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Lewis-Thames MW, Tom LS, Leung IS, Yang A, Simon MA. An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative study. BMC Womens Health 2022; 22:28. [PMID: 35120523 PMCID: PMC8815179 DOI: 10.1186/s12905-022-01610-7] [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: 09/01/2021] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chinese Americans have lower breast and cervical cancer screening rates than the national average and experience multiple barriers to cancer care. Patient navigators have improved screening and follow-up rates for medically underserved populations, yet investigations of cancer navigation programs and their implementation among Chinese Americans are limited. To address this gap, we used the Consolidated Framework for Implementation Research (CFIR) to examine facilitators and barriers to implementing the Chicago-based Chinatown Patient Navigation Program (CPNP) for breast and cervical cancer screening, follow-up, and treatment. METHODS Stakeholders from clinical care, supportive care services, and community organizations were invited to participate in qualitative interviews to illuminate implementation processes and stakeholder perspectives of facilitators and barriers to implementing the CPNP. Interviews were audio-recorded, transcribed, and deductively coded according to CFIR domains, including (1) intervention characteristics; (2) outer setting; (3) inner setting; and (4) the implementation process. RESULTS We interviewed a convenience sample of 16 stakeholders representing a range of roles in cancer care, including nurses, clinical team members, administrators, physicians, a community-based organization leader, and a CPNP navigator. Findings detail several facilitators to implementing the CPNP, including patient navigators that prepared Chinese-speaking patients for their clinic visits, interpretation services, highly accessible patient navigators, and high-quality flexible services. Barriers to program implementation included limited regular feedback provided to stakeholders regarding their program involvement. Also, early in the program's implementation there was limited awareness of the CPNP navigators' roles and responsibilities, insufficient office space for the navigators, and few Chinese language patient resource materials. CONCLUSIONS These findings provide valuable information on implementation of future patient navigation programs serving Chinese American and other limited-English speaking immigrant populations.
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Affiliation(s)
- Marquita W Lewis-Thames
- Department of Medical Social Science, Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Laura S Tom
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Health Equity Transformation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ivy S Leung
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Health Equity Transformation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anna Yang
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Health Equity Transformation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Melissa A Simon
- Department of Medical Social Science, Center for Community Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. .,Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. .,Center for Health Equity Transformation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. .,Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. .,Departments of Obstetrics and Gynecology, Preventive Medicine and Medical Social Science, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1100, Chicago, IL, 60611, USA.
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Wang M, Li M, Dong X. The Associations Between Sociodemographic Characteristics and Trust in Physician With Immunization Service Use in U.S. Chinese Older Adults. Res Aging 2021; 44:164-173. [PMID: 33938299 DOI: 10.1177/01640275211011048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated sociodemographic factors for immunization care use and the relationship between trust in physician (TIP) and immunization service use in older Chinese Americans. Data were collected through the Population Study of Chinese Elderly, including survey information of 3,157 older adults in the Greater Chicago area. Regression results showed that the odds of getting vaccinated were higher for those who were older, female, and had higher education and income. After adjusting for the covariates, higher TIP was associated with greater immunization service use. The highest tertile of TIP was associated with higher odds of using immunization service (OR 2.19, 95% CI [1.76, 2.72]), especially for flu and pneumonia vaccines. Findings suggests that immunization service use may be increased by improving TIP and promoting targeted health care management plans for racial/ethnic minorities, which is highly relevant to increase the vaccination rate and contain the pandemic as the COVID-19 vaccine is available.
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Affiliation(s)
- Mengxiao Wang
- School of Public Administration, 12603Southwestern University of Finance and Economics, Chengdu, China
| | - Mengting Li
- Institute for Health, Health Care Policy and Aging Research, 242612Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.,School of Nursing, 242612Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, 242612Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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3
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Fung J, Vang S, Margolies LR, Li A, Blondeau-Lecomte E, Li A, Jandorf L. Developing a Culturally and Linguistically Targeted Breast Cancer Educational Program for a Multicultural Population. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:395-400. [PMID: 31713105 PMCID: PMC7211551 DOI: 10.1007/s13187-019-01643-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Breast cancer is the most commonly diagnosed cancer among women in the USA. Despite the availability of screening mammograms, significant disparities still exist in breast cancer outcomes of racial/ethnic and sexual/gender minorities. To address these disparities, the Mount Sinai Mobile Breast Health Program in New York City collaborated with local organizations to develop culturally and linguistically appropriate breast cancer education programs aimed at increasing screening mammogram utilization. Literature review of the barriers to mammography screening formed the basis to allow us to draft a narrative presentation for each targeted cultural group: African American, African-born, Chinese, Latina, and Muslim women, as well as LGBTQ individuals. The presentations were then tested with focus groups comprised of gatekeepers and members from local community and faith-based organizations which served the targeted populations. Feedback from focus groups and gatekeepers was incorporated into the presentations, and if necessary, the presentations were translated. Subsequently, the presentations were re-tested for appropriateness and reviewed for consistency in message, design, educational information, and slide sequencing. Our experience demonstrated the importance of collaborating with community organizations to provide educational content that is culturally and linguistically appropriate for minority groups facing barriers to uptake of screening mammography.
