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Lei F, Zheng Y. Perceptions of lung cancer screening and smoking behavior change among Chinese immigrants: A systematic review. Tob Induc Dis 2021; 19:30. [PMID: 33867907 PMCID: PMC8051433 DOI: 10.18332/tid/133579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/27/2021] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Lung cancer is the leading cause of cancer death among Chinese immigrants in the US. Smoking cessation and lung cancer screening are effective ways to decrease lung cancer mortality. This study aims to investigate Chinese immigrants' perceptions of lung cancer screening and to explore the factors/barriers associated with their smoking behavior/cessation. METHODS A systematic review design with narrative methods was used. Electronic literature databases, including PubMed, CINAHL and Google Scholar were searched. RESULTS A total of 11 articles met the search criteria. Methodological rigor of the studies was evaluated by Bowling's checklist and Critical Appraisal Skills Program checklist. Data search revealed that a limited amount of research has been done on Chinese immigrants' perceptions of lung cancer screening. Factors influencing their smoking behavior included personal characteristics, psychological status, acculturation, and cues from external environment. Barriers to their smoking cessation behavior included language barriers, individual's unwillingness to use smoking cessation assistance methods, healthcare environment's insufficiency to counter pro-smoking norms, lack of social support, and wrong personal beliefs. CONCLUSIONS Findings from this study could help healthcare providers to design culturally tailored lung cancer screening programs and smoking cessation projects to decrease morbidity and mortality rates of lung cancer among Chinese immigrants.
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Affiliation(s)
- Fang Lei
- University of California Los Angeles, Los Angeles, United States
| | - Ying Zheng
- Shenzhen Nanshan Medical Group Headquarter, Shenzhen, China
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Lee HY, Rhee TG, Kim NK. Cancer literacy as a mediator for cancer screening behaviour in Korean adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:e34-e42. [PMID: 25975449 DOI: 10.1111/hsc.12243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/19/2015] [Indexed: 06/04/2023]
Abstract
This study investigates the cancer literacy level in Korean adults and examines whether cancer literacy plays a mediating role in the relationship between population characteristics and cancer screening behaviours. We collected data from 585 community-dwelling adults in Korea using self-administered surveys and face-to-face interviews from October to December in 2009. Guided by Andersen's behavioural model, we used a structural equation model to estimate the effect of cancer literacy as a mediator and found that cancer literacy mediated cancer screening behaviour. In the individual path analysis models, cancer literacy played a significant mediating role for the use of eastern medicine, fatalism, health status and the number of chronic diseases. When controlling for other relevant covariates, we found that in the optimal path model, cancer literacy played a mediating role in the relationship between the use of eastern medicine and self-rated health status as well as cancer screening behaviour. Thus, developing community-based cancer education programmes and training clinical practitioners in eastern medicine clinics about the importance of informing their patients about regular cancer screening may be an option to boost cancer literacy and screening behaviour in Korea.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, College of Education and Human Development, University of Minnesota, Twin Cities, St. Paul, Minnesota, USA
| | - Taeho Greg Rhee
- Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Twin Cities, Minneapolis, Minnesota, USA
| | - Nam Keol Kim
- Department of Educational Psychology, College of Education and Human Development, University of Minnesota, Twin Cities, Minneapolis, Minnesota, USA
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Facilitators and Hindrances of Implementing Colorectal Cancer Screening Intervention Among Vietnamese Americans. Cancer Nurs 2016; 40:E41-E47. [PMID: 27105470 DOI: 10.1097/ncc.0000000000000384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little is published about the factors that facilitate and hinder the intervention implementation process. OBJECTIVE The aim of this study was to examine factors that facilitated and hindered the implementation of a culturally appropriate colorectal cancer screening intervention targeting Vietnamese Americans in a Federally Qualified Health Center located in the Puget Sound area of Washington. METHODS Three focus group discussions (2 during the implementation phase and 1 during the maintenance phase) with the medical assistants (N = 13) who were the intervention implementation agents were conducted at the Federally Qualified Health Center. Three research team members independently analyzed the data using content analysis and then compared for agreement. We reread and recoded the transcripts until consensus was reached. The themes were clustered by similar codes and categorized into 4 groups, each including facilitators and hindrances of implementation: identification of implementation agents, implementation environment, intervention recipients, and the colorectal cancer screening intervention. RESULTS Facilitators included medical assistants' high motivation with a positive attitude toward the intervention, team approach, and simplicity of the intervention, whereas hindrances included lack of time, forgetfulness, staff turnover, and language barriers. CONCLUSION The findings emphasized the importance of supporting implementation agents to ensure effective intervention program implementation. IMPLICATIONS FOR PRACTICE Oncology nurses need to particularly take into consideration the evidence-based findings when planning any intervention programs.
