of regular mammography, and reduced anxiety about mammography); (2) health navigators as a trigger to promote mammography (e.g., providing resources for free or low-cost mammograms and scheduling mammogram appointments); and (3) suggestions for mMammogram (e.g., technical issues and program period). Conclusions: Mobile app intervention that is culturally tailored, along with health navigation services, can be a feasible, effective, and acceptable tool to promote breast cancer screening behaviors in underserved immigrant women. A mobile app can cover a broad range of breast cancer health topics and the health navigator can further help women overcome barriers to screening. A health navigation service is critical in overcoming language, transportation, and health accessibility barriers and triggering a positive change in their health screening behavior, especially for newly arrived immigrant populations.
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Hong HC, Lee H, Collins EG, Park C, Quinn L, Ferrans CE. Factors affecting trust in healthcare among middle-aged to older Korean American women. BMC WOMENS HEALTH 2018; 18:109. [PMID: 29929508 PMCID: PMC6013887 DOI: 10.1186/s12905-018-0609-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/15/2018] [Indexed: 01/02/2023]
Abstract
Background Predictors of trust in healthcare providers and the healthcare system have never been studied in Korean Americans (KA) despite the fact that trust plays an important role in health behaviors. The purpose of this study is to examine factors influencing trust in the healthcare system and providers among KA women. Methods Data were collected in 196 KA women examining the effects of perceived discrimination and trust on breast cancer screening in the Chicago metropolitan area. Path analysis was used to identify factors influencing trust in the healthcare system and providers. Results Acculturation was positively related to trust in healthcare providers (β = .15, p =. 002), and discrimination in the healthcare system was inversely related to trust in healthcare providers (β = −.60, p <. 001). Length of stay in the US was inversely related to distrust in the healthcare system (β = −.14, p <. 001), and discrimination in healthcare was positively related to distrust in the healthcare system (β = .60, p <. 001). Trust in healthcare providers and distrust in the healthcare system were moderately correlated (r = .51, p < .001). Conclusion Higher levels of acculturation and lower levels of perceived discrimination were identified as predictors of higher levels of trust in healthcare providers. A shorter stay in the US and higher levels of discrimination were identified as predictors of higher levels of distrust in the healthcare system. Perceived discrimination is a target for interventions to enhance trust in the healthcare system, and therefore reduce healthcare disparities in KAs.
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Affiliation(s)
- Hye Chong Hong
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - Hyeonkyeong Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Eileen G Collins
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Chang Park
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Lauretta Quinn
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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Factors Associated with Health Insurance Status in an Asian American Population in New York City: Analysis of a Community-Based Survey. J Racial Ethn Health Disparities 2018; 5:1354-1364. [PMID: 29582383 DOI: 10.1007/s40615-018-0485-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/09/2018] [Accepted: 03/15/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Immigrants comprise approximately 13% of the US population and 33% lack health coverage. Asian Americans are the fastest growing immigrant group; many lack a usual source of care. This study examines factors associated with health insurance among Asian American immigrants living in New York City. METHODS Community needs assessments were conducted among Asian American subgroups in New York City from 2013 to 2015; analysis was completed in 2017 and 2018. Descriptive statistics examined factors associated with health insurance status while stratifying by Asian ethnic subgroup; multivariable logistic regression models further assessed these associations (p < 0.05 significance level). RESULTS Approximately 19% of the study population (n = 1399) was uninsured. Logistic regression models adjusted for all factors. Among East Asians, insurance status was associated with female sex (OR = 2.8, p = 0.005), excellent/very good health status (OR = 3.5, p = 0.014), and seeing a private doctor when sick or injured (OR = 3.2, p = 0.033). Among South Asians, insurance status was associated with high school/some college and college education (OR = 2.6 and 2.9, respectively, p = 0.039 and p = 0.021), having a routine health check in the past year (OR = 6.4, p < 0.001), no diabetes diagnosis (OR = 2.7, p = 0.030), and a tuberculosis diagnosis (OR = 4.7, p = 0.019). Among Southeast Asians, insurance status was associated with less than high school education (p < 0.05), living in the USA > 20 years (OR = 3.7, p = 0.009), having a routine health check in the past year (OR = 5.6, p = 0.025), and seeing a private doctor when sick or injured (OR = 2.6, p = 0.018). CONCLUSIONS Health insurance status was associated with differing factors among each subgroup. Findings may inform strategies to address challenges and barriers of healthcare access to immigrants, making healthcare more accessible to this underserved population.