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Affiliation(s)
- Jenny Fung
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA
| | - Suzanne Vang
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA.
| | - Laurie R Margolies
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alicia Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA
| | - Esther Blondeau-Lecomte
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA
| | - Alice Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA
| | - Lina Jandorf
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA
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4
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Iddrisu M, Aziato L, Ohene LA. Socioeconomic impact of breast cancer on young women in Ghana: A qualitative study. Nurs Open 2021; 8:29-38. [PMID: 33318809 PMCID: PMC7729654 DOI: 10.1002/nop2.590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/05/2020] [Accepted: 07/13/2020] [Indexed: 12/13/2022] Open
Abstract
Aim This study was undertaken to discover the socioeconomic impact of breast cancer on young women in Ghana. Methods A qualitative exploratory and descriptive design was used to recruit 12 young women from the University of Ghana hospital, 37 Military hospital and Ridge hospital. Individual interviews were conducted face to face and data transcribed verbatim and analysed using content analysis. Results Three themes emerged: perceptions and beliefs; economic concerns; and secrecy. Participants perceived that breast cancer was a test of faith, a spiritual disease that is contagious and disgraceful. Mostly, participants stopped work to cater for themselves, and as a result, they encountered financial challenges. Their challenges were compounded with conscious efforts to keep diagnosis secret to avoid being stigmatized. Conclusion Young women living with breast cancer need support physically, economically and socially from healthcare providers, their families and the society at large.
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Affiliation(s)
- Merri Iddrisu
- Department of Adult HealthSchool of Nursing and MidwiferyUniversity of GhanaAccraGhana
| | - Lydia Aziato
- Department of Adult HealthSchool of Nursing and MidwiferyUniversity of GhanaAccraGhana
| | - Lillian A. Ohene
- Department of Community Health NursingSchool of Nursing and MidwiferyUniversity of GhanaAccraGhana
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5
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Zhang X, Li P, Guo P, Wang J, Liu N, Yang S, Yu L, Zhang X, Zhang W. Culturally Tailored Intervention to Promote Mammography Screening Practice Among Chinese American Women: a Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1052-1060. [PMID: 32140968 DOI: 10.1007/s13187-020-01730-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Our review aimed to assess the effectiveness of culturally tailored intervention in mammography practice for Chinese American women. We searched the entire paper published by the Cochrane Library, PubMed, and Web of Science from inception to 17 October 2019. Moreover, we manually checked reference lists of included studies to find other potentially eligible studies. It included clinical trials published in English that evaluated the effects of culturally tailored intervention on mammography practice for Chinese American women. Finally, we involved eight studies in our review. After the intervention, the mammography intention and breast cancer-related knowledge were significantly improved. However, there was no significant impact on mammography completion rate, perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, and Eastern cultural views of Chinese American women. The culturally tailored interventions could serve as promising approaches to improve mammography screening practice for Chinese American women, but further improvements are needed.
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Affiliation(s)
- Xuehui Zhang
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Ping Li
- The Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Pingping Guo
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Jie Wang
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Na Liu
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Shu Yang
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Lin Yu
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China
| | - Xiumin Zhang
- School of Public Health, Jilin University, Changchun, 130021, Jilin Province, China.
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, 130021, Jilin Province, China.
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6
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Austin JD, Shelton RC, Lee Argov EJ, Tehranifar P. Older Women’s Perspectives Driving Mammography Screening Use and Overuse: a Narrative Review of Mixed-Methods Studies. CURR EPIDEMIOL REP 2020. [DOI: 10.1007/s40471-020-00244-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Abstract
Purpose of Review
Examining what older women know and perceive about mammography screening is critical for understanding patterns of under- and overuse, and concordance with screening mammography guidelines in the USA. This narrative review synthesizes qualitative and quantitative evidence around older women’s perspectives toward mammography screening.
