Access to Health Care, Beliefs, and Behaviors about Colorectal Cancer Screening among Korean Americans

Publisher: Asian Pacific Organization for Cancer Prevention Country of Publication: Thailand NLM ID: 101130625 Publication Model: Electronic Cited Medium: Internet ISSN: 2476-762X (Electronic) Linking ISSN: 15137368 NLM ISO Abbreviation: Asian Pac J Cancer Prev Subsets: MEDLINE

Original Publication: Bangkok : Asian Pacific Organization for Cancer Prevention,

Culture* ; Health Behavior* ; Health Services Accessibility*; Asian/*statistics & numerical data ; Colorectal Neoplasms/*diagnosis ; Early Detection of Cancer/*psychology; Aged ; Colorectal Neoplasms/psychology ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Occult Blood ; Prognosis

Background: Colorectal cancer (CRC) is one of the most common cancers among Korean Americans (KAs) and their CRC screening rates are low. To raise the rates of CRC screening among KAs, it is necessary to improve our understanding of factors that influence their CRC screening behaviors. This study examined socio-demographics, access to health care, health and cultural beliefs, and behaviors about the fecal occult blood test (FOBT) for CRC screening among KAs aged 50 and older. Methods: Based on the health belief model, the cultural assessment model for health, and the Powe fatalism model, this study measured socio-demographics (age, gender, years in the U.S., marital status, education, employment, income, and acculturation), health care access (health insurance, having a regular doctor, physician recommendation, and trust in doctor), health beliefs (susceptibility, severity, benefits, barriers, and self-efficacy), and cultural beliefs (physical space, health temporal orientation, personal control, and fatalism) and FOBT. A cross-sectional survey (n=202) was conducted. Data analysis was conducted using descriptive analysis, Pearson correlation, and multivariate logistic regression. Results: This study found that physician recommendation was the strongest factor in lifetime FOBT utilization in KAs. The results also revealed a positive association among health temporal orientation, health fatalism, and lifetime FOBT among KAs, while previous research found a negative association between fatalism and cancer screening. Years in the U.S., employment, and having a regular doctor were significantly associated with having had a FOBT in the previous year. Conclusion: Study results suggested the need for public education programs to increase physician recommendation among KAs. Furthermore, the positive relationships among health temporal orientation, health fatalism, and FOBT utilization in KAs suggests that KAs have a desire to maintain health and find cancer early despite their fatalistic view on health.
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Keywords: Colorectal cancer*; beliefs*; screening*; Korean Americans*

Date Created: 20180728 Date Completed: 20181115 Latest Revision: 20230928

20230928

PMC6165655

10.22034/APJCP.2018.19.7.2021

30051703