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Sin MK, Taylor V, Tu SP. Issues in Lung Cancer Screening Among Asian American Immigrants. J Immigr Minor Health 2015; 18:495-496. [PMID: 26048357 DOI: 10.1007/s10903-015-0230-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mo-Kyung Sin
- Seattle University College of Nursing, 901 12th Ave, P.O. Box 222000, Seattle, WA, 98122-1090, USA.
| | - Vicky Taylor
- Division of Public Health Sciences, Fred Hutchinson Cancer Research, Seattle, WA, USA
| | - Shin-Ping Tu
- Division of General Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
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Abstract
Although cervical cancer rates in the United States have declined sharply in recent decades, certain groups of women remain at elevated risk, including middle-aged and older women in central Appalachia. Cross-sectional baseline data from a community-based randomized controlled trial were examined to identify barriers to cervical cancer screening. Questionnaires assessing barriers were administered to 345 Appalachian women aged 40-64, years when Papanicolaou (Pap) testing declines and cervical cancer rates increase. Consistent with the PRECEDE/PROCEED framework, participants identified barriers included predisposing, enabling, and reinforcing factors. Descriptive and bivariate analyses are reported, identifying (a) the most frequently endorsed barriers to screening, and (b) significant associations of barriers with sociodemographic characteristics in the sample. Recommendations are provided to decrease these barriers and, ultimately, improve rates of Pap tests among this traditionally underserved and disproportionately affected group.
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Do M. Predictors of Cervical Cancer Screening Among Vietnamese American Women. J Immigr Minor Health 2013; 17:756-64. [DOI: 10.1007/s10903-013-9925-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Nguyen-Truong CKY, Lee-Lin F, Gedaly-Duff V. Contributing Factors to Colorectal Cancer and Hepatitis B Screening Among Vietnamese Americans. Oncol Nurs Forum 2013; 40:238-51. [DOI: 10.1188/13.onf.238-251] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hwang JP, Roundtree AK, Suarez-Almazor ME. Attitudes toward hepatitis B virus among Vietnamese, Chinese and Korean Americans in the Houston area, Texas. J Community Health 2013; 37:1091-100. [PMID: 22302653 DOI: 10.1007/s10900-012-9543-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We explored attitudes about prevention, screening and treatment of hepatitis B virus (HBV) infection in Chinese, Korean and Vietnamese communities. We use qualitative methods in 12 focus groups (n = 113) of adults who self-reported their ethnicity to be Chinese, Korean, or Vietnamese. We use grounded theory (i.e., consensus-building between co-coders about recurring, emerging themes) for analysis. Diet, nutrition, fatigue and stress were misidentified as HBV causes. Improving hygiene, diet, exercise, and holistic methods were misidentified as viable HBV prevention methods. Common screening problems included not affording test and not understanding test results. Participants shared reasons for using complementary and alternative medicine--when Western medicine fails or becomes unaffordable. Participants sought information from medical providers and fellow community members, but also from the internet. Many of the attitudes and opinions that emerged may deter participation in HBV screening, prevention and treatment, insofar as community members may factor them into healthcare decision-making, choose alternative but ineffective methods of prevention and treatment, and undervalue the benefits of screening. More patient education in both traditional and new media is necessary for clarifying transmission, screening and treatment misunderstandings.
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Affiliation(s)
- Jessica P Hwang
- Department General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1465, Houston, TX 77030, USA.