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Tapales A, Douglas-Hall A, Whitehead H. The sexual and reproductive health of foreign-born women in the United States. Contraception 2018; 98:47-51. [PMID: 29453946 PMCID: PMC6029875 DOI: 10.1016/j.contraception.2018.02.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 02/06/2018] [Accepted: 02/09/2018] [Indexed: 11/14/2022]
Abstract
Objective To explore the sexual and reproductive health (SRH) behaviors, health insurance coverage and use of SRH services of women in the United States (U.S.) by nativity, disaggregated by race and ethnicity. Study design We analyzed publicly available and restricted data from the National Survey of Family Growth to assess differences and similarities between foreign-born and U.S.-born women, both overall and within Hispanic, non-Hispanic (NH) white, NH black and NH Asian groups. Results A larger proportion of foreign-born women than U.S.-born women lacked health insurance coverage. Foreign-born women utilized SRH services at lower rates than U.S.-born women; this effect diminished at the multivariate level, although race and ethnicity differences remained. Overall, foreign-born women were less likely to pay for SRH services with private insurance than U.S.-born women. Foreign-born women were less likely to use the most effective contraceptive methods than U.S.-born women, with some variation across race and ethnicity: NH white and NH black foreign-born women were less likely to use highly effective contraceptive methods than their U.S.-born counterparts, but among Hispanic women, the reverse was true. Conclusion Our findings demonstrate that the SRH behaviors, needs and outcomes of foreign-born women differ from those of U.S-born women within the same race/ethnic group. Implications This paper contributes to the emergent literature on immigrants in the U.S. by laying the foundation for further research on the SRH of the foreign-born population in the country, which is critical for developing public health policies and programs to understand better and serve this growing and diverse population.
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Affiliation(s)
- Athena Tapales
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038, USA.
| | - Ayana Douglas-Hall
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038, USA.
| | - Hannah Whitehead
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038, USA.
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Stevenson JK, Cheung MC, Earle CC, Fischer HD, Camacho X, Saskin R, Shah BR, Austin PC, Singh S. Chinese and South Asian ethnicity, immigration status, and clinical cancer outcomes in the Ontario Cancer System. Cancer 2018; 124:1473-1482. [DOI: 10.1002/cncr.31231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/13/2017] [Accepted: 12/19/2017] [Indexed: 01/01/2023]
Affiliation(s)
| | - Matthew C. Cheung
- Division of Hematology, Department of Medicine; University of Toronto; Toronto Ontario Canada
- Odette Cancer Centre; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
| | - Craig C. Earle
- Department of Medicine; University of Toronto; Toronto Ontario Canada
- Odette Cancer Centre; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
- Ontario Institute for Cancer Research; Toronto Ontario Canada
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
| | - Hadas D. Fischer
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
| | - Ximena Camacho
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
| | - Refik Saskin
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
| | - Baiju R. Shah
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Division of Endocrinology, Department of Medicine; University of Toronto; Toronto Ontario Canada
| | - Peter C. Austin
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Institute for Health Policy, Management and Evaluation; University of Toronto; Toronto Ontario Canada
| | - Simron Singh
- Odette Cancer Centre; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
- Division of Medical Oncology, Department of Medicine; University of Toronto; Toronto Ontario Canada
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Oh KM, Taylor KL, Jacobsen KH. Breast Cancer Screening Among Korean Americans: A Systematic Review. J Community Health 2018; 42:324-332. [PMID: 27678390 DOI: 10.1007/s10900-016-0258-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cancer is the leading cause of death for Korean Americans (KAs). Breast cancer (BC) is the most commonly occurring cancer among KA women, and its rate has been rapidly increasing. Low BC screening rates for KAs puts them at greater risk for late-stage breast cancer. We conducted a systematic review of the published literature on cancer screening among KAs, and identified 38 eligible studies. Despite significant increases in mammogram utilization over the past two decades, KAs have consistently lower rates of mammogram screening than other American populations. KA women also report lower rates of clinical breast examination and breast self-examination. Screening rates are higher among adults with higher socioeconomic status, greater acculturation to the United States, more cancer knowledge, higher perceived susceptibility to BC, more social support, and better access to health services. However, fear of finding something wrong, fear of embarrassment or lack of modesty, not knowing where to go for screening, believing that mammography is only necessary when symptoms are present, and perceived time and cost difficulties in accessing mammography were reported as barriers to mammogram screening. Coordinated efforts from clinicians, public health workers, KA cultural and religious organizations, and the broader breast cancer advocacy and awareness community are necessary for improving BC screening among KAs.