Recent Findings
The majority of 43 identified studies focused on promoting mammography screening in women of different ages, with only four studies focusing on the overuse of mammography in women ≥ 70 years old. Older women hold positive attitudes around screening, perceive breast cancer as serious, believe the benefits outweigh the barriers, and are worried about undergoing treatment if diagnosed. Older women have limited knowledge of screening guidelines and potential harms of screening.
Summary
Efforts to address inequities in mammography access and underuse need to be supplemented by epidemiologic and interventional studies using mixed-methods approaches to improve awareness of benefits and harms of mammography screening in older racially and ethnically diverse women. As uncertainty around how best to approach mammography screening in older women remains, understanding women’s perspectives along with healthcare provider and system-level factors is critical for ensuring appropriate and equitable mammography screening use in older women.
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7
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Hong A, Chua J, Cheng M, Law M. Breast cancer subtypes in Australian Chinese women. ANZ J Surg 2020; 90:2516-2520. [PMID: 32935473 DOI: 10.1111/ans.16313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/15/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND It has been suggested that Chinese patients with breast cancer present at a younger age compared to the general Australian population, with tumour pathological characteristics that carry less favourable outcomes. This study was aimed to investigate if a substantial difference in breast cancer subtypes exists between the Australian Chinese population and the general Australian population. METHODS All patients with breast cancer treated by two of the authors (consultant breast surgeons) at Eastern Health, Victoria between 2010 and 2016 were identified through the BreastSurgANZ Quality Audit database. Australian Chinese patients were further identified through outpatient records and registration information. Medical histories were examined to obtain patient demographics, tumour characteristics and outcome. Patient and tumour characteristics between the Australian Chinese population were then compared to the general Australian population. RESULTS A total of 97 Australian Chinese patients with breast cancer were identified out of 582 patients. Mean age at diagnosis was 56.7 years, approximately 6 years younger than the general Australian population. There was a statistically significant difference in incidence of Luminal A tumours with 25 patients (25.77%) from the Chinese group affected compared to 310 patients (63.92%) from the general group (P < 0.001). There was no significant difference in proportions of the other tumour subtypes between the two groups. CONCLUSION Australian Chinese breast cancer patients present at a younger age compared to the general Australian population, with a smaller proportion of patients having Luminal A tumours.
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Affiliation(s)
- Alton Hong
- Breast and Endocrine Surgery, Eastern Health, Melbourne, Victoria, Australia
| | - Jonathan Chua
- Breast and Endocrine Surgery, Eastern Health, Melbourne, Victoria, Australia
| | - Michael Cheng
- Breast and Endocrine Surgery, Eastern Health, Melbourne, Victoria, Australia
| | - Michael Law
- Breast and Endocrine Surgery, Eastern Health, Melbourne, Victoria, Australia
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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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9
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Maves H, Flodman P, Nathan D, Smith M. Ethnic disparities in the frequency of cancer reported in family histories. J Genet Couns 2020; 29:451-459. [DOI: 10.1002/jgc4.1264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 02/17/2020] [Accepted: 02/22/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Heather Maves
- Division of Genetic and Genomic Medicine Department of Pediatrics University of California, Irvine Irvine California
| | - Pamela Flodman
- Division of Genetic and Genomic Medicine Department of Pediatrics University of California, Irvine Irvine California
| | - Deepika Nathan
- Division of Genetic and Genomic Medicine Department of Pediatrics University of California, Irvine Irvine California
| | - Moyra Smith
- Division of Genetic and Genomic Medicine Department of Pediatrics University of California, Irvine Irvine California
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10
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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: 8] [Impact Index Per Article: 1.6] [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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Simon MA, Tom LS, Leung I, Wong E, Knightly EE, Vicencio DP, Yau A, Ortigara K, Dong X. The Chinatown Patient Navigation Program: Adaptation and Implementation of Breast and Cervical Cancer Patient Navigation in Chicago's Chinatown. Health Serv Insights 2019; 12:1178632919841376. [PMID: 31037032 PMCID: PMC6475834 DOI: 10.1177/1178632919841376] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 03/09/2019] [Indexed: 01/09/2023] Open
Abstract
Background As health care reform continues within the United States, navigators may play increasingly diverse and vital roles across the health care continuum. The growing interest in patient navigation programs for underserved populations calls for detailed descriptions of intervention components to facilitate implementation and dissemination efforts. Methods In Chicago's Chinatown, Chinese immigrant women face language, cultural, and access barriers in obtaining breast and cervical cancer screening and follow-up. These barriers spurred the research partnership between Northwestern University, the Chinese American Service League, Mercy Hospital & Medical Center, and Rush University Medical Center to formalize the Chinatown Patient Navigation Collaborative for adapting and implementing previously developed patient navigation models. Results In this report, we describe the adaptation of patient navigation to build the Chinatown Patient Navigation Collaborative's community-based patient navigation program for breast and cervical cancer. We offer insights into the roles of community patient navigators in safety net hospital and underserved Chinese immigrant communities, and describe implications for patient navigation initiatives to maximize community benefits by improving access to health care for vulnerable populations. Conclusions Our adaptation and implementation of a patient navigation intervention in Chicago's Chinatown illustrates promising approaches for future navigator research.
