Top

Journal of Immigrant and Minority Health

Published in:

01-04-2008 | Original Paper

Colorectal Cancer Screening among Underserved Korean Americans in Los Angeles County

Authors: Angela M. Jo, Annette E. Maxwell, Weng K. Wong, Roshan Bastani

Published in: Journal of Immigrant and Minority Health | Issue 2/2008

Abstract

Objectives

Use of colorectal cancer screening is extremely low among Korean Americans. The objective of this study was to gather information on predictors, facilitators, barriers, and intervention preferences with respect to colorectal cancer screening that may inform the development of future interventions for underserved Korean Americans.

Design

We developed a questionnaire guided by the Health Behavior Framework and administered it to a convenience sample of 151 Korean Americans aged 40–70 recruited through a community based organization in Los Angeles.

Results

In our sample in which 60% of the subjects did not have health insurance, only 17% reported having received a stool blood test within the past year or sigmoidoscopy or colonoscopy within the past 5 years. Having received a physician recommendation was significantly associated and having symptoms of the disease was marginally associated with the outcome variable. Although 64% of respondents reported having a primary care physician, only 29% received a screening recommendation from a physician. Barriers to colorectal cancer screening were lack of health insurance and inability to afford testing, not knowing where to go for testing, language barrier, and fear of being a burden to the family. Intervention preferences included educational seminars, media campaigns, and print materials.

Conclusion

Our findings point to the need for a multi-faceted approach that includes educational seminars at community venues, a media campaign, and physician education to increase colorectal cancer screening in this underinsured Korean American population.

US Department of Commerce Bureau of Commerce. Statistical Brief: United States, November 2000.

Maxwell AE, Song H. Cancer screening of Korean Americans in Los Angeles County: adding pieces to the puzzle. Korean Korean Am Stud Bull 2003;13:59–70.PubMed

Koh HK, Koh HC. Health issues in Korean Americans. Asian Am Pac Isl J Health 1993;1(2):176–93.PubMed

Chen MS Jr. A. 1993 status report on the health status of Asian Pacific Islander Americans: comparisons with healthy people 2000 objectives. Asian Am Pac Isl J Health 1993;1(1):37–55.PubMed

Chen MS Jr., Hawks BL. A debunking of the myth of healthy Asian Americans and Pacific Islanders. Am J Health Promot 1995;9(4):261–8.PubMed

Lin-Fu JS. Asian and Pacific Islander Americans: an overview of demographic characteristics and health care issues. Asian Am Pac Isl J Health 1993;1(1):20–36.PubMed

California cancer facts & figures: American Cancer Society; 2002.

California cancer facts and figures: American Cancer Society; 2005.

California cancer facts & figures: American Cancer Society; 2006.

10.

Colorectal cancer test use among persons aged > or = 50 years–United States, 2001. MMWR Morb Mortal Wkly Rep 2003;52(10):193–6.

11.

From the Centers for Disease Control and Prevention. Trends in screening for colorectal cancer–United States, 1997 and 1999. JAMA 2001;285(12):1570–1.

12.

Etzioni DA, Ponce NA, Babey SH, Spencer BA, Brown ER, Ko CY, et al. A population-based study of colorectal cancer test use: results from the 2001 California Health Interview Survey. Cancer 2004;101(11):2523–32.PubMedCrossRef

13.

Juon HS, Han W, Shin H, Kim KB, Kim MT. Predictors of older Korean Americans’ participation in colorectal cancer screening. J Cancer Educ 2003;18(1):37–42.PubMedCrossRef

14.

Kim K, Yu ES, Chen EH, Kim J, Brintnall RA. Colorectal cancer screening knowledge and practices among Korean Americans. Cancer Pract 1998;6(3):167–75.PubMedCrossRef

15.

Maxwell AE, Bastani R, Warda US. Demographic predictors of cancer screening among Filipino and Korean immigrants in the United States. Am J Prev Med 2000;18(1):62–8.PubMedCrossRef

16.

Sarna L, Tae YS, Kim YH, Brecht ML, Maxwell AE. Cancer screening among Korean Americans. Cancer Pract 2001;9(3):134–40.PubMedCrossRef

17.

Bastani R, Marcus AC, Maxwell AE, Das IP, Yan KX. Evaluation of an intervention to increase mammography screening in Los Angeles. Prev Med 1994;23(1):83–90.PubMedCrossRef

18.

Bastani R, Maxwell AE, Bradford C, Das IP, Yan KX. Tailored risk notification for women with a family history of breast cancer. Prev Med 1999;29(5):355–64.PubMedCrossRef

19.

Becker M, Maiman L. The health belief model: origins and correlates in psychological theory. Health Educ Monogr 1974;2:336–53.

20.

Ajzen I, Madden T. Prediction of goal-directed behaviour: attitudes, intentions ad perceived behavioral control. J Exp Soc Psychol 1986;22:453–74.CrossRef

21.

Fishbein M, Ajzen I. Belief, attitude, intention and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley; 1975.

22.

Green L, Kreuter M, Deeds S, Partridge K. Health education planning: a diagnostic approach. Palo Alto, CA: Mayfield Publishing Co.; 1980.

23.

Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977;84(2):191–215.PubMedCrossRef

24.

Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Q 1988;15(2):175–83.PubMed

25.