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Affiliation(s)
- Kyeung Mi Oh
- School of Nursing, George Mason University, 4400 University Drive 3C4, Fairfax, VA, 22030, USA.
| | - Karen L Taylor
- Department of Global and Community Health, George Mason University, 4400 University Drive 5B7, Fairfax, VA, 22030, USA
| | - Kathryn H Jacobsen
- Department of Global and Community Health, George Mason University, 4400 University Drive 5B7, Fairfax, VA, 22030, USA
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Hong HC, Ferrans CE, Park C, Lee H, Quinn L, Collins EG. Effects of Perceived Discrimination and Trust on Breast Cancer Screening among Korean American Women. Womens Health Issues 2017; 28:188-196. [PMID: 29223326 DOI: 10.1016/j.whi.2017.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 10/23/2017] [Accepted: 11/03/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Korean American (KA) women continue to have lower breast cancer screening rates than other racial groups. Perceived discrimination and trust have been associated with breast cancer screening adherence, but little is known about the associations in KA women. METHODS Surveys were completed by 196 KA women in the Chicago metropolitan area. Multiple and Firth logistic regression analyses were performed to identify factors (perceived discrimination, trust, acculturation, cultural beliefs, health care access) influencing breast cancer screening adherence (mammogram). In addition, SPSS macro PROCESS was used to examine the mediating role of trust between perceived discrimination and breast cancer screening adherence. RESULTS Ninety-three percent of the women surveyed had health insurance and 54% reported having a mammogram in the past 2 years. Predictors of having a mammogram were knowing where to go for a mammogram, having a regular doctor or usual place for health care, greater trust in health care providers, and lower distrust in the health care system. Perceived discrimination had an indirect effect on breast cancer screening through trust. CONCLUSIONS The breast cancer screening rate among KA women is low. Perceived discrimination in health care, trust in health care providers, and distrust in the health care system directly or indirectly influenced breast cancer screening adherence in KA women. Trust is a factor that can be strengthened with educational interventions.
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Affiliation(s)
| | | | - Chang Park
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | | | - Lauretta Quinn
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Eileen G Collins
- College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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Lee H, Ghebre R, Le C, Jang YJ, Sharratt M, Yee D. Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2017; 5:e154. [PMID: 29113961 PMCID: PMC5698632 DOI: 10.2196/mhealth.7091] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 07/08/2017] [Accepted: 07/29/2017] [Indexed: 12/20/2022] Open
Abstract
Background Despite the increasing breast cancer incidence and mortality rates, Korean American immigrant women have one of the lowest rates of breast cancer screening across racial groups in the United States. Mobile health (mHealth), defined as the delivery of health care information or services through mobile communication devices, has been utilized to successfully improve a variety of health outcomes. Objective This study adapted the principles of mHealth to advance breast cancer prevention efforts among Korean American immigrant women, an underserved community. Methods Using a randomized controlled trial design, 120 Korean American women aged 40 to 77 years were recruited and randomly assigned to either the mMammogram intervention group (n=60) to receive culturally and personally tailored multilevel and multimedia messages through a mobile phone app along with health navigator services or the usual care control group (n=60) to receive a printed brochure. Outcome measures included knowledge, attitudes, and beliefs about breast cancer screening, readiness for mammography, and mammogram receipt. The feasibility and acceptability of the mMammogram intervention was also assessed. Results The intervention group showed significantly greater change on scores of knowledge of breast cancer and screening guidelines (P=.01). The intervention group also showed significantly greater readiness for mammography use after the intervention compared with the control group. A significantly higher proportion of women who received the mMammogram intervention (75%, 45/60) completed mammograms by the 6-month follow-up compared with the control group (30%, 18/60; P<.001). In addition, the intervention group rated satisfaction with the intervention (P=.003), effectiveness of the intervention (P<.001), and increase of knowledge on breast cancer and screenings (P=.001) significantly higher than the control group. Conclusions A mobile phone app–based intervention combined with health navigator service was a feasible, acceptable, and effective intervention mechanism to promote breast cancer screening in Korean American immigrant women. A flexible, easily tailored approach that relies on recent technological advancements can reach underserved and hard-to-recruit populations that bear disproportionate cancer burdens. Trial Registration Clinicaltrials.gov NCT01972048; https://clinicaltrials.gov/show/NCT01972048 (Archived by WebCite at https://clinicaltrials.gov/archive/NCT01972048/2013_10_29)