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Affiliation(s)
- Melissa A Simon
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Laura S Tom
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ivy Leung
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Chinese American Service League, Chicago, IL, USA
| | - Esther Wong
- Chinese American Service League, Chicago, IL, USA
| | - Eileen E Knightly
- University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | | | - Ann Yau
- Mercy Hospital & Medical Center, Chicago, IL, USA
| | | | - XinQi Dong
- Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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12
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Hei A, Dong X. Association Between Social Engagement and Cancer Screening Utilization in a Community-Dwelling Chinese American Older Population. Gerontol Geriatr Med 2018; 4:2333721418778184. [PMID: 30035194 PMCID: PMC6050613 DOI: 10.1177/2333721418778184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 09/25/2017] [Accepted: 11/30/2017] [Indexed: 11/26/2022] Open
Abstract
Objectives: This study aims to examine the association between social engagement and cancer screening utilization among a Chinese American older population. Method: Data were drawn from the Population Study of Chinese Elderly (PINE). In total, 3,157 Chinese older adults enrolled in this study. Cancer screening utilization was assessed by asking whether participants had utilized cancer screenings. Social engagement was measured with 16 questions. Results: After controlling for potential confounders, a higher level of social engagement was associated with increased utilization in blood stool test (OR 1.03, [1.02, 1.05]), colonoscopy (OR 1.02, [1.01, 1.03]), mammography (OR 1.06, [1.05, 1.08]), Pap test (OR 1.04, [1.03, 1.06]), and prostate specific antigen (PSA) test (OR 1.03, [1.01, 1.05]). Compared with those with low levels of social engagement, older adults with high levels of social engagement were more likely to have utilized a blood stool test (OR 1.85, [1.46, 2.35]), a colonoscopy (OR 1.37, [1.09, 1.72]), a mammography (OR 3.05, [2.25, 4.14]), and a Pap test (OR 1.99, [1.49, 2.66]), but not more likely to have utilized a PSA test (OR 1.40, [0.97, 2.03]). Conclusion: This study underscores the association between active social engagement and increased utilization of cancer screening among a Chinese American older population. Improving social engagement could be helpful in promoting cancer screening utilization.
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13
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Bao Y, Kwok C, Lee CF. Breast cancer screening behaviors among Chinese women in Mainland China. Nurs Health Sci 2018; 20:445-451. [PMID: 29920900 DOI: 10.1111/nhs.12533] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 03/15/2018] [Accepted: 04/06/2018] [Indexed: 01/01/2023]
Abstract
In the present study, we reported on the current breast cancer screening rates among Chinese women in China and examined whether demographic factors and cultural beliefs were associated with their screening behavior. A cross-sectional survey was conducted with a convenience sample of 494 Chinese women who completed the modified Breast Cancer Screening Beliefs Questionnaire (BCSBQ). Two-sample t-tests and multivariable logistic regression were employed to analyze the data. The results indicated that participation in screening practices ranged from 27.5% for breast self-examination (BSE), 36.4% for clinical breast examination, 23.5% for mammography, and 40% for ultrasonography. Women who had previously engaged in one of the four screening practices had significantly higher scores on the three subscales of the modified BCSBQ. Being older and having a friend who had been diagnosed with breast cancer were shown to be predictors for BSE and participation in either mammography or ultrasonography, respectively. Education levels were also shown to be positively associated with the four screening measures. We suggest that cultural beliefs about breast cancer and screening practices play a significant role in Chinese women's screening behavior.
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Affiliation(s)
- Yingyi Bao
- School of Stomatology and Medicine, Foshan University, Foshan, China
| | - Cannas Kwok
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia
| | - Chun Fan Lee
- School of Public Health, The University of Hong Kong, Hong Kong
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