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

Document Type: Research Articles

Authors

1 Department of Nursing, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-759 Republic of Korea.

2 School of Nursing, University of California, Los Angeles, CA, United States.

Abstract

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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