Maxwell AE, Bastani R, Warda US. Mammography utilization and related attitudes among Korean-American women. Women Health 1998;27(3):89–107.PubMedCrossRef

26.

Maxwell AE, Bastani R, Warda US. Misconceptions and mammography use among Filipino-and Korean-American women. Ethn Dis 1998;8(3):377–84.PubMed

27.

Choi S. Korean translation of the AANCART questionnaire. Korean Korean Am Stud Bull 2003;13:98–117.PubMed

28.

Ponce NA, Lavarreda SA, Yen W, Brown ER, DiSogra C, Satter DE. The California health interview survey 2001: translation of a major survey for California’s multiethnic population. Public Health Rep 2004;119(4):388–95.PubMedCrossRef

29.

Wong ST, Gildengoren G, Nguyen T, Mock J. Disparities in colorectal cancer screening rates among Asian Americans and non-Latino whites. Cancer. 2005;104(12 Suppl):2940–7.PubMedCrossRef

30.

AskCHIS. Available: http://www.chis.ucla.edu/main/. Accessed November 2006.

31.

Juon HS, Kim M, Shankar S, Han W. Predictors of adherence to screening mammography among Korean American women. Prev Med 2004;39(3):474–81.PubMedCrossRef

32.

Hay JL, Ford JS, Klein D, Primavera LH, Buckley TR, Stein TR, et al. Adherence to colorectal cancer screening in mammography-adherent older women. J Behav Med 2003;26(6):553–76.PubMedCrossRef

33.

Honda K. Factors associated with colorectal cancer screening among the US urban Japanese population. Am J Public Health 2004;94(5):815–22.PubMedCrossRef

34.

Klabunde CN, Vernon SW, Nadel MR, Breen N, Seeff LC, Brown ML. Barriers to colorectal cancer screening: a comparison of reports from primary care physicians and average-risk adults. Med Care 2005;43(9):939–44.PubMedCrossRef

35.

Seeff LC, Nadel MR, Klabunde CN, Thompson T, Shapiro JA, Vernon SW, et al. Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer 2004;100(10):2093–103.PubMedCrossRef

36.

Tang TS, Solomon LJ, McCracken LM. Barriers to fecal occult blood testing and sigmoidoscopy among older Chinese-American women. Cancer Pract 2001;9(6):277–82.PubMedCrossRef

37.

Coughlin SS, Thompson T. Physician recommendation for colorectal cancer screening by race, ethnicity, and health insurance status among men and women in the United States, 2000. Health Promot Pract 2005;6(4):369–78.PubMedCrossRef

38.

Jang Y, Kim G, Chiriboga DA. Health, healthcare utilization, and satisfaction with service: barriers and facilitators for older Korean Americans. J Am Geriatr Soc 2005;53(9):1613–7.PubMedCrossRef

39.

Shin H, Song H, Kim J, Probst JC. Insurance, acculturation, and health service utilization among Korean-Americans. J Immigr Health 2005;7(2):65–74.PubMedCrossRef

40.

Sohn L, Harada ND. Knowledge and use of preventive health practices among Korean women in Los Angeles county. Prev Med 2005;41(1):167–78.PubMedCrossRef

41.

Juon HS, Choi Y, Kim MT. Cancer screening behaviors among Korean-American women. Cancer Detect Prev 2000;24(6):589–601.PubMed

42.

Min PG. Korean immigrants in Los Angeles. ISSR working papers in the Social Sciences 1998;5:1–17.

43.

Juon HS, Seo YJ, Kim MT. Breast and cervical cancer screening among Korean American elderly women. Eur J Oncol Nurs 2002;6(4):228–35.PubMedCrossRef

44.

Adams EK, Thorpe KE, Becker ER, Joski PJ, Flome J. Colorectal cancer screening, 1997–1999: role of income, insurance and policy. Prev Med 2004;38(5):551–7.PubMedCrossRef

45.

Jacobs EA, Karavolos K, Rathouz PJ, Ferris TG, Powell LH. Limited English proficiency and breast and cervical cancer screening in a multiethnic population. Am J Public Health 2005;95(8):1410–6.PubMedCrossRef

46.

Yu MY, Wu TY. Factors influencing mammography screening of Chinese American women. J Obstet Gynecol Neonatal Nurs 2005;34(3):386–94.

Title: Colorectal Cancer Screening among Underserved Korean Americans in Los Angeles County
Authors: Angela M. Jo
Annette E. Maxwell
Weng K. Wong
Roshan Bastani
Publication date: 01-04-2008
Publisher: Springer US
Published in: Journal of Immigrant and Minority Health / Issue 2/2008
Print ISSN: 1557-1912
Electronic ISSN: 1557-1920
DOI: https://doi.org/10.1007/s10903-007-9066-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Colorectal Cancer Screening among Underserved Korean Americans in Los Angeles County

Abstract

Objectives

Design

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Design

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2008

Reproductive characteristics of Southeast Asian immigrants before and after migration

Health Coverage of Low-Income Citizen and Noncitizen Wage Earners: Sources and Disparities

Parental Nativity Affects Children’s Health and Access to Care

Acculturating Indian Immigrant Men in New York City: Applying the Social Capital Construct to Understand Their Experiences and Health

TB Perspectives among a Sample of Mexicans in the United States: Results from an Ethnographic Study

The Impact of Nativity on Chronic Diseases, Self-Rated Health and Comorbidity Status of Asian and Hispanic Immigrants