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Affiliation(s)
- Hee Lee
- School of Social Work, College of Education and Human Development, University of Minnesota, Twin Cities, St Paul, MN, United States
| | - Rahel Ghebre
- Department of Obstetrics, Gynecology and Women's Health, School of Medicine, University of Minnesota, Twin Cities, Minneapolis, MN, United States
| | - Chap Le
- Division of Biostatistics, School of Public Health, University of Minnesota, Twin Cities, Minneapolis, MN, United States
| | - Yoo Jeong Jang
- Department of Educational Psychology, College of Education and Human Development, University of Minnesota, Twin Cities, Minneapolis, MN, United States
| | - Monica Sharratt
- School of Social Work, College of Education and Human Development, University of Minnesota, Twin Cities, St Paul, MN, United States
| | - Douglas Yee
- Division of Hematology, Oncology and Transplantation, School of Medicine and Pharmacology, University of Minnesota, Twin Cities, Minneapolis, MN, United States
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Yoon H, Chatters L, Kao TS, Saint-Arnault D, Northouse L. Factors Affecting Quality of Life for Korean American Cancer Survivors: An Integrative Review. Oncol Nurs Forum 2017; 43:E132-42. [PMID: 27105204 DOI: 10.1188/16.onf.e132-e142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Understanding of Korean American cancer survivors' quality of life (QOL) within a cultural context is limited. This article examines factors associated with the QOL of Korean American cancer survivors.
. LITERATURE SEARCH A systematic literature search was conducted of PubMed, CINAHL®, Google Scholar, and EBSCO databases from January 2000 to January 2014.
. DATA EVALUATION The studies were assessed for the relevance to the purpose of the review. Each study was rated on a two-point scale using an 11-item quality criteria checklist.
. SYNTHESIS The 13 studies that met the criteria for inclusion included 7 descriptive, 5 qualitative, and 1 mixed-method.
. CONCLUSIONS Social support, communication, and acculturation were key factors associated with Korean Americans' QOL. Cultural differences were evident for Korean Americans versus other Asian American ethnic groups.
. IMPLICATIONS FOR PRACTICE More innovative and culturally driven research is needed to understand each minority group's cultural barriers, as well as to improve cancer survivors' QOL. Improving the doctor-patient relationship is critical to promoting better cancer experiences for Korean American cancer survivors.
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Kim M, Lee H, Kiang P, Kim D. Human Papillomavirus: A Qualitative Study of Korean American Female College Students' Attitudes Toward Vaccination
. Clin J Oncol Nurs 2017; 21:E239-E247. [PMID: 28945722 DOI: 10.1188/17.cjon.e239-e247] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) vaccines have the potential to reduce Korean American women's high burden of cervical cancer, but information is limited about their awareness of HPV and its vaccine.
. OBJECTIVES This study aimed to explore Korean American female college students' awareness of and attitudes toward HPV vaccination.
. METHODS A qualitative descriptive study was used. Five focus group interviews were conducted with 20 Korean American female college students aged 18-26 years from Massachusetts. Data were analyzed using inductive content analysis.
. FINDINGS Major themes were awareness, misunderstandings, attitudes, social influences, and cultural influence. A critical need exists to develop and implement culturally and linguistically appropriate HPV prevention education programs to promote HPV vaccination in this population.
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Affiliation(s)
- Minjin Kim
- University of Massachusetts Medical School
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Davis C, Cadet TJ, Moore M, Darby K. A Comparison of Compliance and Noncompliance in Breast Cancer Screening among African American Women. HEALTH & SOCIAL WORK 2017; 42:159-166. [PMID: 28859423 DOI: 10.1093/hsw/hlx027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 09/02/2016] [Indexed: 06/07/2023]
Abstract
African American women are more likely to be diagnosed with late stage breast cancer, due in part to low participation in screening procedures. The purpose of this study was to explore the differences among African American women who were compliant and noncompliant with standard mammography screening recommendations. The study participants were African American women (N = 599) over the age of 40 with no history of cancer, who were recruited to attend a local community health event. Findings revealed that 78 percent of the women reported having had a mammogram within the past year, whereas 22 percent had not. The most commonly reported reasons given by those who did not have a mammogram in the past year were that they simply did not think to do so, or that they were not told to do so by their doctor. Women who reported that they did not have a mammogram last year were significantly less likely to have health insurance, to have had a clinical breast exam at their last checkup, to have had their breasts examined by their doctor at least once per year, or to have previously had a mammogram. There were no group differences in the number of visits to a doctor during the past 12 months. The article concludes with a discussion of the implications for health care professionals and suggestions for future research.