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Nguyen-Truong CKY, Lee-Lin F, Leo MC, Gedaly-Duff V, Nail LM, Wang PR, Tran T. A community-based participatory research approach to understanding pap testing adherence among Vietnamese American immigrants. J Obstet Gynecol Neonatal Nurs 2012; 41:E26-40. [PMID: 23030739 DOI: 10.1111/j.1552-6909.2012.01414.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore factors potentially influencing Pap testing practices among Vietnamese American immigrant women (VIW, foreign-born) and describe their awareness of cervical cancer screening resources in their community. DESIGN Descriptive study guided by the ecological model and community-based participatory research principles. SETTING Portland, Oregon, metropolitan area. PARTICIPANTS Vietnamese American immigrant women (211) who were age 21 and older. METHODS We used descriptive statistics and logistic regression analyses to analyze a self-administered questionnaire that was pretested and translated using a team approach. RESULTS Approximately 74% of VIW who completed the survey reported at least one Pap test, and 69% reported Pap testing history adherent to national guidelines. The factor most strongly associated with Pap testing receipt was suggestion from a friend, followed by longer residency in the United States, lower perceived common barriers, and lower perceived cultural barriers, for example, lack of family support and use of Eastern/Asian medicine. The factor most strongly associated with guideline adherence was having health insurance, followed by a recommendation from a physician or nurse practitioner. Only 11% of VIW knew where to obtain a free or low-cost Pap tests. CONCLUSION Nurses can influence rates of Pap testing among VIW by providing health education through outreach programs targeted at lay health workers and their social networks, identifying at-risk patients such as recently immigrated women, reducing perceived common and cultural barriers to Pap testing, and helping women seek alternative payment options if they lack health insurance. Primary health care providers should be reminded of their essential role in increasing Pap testing adherence.
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Gregg J, Nguyen-Truong CKY, Wang PR, Kobus A. Prioritizing prevention: culture, context, and cervical cancer screening among Vietnamese American women. J Immigr Minor Health 2012; 13:1084-9. [PMID: 21681408 DOI: 10.1007/s10903-011-9493-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Few studies have investigated what Vietnamese American women believe about the Pap smear or how those beliefs might influence behavior. Thirty-one Vietnamese American women recruited through snowball sampling were interviewed about their beliefs regarding the Pap smear. Interviews were qualitatively analyzed using a theoretically informed, inductive approach. The women interviewed emphasized the importance of primary prevention of disease through culturally-informed personal health regimens. They were also largely unfamiliar with the Pap smear, but believed that gynecological exams in general were effective and necessary for disease detection. Finally, when access to gynecological care was difficult, women's faith in their own preventive behaviors helped alleviate their concerns over lack of care. While culturally associated beliefs do not simply "cause" Vietnamese American women to seek or avoid Pap smears, they do influence screening behaviors to a greater or lesser degree, depending on other contextual variables.
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Affiliation(s)
- Jessica Gregg
- Division of General Internal Medicine, Oregon Health & Science University, Portland, OR 97239, USA.
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Lee HY, Vang S. Barriers to cancer screening in Hmong Americans: the influence of health care accessibility, culture, and cancer literacy. J Community Health 2010; 35:302-14. [PMID: 20140486 DOI: 10.1007/s10900-010-9228-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Hmong Americans face high cancer mortality rates even in comparison to their Asian American counterparts, and report low utilization of cancer screenings. To date, no study has been conducted on the cultural barriers this population faces in undergoing cancer screenings. A systematic review of the literature was conducted to examine the existing knowledge regarding the barriers to cancer screening for Hmong Americans. Potential barriers were identified from this examination to include: health access factors (type of health insurance, ethnicity of provider, low English proficiency, and years spent in the U.S.); cultural factors (belief in the spiritual etiology of diseases, patriarchal values, modesty, and mistrust of the western medical system); and cancer literacy factors (cancer and prevention illiteracy). Based on this review, potential cultural and ethnic group-specific prevention strategies and cancer health policies are discussed to address these barriers and enhance screening behavior among the Hmong.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Minnesota, Twin Cities, 105 Peters Hall, 1404 Gortner Avenue, Saint Paul, MN 55108, USA.
