title: Differences in knowledge, attitudes, beliefs, and perceived risks regarding colorectal cancer screening among Chinese, Korean, and Vietnamese sub-groups.
abstract: Asian ethnic subgroups are often treated as a single demographic group in studies looking at cancer screening and health disparities. To evaluate knowledge and health beliefs associated with colorectal cancer (CRC) and CRC screening among Chinese, Korean, and Vietnamese subgroups, a survey assessed participants' demographic characteristics, healthcare utilization, knowledge, beliefs, attitudes associated with CRC and CRC screening. Exploratory factor analysis identified six factors accounting >60 % of the total variance in beliefs and attitudes. Cronbach's alpha coefficients assessed internal consistency. Differences among Asian subgroups were assessed using a Chi square, Fisher's exact, or Kruskal-Wallis test. Pearson's correlation coefficient assessed an association among factors. 654 participants enrolled: 238 Chinese, 217 Korean, and 199 Vietnamese. Statistically significant differences existed in demographic and health care provider characteristics, knowledge, and attitude/belief variables regarding CRC. These included knowledge of CRC screening modalities, reluctance to discuss cancer, belief that cancer is preventable by diet and lifestyle, and intention to undergo CRC screening. Chinese subjects were more likely to use Eastern medicine (52 % Chinese, 25 % Korean, 27 % Vietnamese; p < 0.001); Korean subjects were less likely to see herbs as a form of cancer prevention (34 % Chinese, 20 % Korean, 35 % Vietnamese; p < 0.001). Vietnamese subjects were less likely to consider CRC screening (95 % Chinese, 95 % Korean, 80 % Vietnamese; p < 0.0001). Important differences exist in knowledge, attitudes, and health beliefs among Asian subgroups. Understanding these differences will enable clinicians to deliver tailored, effective health messages to improve CRC screening and other health behaviors.
authors.affiliation: Department of Gastroenterology and Hepatology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, L-461, Portland, OR, 97239, USA, lethi@ohsu.edu.
authors.forename: T Domi
authors.initials: TD
authors.lastname: Le
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
authors.forename: Frances
authors.initials: F
authors.lastname: Lee-Lin
authors.forename: Motomi
authors.initials: M
authors.lastname: Mori
authors.forename: Zunqiu
authors.initials: Z
authors.lastname: Chen
authors.forename: Holden
authors.initials: H
authors.lastname: Leung
authors.forename: Christine
authors.initials: C
authors.lastname: Lau
authors.forename: David A
authors.initials: DA
authors.lastname: Lieberman
mesh_terms: D000367:Age Factors; D000368:Aged; D001213:Asian / Q000523:psychology*; D044466:Asian People; D002681:China / Q000208:ethnology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology*; D003469:Culture; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000208:ethnology; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014744:Vietnam / Q000208:ethnology