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Affiliation(s)
- Cindy Davis
- Social Work, University of the Sunshine Coast, Sippy Downs, 4558, Australia. School of Social Work, Simmons College, Boston. College of Social Work, University of Tennessee, Knoxville. Department of Social Work, College of Behavioral and Health Sciences, Middle Tennessee State University, Murfreesboro
| | - Tamara J Cadet
- Social Work, University of the Sunshine Coast, Sippy Downs, 4558, Australia. School of Social Work, Simmons College, Boston. College of Social Work, University of Tennessee, Knoxville. Department of Social Work, College of Behavioral and Health Sciences, Middle Tennessee State University, Murfreesboro
| | - Matthew Moore
- Social Work, University of the Sunshine Coast, Sippy Downs, 4558, Australia. School of Social Work, Simmons College, Boston. College of Social Work, University of Tennessee, Knoxville. Department of Social Work, College of Behavioral and Health Sciences, Middle Tennessee State University, Murfreesboro
| | - Kathleen Darby
- Social Work, University of the Sunshine Coast, Sippy Downs, 4558, Australia. School of Social Work, Simmons College, Boston. College of Social Work, University of Tennessee, Knoxville. Department of Social Work, College of Behavioral and Health Sciences, Middle Tennessee State University, Murfreesboro
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Lee EE, Brecht ML, Park H, Lee J, Oh KM. Web-Based Study for Improving Mammography Among Korean American Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:257-263. [PMID: 26423058 DOI: 10.1007/s13187-015-0920-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Web-based culture-specific interventions for Korean American (KA) women to improve mammography utilization are not available. An established intervention developed to improve mammography utilizations for Korean American (KA) women was tested via the Web for its efficacy, feasibility, and acceptability. A randomized controlled trial, with a pretest-posttest control group design, was conducted with 136 KA women and their spouses. Intention to have a mammogram within the next 12 months increased significantly in the intervention group compare to controls. Among women whose mammograms had not been updated, 22 % of women in the intervention and 13 % of women in the control group obtained a mammogram at 2-month post-baseline, even though the difference was not statistically significant. The Web-based study educating couples was feasible and could improve KA women's breast cancer screening intention and behaviors. Combining off-line contact for recruitment/data collection with online intervention material could decrease the attrition rate in the future study because the attrition rate in this study was higher than the original study.
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Affiliation(s)
- Eunice E Lee
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave. 4-940 Factor Building, Mail Code: 691821, Los Angeles, CA, 90095-6918, USA
| | - Mary-Lynn Brecht
- School of Nursing, University of California, Los Angeles, 700 Tiverton Ave. 5-151 Factor Building, Mail Code: 691821, Los Angeles, CA, USA
| | - HanJong Park
- College of Nursing Science, Kyung Hee University, 26 Kyunghee dae-ro, Dongdaemun-gu, Seoul, 130-701, South Korea
| | - Jongwon Lee
- College of Nursing, University of New Mexico, MSC07 4380, 1 University of New Mexico, Albuquerque, NM, 87131, USA
| | - Kyeung Mi Oh
- School of Nursing, George Mason University, MS3C4, 4400 University Dr, Fairfax, VA, 22030, USA.
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Choi GY, Koh E, Choi S, Cho JY. Understanding breast cancer screening behaviors of Korean American women in sociocultural contexts. SOCIAL WORK IN HEALTH CARE 2017; 56:45-63. [PMID: 27779462 DOI: 10.1080/00981389.2016.1244138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examines the breast cancer screening behaviors of Korean American women focusing on their cultural beliefs and access to health care. A total of 111 Korean American women participated in the cross-sectional survey research. Korean American women who felt embarrassed about breast cancer screenings were less likely to have received clinical breast exams or mammograms. Implications to culturally competent social work practice in promoting their breast cancer screening behaviors are discussed.
