TY - JOUR
T1 - Effects of Neighborhood Ethnic Density and Psychosocial Factors on Colorectal Cancer Screening Behavior Among Asian American Adults, Greater Philadelphia and New Jersey, United States, 2014–2019
AU - Bhimla, Aisha
AU - Mann-Barnes, Tyrell
AU - Park, Hemi
AU - Yeh, Ming Chin
AU - Do, Phuong
AU - Aczon, Ferdinand
AU - Ma, Grace X.
N1 - Publisher Copyright:
© 2021. The Authors.
PY - 2021
Y1 - 2021
N2 - INTRODUCTION: We examined how neighborhood ethnic composition influences colorectal cancer (CRC) screening behavior in Asian American adults and explored whether associations between psychosocial predictors, including knowledge, self-efficacy, and barriers affecting CRC screening behavior, varied by level of neighborhood ethnic composition.METHODS: Filipino, Korean, and Vietnamese Americans (N = 1,158) aged 50 years or older were included in the study. Psychosocial factors associated with CRC screening, CRC screening behavior, and sociodemographic characteristics were extracted from participants' data. Neighborhood ethnic composition was characterized as the census-tract-level percentage of Asian residents. Participants' addresses were geocoded to the census tract level to determine whether they resided in an ethnically dense neighborhood. Multilevel logistic regression models were run with and without interaction terms.RESULTS: In mixed-effects logistic regression model 1, residing in an ethnically dense neighborhood was associated with lower odds of CRC screening (odds ratio [OR] = 0.65; 95% CI, 0.45-0.93; P = .02) after controlling for age, sex, education, ethnic group, and neighborhood socioeconomic status. Greater perceived barriers to CRC screening (OR = 0.62; 95% CI, 0.50-0.77; P < .001) resulted in significantly lower odds of obtaining a CRC screening, while higher self-efficacy (OR = 1.17, 95% CI, 1.11-1.23, P < .001) was associated with higher odds. In model 2, among those residing in a high ethnic density neighborhood, greater barriers to screening were associated with lower odds of having obtained a CRC screening (OR = 0.53; 95% CI, 0.30-0.96; P = .04).CONCLUSION: We found that residing in an ethnically dense neighborhood indicated higher disparities in obtaining CRC screenings. Future studies should examine socioeconomic and cultural disparities, as well as disparities in the built environment, that are characteristic of ethnically dense neighborhoods and assess the impact of these disparities on CRC screening behaviors.
AB - INTRODUCTION: We examined how neighborhood ethnic composition influences colorectal cancer (CRC) screening behavior in Asian American adults and explored whether associations between psychosocial predictors, including knowledge, self-efficacy, and barriers affecting CRC screening behavior, varied by level of neighborhood ethnic composition.METHODS: Filipino, Korean, and Vietnamese Americans (N = 1,158) aged 50 years or older were included in the study. Psychosocial factors associated with CRC screening, CRC screening behavior, and sociodemographic characteristics were extracted from participants' data. Neighborhood ethnic composition was characterized as the census-tract-level percentage of Asian residents. Participants' addresses were geocoded to the census tract level to determine whether they resided in an ethnically dense neighborhood. Multilevel logistic regression models were run with and without interaction terms.RESULTS: In mixed-effects logistic regression model 1, residing in an ethnically dense neighborhood was associated with lower odds of CRC screening (odds ratio [OR] = 0.65; 95% CI, 0.45-0.93; P = .02) after controlling for age, sex, education, ethnic group, and neighborhood socioeconomic status. Greater perceived barriers to CRC screening (OR = 0.62; 95% CI, 0.50-0.77; P < .001) resulted in significantly lower odds of obtaining a CRC screening, while higher self-efficacy (OR = 1.17, 95% CI, 1.11-1.23, P < .001) was associated with higher odds. In model 2, among those residing in a high ethnic density neighborhood, greater barriers to screening were associated with lower odds of having obtained a CRC screening (OR = 0.53; 95% CI, 0.30-0.96; P = .04).CONCLUSION: We found that residing in an ethnically dense neighborhood indicated higher disparities in obtaining CRC screenings. Future studies should examine socioeconomic and cultural disparities, as well as disparities in the built environment, that are characteristic of ethnically dense neighborhoods and assess the impact of these disparities on CRC screening behaviors.
KW - Adult
KW - Asian
KW - Census Tract
KW - Colorectal Neoplasms/diagnosis
KW - Early Detection of Cancer
KW - Ethnicity
KW - Humans
KW - New Jersey
KW - Philadelphia
KW - Residence Characteristics
KW - Socioeconomic Factors
KW - United States
UR - http://www.scopus.com/inward/record.url?scp=85117524038&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000706195600002&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.5888/PCD18.210062
DO - 10.5888/PCD18.210062
M3 - Article
C2 - 34591753
SN - 1545-1151
VL - 18
SP - E90
JO - Preventing chronic disease
JF - Preventing chronic disease
ER -