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Tung WC. Benefits and Barriers of Pap Smear Screening: Differences in Perceptions of Vietnamese American Women by Stage. J Community Health Nurs 2010; 27:12-22. [DOI: 10.1080/07370010903466130] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tung WC, Hsu CH. Assessing transcultural validity of the transtheoretical model with Chinese Americans and physical activity. J Transcult Nurs 2009; 20:286-95. [PMID: 19376963 DOI: 10.1177/1043659609334929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Transtheoretical model has shown promise in promoting adoption and maintenance of physical activity and was used to guide this study. A cross-sectional design with snowball sampling was applied to recruit 201 Chinese Americans. Self-efficacy scores were significantly higher for participants in maintenance than those in precontemplation. There were no significant differences in perceived benefits and barriers in different stages. The transtheoretical model partially applied to the participants for whom the reinforcement of self-efficacy is more important than emphasizing the benefits or decreasing the barriers to regular physical activity. Cultural issues may play a critical role and should be further investigated.
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Coronado GD, Woodall ED, Do H, Li L, Yasui Y, Taylor VM. Heart disease prevention practices among immigrant Vietnamese women. J Womens Health (Larchmt) 2008; 17:1293-300. [PMID: 18808332 PMCID: PMC2944441 DOI: 10.1089/jwh.2007.0751] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cardiovascular disease is a leading cause of death in the United States as well as in many countries around the world, including Vietnam. METHODS Using data from a household survey of Vietnamese American women aged 20-79 years in Seattle, Washington, collected in 2006 and 2007, we examined heart disease prevention practices. Multivariable analyses were conducted to examine the relationship between demographic factors and preventive behaviors. RESULTS A total of 1523 immigrant women completed interviews. The average daily consumption of fruits and vegetables was 3.5 servings, and 31% of our sample reported being physically active (engaging in at least 30 minutes of physical activity 5 or more days per week). Few respondents reported being current smokers (1.5%). Over three quarters of women had received a recent blood pressure check and a recent cholesterol check. Age and length of time in the United States were strongly associated with several cardiovascular prevention behaviors. CONCLUSIONS Our findings confirm the need for continued efforts to develop and implement targeted educational campaigns to reduce the risk of cardiovascular disease among Vietnamese American women.
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Affiliation(s)
- Gloria D Coronado
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
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Tu SP, Yip MP, Chun A, Choe J, Bastani R, Taylor V. Development of intervention materials for individuals with limited English proficiency: lessons learned from "Colorectal Cancer Screening in Chinese Americans". Med Care 2008; 46:S51-61. [PMID: 18725834 DOI: 10.1097/mlr.0b013e31817f0cde] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND According to recent US census data, 52 million people reported speaking a language other than English at home, and almost 45% of this population reported limited English proficiency (LEP). Colorectal cancer (CRC) ranks among the top 3 most common cancers for several Asian ethnic groups, yet screening remains underutilized by Asian Americans. OBJECTIVES This article describes the development of culturally and linguistically appropriate intervention materials for individuals with LEP. We discuss lessons learned from this research and implications for the translation of research into practice. METHODS The Health Behavior Framework served as the conceptual model for this study, and qualitative findings guided the development of our intervention materials (a video and pamphlet). To recommend Western preventive behaviors, the research team bridged the gap between Western and Chinese values and beliefs by devoting particular attention to: (1) the target population's sociocultural values and health beliefs; and (2) unique linguistic features of the Chinese language. RESULTS Key lessons learned from this study include the importance of: (1) a conceptual framework to guide intervention development; (2) incorporating sociocultural values and health beliefs into the intervention; (3) addressing and capitalizing on complex linguistics issues; (4) using qualitative methodology in cross-cultural research; and (5) contributions from a multicultural and multilingual research team. Other lessons relate to the translation of research findings into practice. We surmise that lessons learned from this study may be pertinent to the promotion of CRC screening among other patient groups with LEP and applicable to additional cancer screening tests.
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Affiliation(s)
- Shin-Ping Tu
- Department of Medicine, University of Washington, Seattle, Washington, USA.
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