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Affiliation(s)
- Ga-Young Choi
- a Department of Social Work , University of Northern Iowa , Cedar Falls , Iowa , USA
| | - Eun Koh
- b National Catholic School of Social Service , The Catholic University of America , Washington , District of Columbia , USA
| | - Sam Choi
- c Department of Social Work , Alabama A&M University , Normal , Alabama , USA
| | - Ji-Young Cho
- d Korean Community Service Center of Greater Washington , Annandale , Virginia , USA
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Schuster AL, Frick KD, Huh BY, Kim KB, Kim M, Han HR. Economic evaluation of a community health worker-led health literacy intervention to promote cancer screening among Korean American women. J Health Care Poor Underserved 2016; 26:431-40. [PMID: 25913341 DOI: 10.1353/hpu.2015.0050] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The study's objectives were to calculate the costs and evaluate the cost-effectiveness of implementing a health literacy-focused intervention to promote breast and cervical cancer screenings among Korean American women overdue for these tests. METHODS Researchers estimated the costs of a cluster-randomized controlled trial that evaluated this intervention. Effectiveness was measured as the number of breast or cervical cancer screenings received by women in either the intervention and control arms of the study. Cost-effectiveness was calculated as the incremental cost of each additional screening received by the intervention group. RESULTS Comparing the intervention and control group, the incremental cost-effectiveness ratio was estimated to be US$236 per screening, without program development costs. CONCLUSION These findings suggest this program, when compared with others, offered a more cost-effective approach for promoting cancer screening. Local health officials could use this information to guide decisions about reducing cancer disparities among recent immigrant women.
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Focella ES, Shaffer VA, Dannecker EA, Clark MJ, Schopp LH. Racial/Ethnic Differences in the Use of Primary Care Providers and Preventive Health Services at a Midwestern University. J Racial Ethn Health Disparities 2016; 3:309-19. [PMID: 27271072 DOI: 10.1007/s40615-015-0148-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/28/2015] [Accepted: 06/30/2015] [Indexed: 11/24/2022]
Abstract
Many universities seek to improve the health and wellbeing of their faculty and staff through employer wellness programs but racial/ethnic disparities in health care use may still persist. The purpose of this research was to identify racial/ethnic disparities in the use of preventive health services at a Midwestern university. A record review was conducted of self-reported health data from University employees, examining the use of primary care and common screening procedures collected in a Personal Health Assessment conducted by the University's wellness program. Results show that there were significant racial/ethnic differences in the use of primary care and participation in screening. Notably, Asian employees in this sample were less likely to have a primary care provider and participate in routine cancer screenings. The observed racial/ethnic differences in screening behavior were mediated by the use of primary care. Together, these data show that despite equal access to care, racial and ethnic disparities in screening persist and that having a primary care provider is an important predictor of screening behavior. Results suggest that health communications designed to increase screening among specific racial/ethnic minority groups should target primary care use.
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Affiliation(s)
- Elizabeth S Focella
- School of Health Professions, University of Missouri, Columbia, MO, 65201, USA.
| | - Victoria A Shaffer
- School of Health Professions, University of Missouri, Columbia, MO, 65201, USA
| | - Erin A Dannecker
- School of Health Professions, University of Missouri, Columbia, MO, 65201, USA
| | - Mary J Clark
- School of Health Professions, University of Missouri, Columbia, MO, 65201, USA
| | - Laura H Schopp
- School of Health Professions, University of Missouri, Columbia, MO, 65201, USA
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48
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Lee HY, Lee MH. Barriers to Cervical Cancer Screening and Prevention in Young Korean Immigrant Women: Implications for Intervention Development. J Transcult Nurs 2016; 28:353-362. [DOI: 10.1177/1043659616649670] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to identify major barriers to Papanicolaou (Pap) test uptake and human papillomavirus (HPV) vaccine acceptability. Three focus groups with 16 young Korean immigrant women residing in a community in the Midwest were conducted. Braun and Clarke’s six phases of thematic analysis were used to develop themes. Three major themes emerged as barriers: (a) limited knowledge about cervical cancer and preventive behaviors, (b) culture-specific barriers, and (c) low accessibility to health care services. These themes were multifactorial and interrelated barriers to Pap test uptake and HPV vaccine acceptability among young Korean immigrant women. These findings indicate that culturally tailored cervical cancer education is needed to promote Pap test uptake and HPV vaccination in this underserved population.
