Heterogeneous demographic and cultural profiles of Chinese American patients nonadherent to colorectal cancer screening: a latent class analysis.
Heterogeneous demographic and cultural profiles of Chinese American patients nonadherent to colorectal cancer screening: a latent class analysis.
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DOI：
10.1097/ncc.0b013e3182888b5b
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发表时间：
2014-03
期刊：
影响因子：
2.6
通讯作者：
Wang JH
中科院分区：
文献类型：
--
作者：
Strong C;Ji CS;Liang W;Ma G;Brown R;Wang JH
Colorectal cancer (CRC) is one of the leading causes of cancer death for Chinese Americans, but their CRC screening rates remain low. We examined subgroups of Chinese-American patients non-adherent to CRC screening guidelines to better inform clinical practices to effectively promote screening. Using latent class analysis (LCA) of data from 327 participants recruited from 18 primary care clinics, we classified non-adherent patients based on sociodemographics, screening barriers, attitudinal and clinical factors for CRC screening. The best-fitting LCA model described three distinctive classes: Western Healthcare Class (WHC, 35%), Eastern Healthcare Class (EHC, 18%) and Mixed Healthcare Class (MHC, 46%). WHC patients were highly-educated with average 20 years of U.S. residency, 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. EHC patients were highly-educated seniors and recent immigrants with the least CRC knowledge and the more Eastern cultural views. MHC patients had low level of education, resided in the U.S. for 20 years, and had relatively long relationships with physicians, but their knowledge and cultural views were similar to those of EHC patients. Non-adherent Chinese-American patients are heterogeneous. It is essential to have future intervention programs tailored to address specific screening beliefs and barriers for subtypes of non-adherent patients. Training primary care physicians to recognize patients’ different demographic characteristics and healthcare beliefs may facilitate physician’s communication with patients to overcome their barriers and improve screening behaviors.
