The Chinese and Korean American immigrant experience: a mixed-methods examination of facilitators and barriers of colorectal cancer screening.
The Chinese and Korean American immigrant experience: a mixed-methods examination of facilitators and barriers of colorectal cancer screening.
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中国和韩国移民的经验：对促进者和结肠癌筛查障碍的混合方法。
DOI：
10.1080/13557858.2017.1296559
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发表时间：
2018-11
影响因子：
3.1
通讯作者：
Lee S
中科院分区：
文献类型：
--
作者：
Jung MY;Holt CL;Ng D;Sim HJ;Lu X;Le D;Juon HS;Li J;Lee S
在亚裔美国人中，结直肠癌（CRC）是癌症死亡的第二大原因。尽管有强有力的证据表明筛查可以降低结直肠癌相关死亡率，但与非西班牙裔白人和黑人相比，接受筛查的中国人和韩国人较少。本研究的目的是检查促进因素和障碍以及促进该人群进行结直肠癌筛查的策略。本研究采用了混合方法设计。我们在华盛顿特区大都市地区进行了 17 次关键知情人访谈和 12 个焦点小组。 120名年龄在50岁至85岁之间的中国和韩国焦点小组参与者也通过自我管理的调查提供了定量数据。所有参与者都被要求讨论 CRC 筛查的促进因素和障碍，包括与文化相关的因素和障碍。定期接受医生和医生建议进行 CRC 筛查的参与者更有可能接受结肠镜检查（调整后比值比 (aOR)= 3.51；95% 置信区间 (CI)：1.26、9.79；aOR=6.61；95% CI：2.63、16.65）。医生的建议也与接受粪便隐血试验 (FOBT) 显着相关 (aOR=4.00; 95% CI: 1.43, 11.15)。在障碍方面，那些报告没有时间且没有症状的人比那些有时间和有症状的人更不可能进行结肠镜检查（aOR=0.15；95% CI：0.03、0.82；aOR= 0.02；95% CI：0.002、0.23）。预防性医疗保健往往不被视为优先事项，特别是对于那些过着“移民生活”的人来说，他们优先考虑工作。 CRC 筛查的文化障碍包括语言（例如英语水平有限和健康素养低）；担心发现 CRC 并给家庭尤其是孩子带来负担；宿命论;以及对癌症的耻辱。未来旨在增加华裔和韩裔美国人的结直肠癌筛查的干预措施和计划应解决影响结直肠癌筛查率的文化和非文化因素。
Among Asian Americans, colorectal cancer (CRC) is the second leading cause of cancer deaths. Despite strong evidence that screening can reduce CRC-related mortality, fewer Chinese and Koreans receive screening as compared to non-Hispanic whites and blacks. The objective of this study was to examine facilitators and barriers as well as strategies to promote CRC screening in this population. This study employed a mixed-methods design. We conducted 17 key informant interviews and 12 focus groups in the Washington, D.C. metropolitan area. 120 Chinese and Korean focus group participants, aged 50 to 85, also provided quantitative data through self-administered surveys. All participants were asked to discuss facilitators and barriers of CRC screening, including in relation to culture. Participants who had a regular physician and doctor’s recommendation for CRC screening were more likely to ever receive a colonoscopy (adjusted odds ratio (aOR)= 3.51; 95% confidence interval (CI): 1.26, 9.79 and aOR=6.61; 95% CI: 2.63, 16.65, respectively). A doctor’s recommendation was also significantly associated with receipt of a fecal occult blood test (FOBT) (aOR=4.00; 95% CI: 1.43, 11.15). In terms of barriers, those who reported having no time and not having symptoms were less likely to have a colonoscopy (aOR=0.15; 95% CI: 0.03, 0.82 and aOR= 0.02; 95% CI: 0.002, 0.23, respectively) than those who had time and symptoms. Preventive healthcare was often not viewed as a priority, particularly for those living the “immigrant life,” who gave precedence to work. Cultural barriers to CRC screening included language (e.g., limited English proficiency and low health literacy); fear of finding CRC and burdening the family especially children; fatalism; and stigma towards cancer. Future interventions and programs aiming to increase CRC screening among Chinese and Korean Americans should address both cultural and non-cultural factors that influence CRC screening uptake.
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影响因子：
4.5
作者：
Christou, Aliki;Thompson, Sandra C.
通讯作者：
Thompson, Sandra C.
影响因子：
4.4
作者：
Holt, Cheryl L.;Scarinci, Isabel C.;Martin, Michelle Y.
通讯作者：
Martin, Michelle Y.
影响因子：
3
作者：
Klabunde, CN;Vernon, SW;Brown, ML
通讯作者：
Brown, ML
DOI：
10.1046/j.1523-5394.1998.006003167.x
发表时间：
1998-05-01
期刊：
CANCER PRACTICE
影响因子：
--
作者：
Kim, K;Yu, ESH;Brintnall, RA
通讯作者：
Brintnall, RA
DOI：
10.1046/j.1523-5394.2002.105003.x
发表时间：
2002-09-01
期刊：
CANCER PRACTICE
影响因子：
--
作者：
Holmes-Rovner, M;Williams, GA;Given, CW
通讯作者：
Given, CW