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Affiliation(s)
- Hee Yun Lee
- University of Minnesota–Twin Cities, St. Paul, MN, USA
| | - Mi Hwa Lee
- University of Minnesota–Twin Cities, St. Paul, MN, USA
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Crawford J, Ahmad F, Beaton D, Bierman AS. Cancer screening behaviours among South Asian immigrants in the UK, US and Canada: a scoping study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:123-153. [PMID: 25721339 DOI: 10.1111/hsc.12208] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/12/2014] [Indexed: 06/04/2023]
Abstract
South Asian (SA) immigrants settled in the United Kingdom (UK) and North America [United States (US) and Canada] have low screening rates for breast, cervical and colorectal cancers. Incidence rates of these cancers increase among SA immigrants after migration, becoming similar to rates in non-Asian native populations. However, there are disparities in cancer screening, with low cancer screening uptake in this population. We conducted a scoping study using Arksey & O'Malley's framework to examine cancer screening literature on SA immigrants residing in the UK, US and Canada. Eight electronic databases, key journals and reference lists were searched for English language studies and reports. Of 1465 identified references, 70 studies from 1994 to November 2014 were included: 63% on breast or cervical cancer screening or both; 10% examined colorectal cancer screening only; 16% explored health promotion/service provision; 8% studied breast, cervical and colorectal cancer screening; and 3% examined breast and colorectal cancer screening. A thematic analysis uncovered four dominant themes: (i) beliefs and attitudes towards cancer and screening included centrality of family, holistic healthcare, fatalism, screening as unnecessary and emotion-laden perceptions; (ii) lack of knowledge of cancer and screening related to not having heard about cancer and its causes, or lack of awareness of screening, its rationale and/or how to access services; (iii) barriers to access including individual and structural barriers; and (iv) gender differences in screening uptake and their associated factors. Findings offer insights that can be used to develop culturally sensitive interventions to minimise barriers and increase cancer screening uptake in these communities, while recognising the diversity within the SA culture. Further research is required to address the gap in colorectal cancer screening literature to more fully understand SA immigrants' perspectives, as well as research to better understand gender-specific factors that influence screening uptake.
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Affiliation(s)
- Joanne Crawford
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Department of Nursing, Brock University, St. Catharines, Ontario, Canada
| | - Farah Ahmad
- School of Health Policy and Management, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Dorcas Beaton
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Measurement Stream, Institute for Work & Health, Toronto, Ontario, Canada
| | - Arlene S Bierman
- Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, Institute of Health Policy, Management and Evaluation, Department of Medicine and Public Health, University of Toronto, Toronto, Ontario, Canada
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Li J, Maxwell AE, Glenn BA, Herrmann AK, Chang LC, Crespi CM, Bastani R. Healthcare Access and Utilization among Korean Americans: The Mediating Role of English Use and Proficiency. INTERNATIONAL JOURNAL OF SOCIAL SCIENCE RESEARCH 2016; 4:83-97. [PMID: 29057278 PMCID: PMC5647155 DOI: 10.5296/ijssr.v4i1.8678] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The literature suggests that Korean Americans underutilize health services. Cultural factors and language barriers appear to influence this pattern of low utilization but studies on the relationships among length of stay in the US, English use and proficiency, and utilization of health services among Korean Americans have yielded inconsistent results. This study examines whether English language use and proficiency plays a mediating role in the relationships between length of stay in the US and health insurance coverage, access to and use of care. Structural equation modeling was used for mediation analysis with multiple dependent variables among Korean Americans (N = 555) using baseline data from a large trial designed to increase Hepatitis B testing. The results show 36% of the total effect of proportion of lifetime in the US on having health insurance was significantly mediated by English use and proficiency (indirect effect = 0.166, SE = 0.07, p<.05; direct effect = 0.296, SE = 0.13, p<.05). Proportion of lifetime in the US was not associated with usual source of care and health service utilization. Instead, health care utilization was primarily driven by having health insurance and a usual source of care, further underscoring the importance of these factors. A focus on increasing English use and proficiency and insurance coverage among older, female, less educated Korean Americans has the potential to mitigate health disparities associated with reduced access to health services in this population.
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Affiliation(s)
- Jiang Li
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-8954
| | - Annette E Maxwell
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-794-9282
| | - Beth A Glenn
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-9715
| | - Alison K Herrmann
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-8483
| | - L Cindy Chang
- Jonsson Comprehensive Cancer Center and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-204-9038
| | - Catherine M Crespi
- Department of Biostatistics, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-9364
| | - Roshan Bastani
- Department of Health Policy and Management, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, and UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles E. Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095, USA, Tel: 1-310-206-9266
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