title: "Heat in their intestine": colorectal cancer prevention beliefs among older Chinese Americans.
abstract: OBJECTIVE
  Data regarding disease prevention behaviors among Asian-American populations are limited. This study explored the beliefs of older Chinese Americans toward colorectal cancer screening modalities, including fecal occult blood testing (FOBT).
  
  
  METHODS
  We conducted 30 semistructured, open-ended, qualitative interviews in Mandarin and Cantonese, focusing on colorectal cancer prevention and health-seeking behavior. Participants were Chinese patients 50-79 years of age recruited from a community clinic in Seattle, Washington.
  
  
  RESULTS
  When asked about colorectal cancer prevention, interviewees discussed such concepts as maintenance of positive energy (qi) and spirit (jing shen) and moderation of exercise and diet. Until prompted, participants did not discuss FOBT. Interviewees believed that colorectal cancer was caused by diets high in foods with "heat" (huo qi) or by intestinal toxins from frequent constipation. Participants presumed that FOBT is unnecessary in the absence of symptoms.
  
  
  CONCLUSIONS
  Patients in our study expressed beliefs about health promotion and causes of colorectal cancer that differed from Western biomedical concepts. Failure to recognize these different beliefs may create inadvertent confusion among elderly Chinese-American patients. Health promotion programs to increase colorectal cancer screening must incorporate these concepts to improve cultural relevance among Chinese-American patients.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Washington, 325 Ninth Avenue, Box 359780, Seattle, WA 98104, USA. johnchoe@u.washington.edu
authors.forename: John H
authors.initials: JH
authors.lastname: Choe
authors.forename: Shin-Ping
authors.initials: SP
authors.lastname: Tu
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Lim
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Burke
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Acorda
authors.forename: Vicky M
authors.initials: VM
authors.lastname: Taylor
mesh_terms: D000368:Aged; D001213:Asian; D001294:Attitude to Health; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D014861:Washington