Colorectal Cancer Screening: Low Health Literacy and Limited English Proficiency Among Asians and Whites in California
Colorectal Cancer Screening: Low Health Literacy and Limited English Proficiency Among Asians and Whites in California
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DOI：
10.1080/10810730.2013.825669
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发表时间：
2013-12-04
影响因子：
4.4
通讯作者：
Davis, Terry
中科院分区：
文献类型：
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作者：
Sentell, Tetine;Braun, Kathryn L.;Davis, Terry
作者研究了低健康素养(LHL)、有限的英语水平(LEP)和符合当前美国预防服务工作组(CRC)加州亚裔和白人结直肠癌筛查指南之间的关系。在2007年加州健康访谈调查中，1,478名亚洲人和14,410名白人受访者的年龄在50-75岁之间，作者分别和联合使用LEP和LHL的多变量Logistic模型检查了符合CRC筛查指南的情况。分析是在整个样本下进行的，然后分别对白人和亚洲人进行分析，控制人口统计和保险。对于患有LEP的患者，检查患者与提供者的语言一致性和CRC筛查。总体而言，患有LEP和LHL的受试者最不可能符合CRC筛查指南(36%)，其次是仅接受LEP的(45%)，仅接受LHL的(51%)，以及既没有LHL也没有LEP的(59%)，这一等级在多变量模型中仍然显著。对于白人，仅LHL与筛查有关，而仅LEP、LEP和LHL对亚洲人意义重大。在那些患有LEP的患者中，拥有语言一致性提供者与CRC筛查没有显著关联。健康素养与结直肠癌筛查有关，但英语熟练程度也是需要考虑的关键。同时患有LEP和LHL的亚洲人似乎特别容易受到癌症筛查差异的影响。
The authors examined the relationship between low health literacy (LHL), limited English proficiency (LEP), and meeting current U.S. Preventive Service Task Force colorectal cancer (CRC) screening guidelines for Asians and Whites in California. For 1,478 Asian and 14,410 White respondents 50-75 years of age in the 2007 California Health Interview Survey, the authors examined meeting CRC screening guidelines using multivariable logistic models by LEP and LHL separately and in combination. Analyses were run with the full sample, then separately for Whites and Asians controlling for demographics and insurance. For those with LEP, patient-provider language concordance and CRC screening was examined. Overall, respondents with LEP and LHL were the least likely to meet CRC screening guidelines (36%) followed by LEP-only (45%), LHL-only (51%), and those with neither LHL nor LEP (59%), a hierarchy that remained significant in multivariable models. For Whites, LHL-only was associated with screening, whereas LEP-only and LEP and LHL were significant for Asians. Having a language concordant provider was not significantly associated with CRC screening among those with LEP. Health literacy is associated with CRC screening, but English proficiency is also critical to consider. Asians with both LEP and LHL appear particularly vulnerable to cancer screening disparities.