title: Heterogeneous demographic and cultural profiles of Chinese American patients nonadherent to colorectal cancer screening: a latent class analysis.
abstract: BACKGROUND
  Colorectal cancer (CRC) is one of the leading causes of cancer death in Chinese Americans, but their CRC screening rates remain low.
  
  
  OBJECTIVE
  We examined subgroups of Chinese American patients nonadherent to CRC screening guidelines to better inform clinical practices to effectively promote screening.
  
  
  METHODS
  Using latent class analysis of data from 327 participants recruited from 18 primary care clinics, we classified nonadherent patients based on sociodemographics, screening barriers, and attitudinal and clinical factors for CRC screening.
  
  
  RESULTS
  The best-fitting latent class analysis model described 3 distinctive classes: Western healthcare class (36%), Eastern healthcare class (18%), and mixed healthcare class (46%). Western healthcare class patients were highly educated, with average US residency of 20 years, a high level of English proficiency, the least Eastern cultural views of care, and the greatest exposure to physician recommendations, but reported having no time for screenings. Eastern healthcare class patients were highly educated seniors and recent immigrants with the least CRC knowledge and the most Eastern cultural views. Mixed healthcare class patients had low level of education, resided in the United States for 20 years, and half had sought services of their physicians for at least 3 years, but their knowledge and cultural views were similar to those of Eastern healthcare class patients.
  
  
  CONCLUSIONS
  Nonadherent Chinese American patients are heterogeneous. It is essential to have future intervention programs tailored to address specific screening beliefs and barriers for subtypes of nonadherent patients.
  
  
  CONCLUSIONS
  Training primary care physicians to recognize patients' different demographic characteristics and healthcare beliefs may facilitate physicians' communication with patients to overcome their barriers and improve screening behaviors.
authors.affiliation: Author Affiliations: Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Strong); Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC (Drs Ji, Liang, and Wang); Department of Public Health and Center for Asian Health, Temple University, Philadelphia, Pennsylvania (Dr Ma); and School of Nursing, University of Wisconsin-Madison (Dr Brown).
authors.forename: Carol
authors.initials: C
authors.lastname: Strong
authors.forename: Cheng Shuang
authors.initials: CS
authors.lastname: Ji
authors.forename: Wenchi
authors.initials: W
authors.lastname: Liang
authors.forename: Grace
authors.initials: G
authors.lastname: Ma
authors.forename: Roger
authors.initials: R
authors.lastname: Brown
authors.forename: Judy Huei-yu
authors.initials: JH
authors.lastname: Wang
mesh_terms: D000368:Aged; D001213:Asian; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000451:nursing*; D003466:Cultural Characteristics; D055088:Early Detection of Cancer / Q000451:nursing; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D058007:Physicians, Primary Care; D011203:Poverty; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D014481:United States