TY - JOUR
T1 - Heterogeneous demographic and cultural profiles of Chinese American patients nonadherent to colorectal cancer screening
T2 - A latent class Analysis
AU - Strong, Carol
AU - Ji, Cheng Shuang
AU - Liang, Wenchi
AU - Ma, Grace
AU - Brown, Roger
AU - Wang, Judy Huei Yu
PY - 2014/3
Y1 - 2014/3
N2 - 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.
AB - 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.
KW - Chinese Americans
KW - Colorectal cancer
KW - Cultural view of healthcare
KW - Latent class analysis
KW - screening
UR - http://www.scopus.com/inward/record.url?scp=84894499568&partnerID=8YFLogxK
U2 - 10.1097/NCC.0b013e3182888b5b
DO - 10.1097/NCC.0b013e3182888b5b
M3 - Article
C2 - 23519040
AN - SCOPUS:84894499568
SN - 0162-220X
VL - 37
SP - 106
EP - 113
JO - Cancer Nursing
JF - Cancer Nursing
IS - 2
ER -