Cancer Nursing
Volume 37, Issue 2, 2014, Pages 106-113

Heterogeneous demographic and cultural profiles of Chinese American patients nonadherent to colorectal cancer screening: A latent class Analysis (Article)

Strong C. , Ji C.S. , Liang W. , Ma G. , Brown R. , Wang J.H.-Y.*
  • a Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  • b Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Suite 4100, 3300 Whitehaven St, Washington, DC 20007, United States
  • c Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Suite 4100, 3300 Whitehaven St, Washington, DC 20007, United States
  • d Department of Public Health and Center for Asian Health, Temple University, Philadelphia, PA, United States
  • e School of Nursing, University of WisconsinYMadison, United States
  • f Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Suite 4100, 3300 Whitehaven St, Washington, DC 20007, United States

Abstract

Colorectal cancer (CRC) is one of the leading causes of cancer death in Chinese Americans, but their CRC screening rates remain low. OBJECTIVE:: We examined subgroups of Chinese American patients nonadherent to CRC screening guidelines to better inform clinical practices to effectively promote screening. METHODS:: Using latent class analysis of data from 327 participants recruited from 18 primary care clinics, we classified nonadherent patients based on sociodemographics, screening barriers, and attitudinal and clinical factors for CRC screening. RESULTS:: The best-fitting latent class analysis model described 3 distinctive classes: Western healthcare class (36%), Eastern healthcare class (18%), and mixed healthcare class (46%). Western healthcare class patients were highly educated, with average US residency of 20 years, a high level of English proficiency, the least Eastern cultural views of care, and the greatest exposure to physician recommendations, but reported having no time for screenings. Eastern healthcare class patients were highly educated seniors and recent immigrants with the least CRC knowledge and the most Eastern cultural views. Mixed healthcare class patients had low level of education, resided in the United States for 20 years, and half had sought services of their physicians for at least 3 years, but their knowledge and cultural views were similar to those of Eastern healthcare class patients. CONCLUSIONS:: Nonadherent Chinese American patients are heterogeneous. It is essential to have future intervention programs tailored to address specific screening beliefs and barriers for subtypes of nonadherent patients. IMPLICATIONS FOR PRACTICE:: Training primary care physicians to recognize patients' different demographic characteristics and healthcare beliefs may facilitate physicians' communication with patients to overcome their barriers and improve screening behaviors.Copyright © 2014 Wolters Kluwer Health Lippincott Williams & Wilkins.

Author Keywords

Screening Chinese americans Latent class analysis Cultural view of healthcare Colorectal cancer

Index Keywords

multicenter study nursing clinical trial poverty Follow-Up Studies follow up human middle aged controlled study comparative study randomized controlled trial Aged Colorectal Neoplasms general practitioner Early Detection of Cancer ethnology Surveys and Questionnaires United States Humans Asian Americans male Asian American female risk factor Risk Factors questionnaire cultural factor Health Knowledge, Attitudes, Practice patient compliance Physicians, Primary Care Cultural Characteristics social class attitude to health early diagnosis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84894499568&doi=10.1097%2fNCC.0b013e3182888b5b&partnerID=40&md5=4e5bbd6509caf3258eef1ed57e64a367
DOI: 10.1097/NCC.0b013e3182888b5b
ISSN: 0162220X
Cited by: 7
Original Language: English