title: Barriers and facilitators to colorectal cancer screening in Vietnamese Americans: a qualitative analysis.
abstract: Vietnamese Americans are the fourth largest Asian ethnic group in the USA. Colorectal cancer (CRC) ranks as one of the most common cancers in Vietnamese Americans. However, CRC screening rates remain low among Vietnamese Americans, with 40 % of women and 60 % of men reporting never having a sigmoidoscopy, colonoscopy, or fecal occult blood test (FOBT). We partnered with a Federally Qualified Health Center (FQHC) in Seattle, WA, to conduct focus groups as part of a process evaluation. Using interpreters, we recruited and conducted three focus groups comprised of six women screened for CRC, six women not screened for CRC, and seven men screened for CRC, which made up a total of 19 FQHC patients of Vietnamese descent between 50 and 79 years old. Three team members analyzed transcripts using open coding and axial coding. Major themes were categorized into barriers and facilitators to CRC screening. Barriers include lack of health problems, having comorbidities, challenges with medical terminology, and concerns with the colonoscopy. Participants singled out the risk of perforation as a fear they have toward colonoscopy procedures. Facilitators include knowledge about CRC and CRC screening, access to sources of information and social networks, and physician recommendation. Our focus groups elicited information that adds to the literature and has not been previously captured through published surveys. Findings from this study can be used to develop more culturally appropriate CRC screening interventions and improve upon existing CRC screening programs for the Vietnamese American population.
authors.affiliation: Department of Medicine, University of Washington, 325 9th Avenue, Seattle, WA, 98104, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Kimura
authors.forename: Mo-Kyung
authors.initials: MK
authors.lastname: Sin
authors.forename: Clarence
authors.initials: C
authors.lastname: Spigner
authors.forename: Anh
authors.initials: A
authors.lastname: Tran
authors.forename: Shin-Ping
authors.initials: SP
authors.lastname: Tu
mesh_terms: D000328:Adult; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D001294:Attitude to Health / Q000208:ethnology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D015897:Comorbidity; D055088:Early Detection of Cancer / Q000523:psychology*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology; D010818:Practice Patterns, Physicians'; D014744:Vietnam
references.citation: J Cancer Educ. 2012 Mar;27(1):165-71
references.pmid: 22105657
references.citation: Am J Prev Med. 2010 May;38(5):508-16
references.pmid: 20409499
references.citation: Ethn Dis. 2006 Winter;16(1):255-61
references.pmid: 16599380
references.citation: J Cancer Educ. 2010 Dec;25(4):577-81
references.pmid: 20229075
references.citation: J Am Geriatr Soc. 2009 Mar;57(3):412-8
references.pmid: 19175435
references.citation: Am J Public Health. 1999 Sep;89(9):1322-7
references.pmid: 10474547
references.citation: South Med J. 2010 Nov;103(11):1097-102
references.pmid: 20856180
references.citation: J Natl Cancer Inst. 2013 Aug 7;105(15):1096-110
references.pmid: 23878350
references.citation: J Obstet Gynecol Neonatal Nurs. 2012 Nov-Dec;41(6):E26-40
references.pmid: 23030739
references.citation: Fam Med. 2005 May;37(5):341-7
references.pmid: 15883900
references.citation: Proc Nutr Soc. 2004 Nov;63(4):655-60
references.pmid: 15831139
references.citation: J Gen Intern Med. 2004 Feb;19(2):156-66
references.pmid: 15009795
references.citation: Am J Public Health. 2010 May;100(5):870-6
references.pmid: 20299659
references.citation: J Health Commun. 2010 Oct;15(7):754-68
references.pmid: 21104504
references.citation: Arch Intern Med. 2012 Apr 9;172(7):575-82
references.pmid: 22493463
references.citation: N Am J Med Sci (Boston). 2012 Jan;5(1):1-8
references.pmid: 23243486
references.citation: J Gen Intern Med. 2008 Jun;23(6):834-40
references.pmid: 18350339
references.citation: Ann Intern Med. 2008 Nov 4;149(9):627-37
references.pmid: 18838716
references.citation: Am J Med Sci. 2006 Oct;332(4):159-63
references.pmid: 17031239
references.citation: Ethn Health. 2011 Dec;16(6):501-18
references.pmid: 22050536
references.citation: J Cross Cult Gerontol. 2013 Mar;28(1):89-101
references.pmid: 23263883
references.citation: Prev Med. 2011 Feb;52(2):167-73
references.pmid: 21111754
references.citation: J Cancer Educ. 2006 Summer;21(2):80-3
references.pmid: 17020518
references.citation: J Cancer Educ. 2008 Jan-Mar;23(1):37-45
references.pmid: 18444045
references.citation: J Gen Intern Med. 2005 Nov;20(11):989-95
references.pmid: 16307622
references.citation: Ann Intern Med. 2009 Apr 7;150(7):465-73
references.pmid: 19349631
references.citation: Prev Med. 2010 Jan-Feb;50(1-2):3-10
references.pmid: 20006644
references.citation: J Cancer Educ. 2010 Mar;25(1):70-5
references.pmid: 20082178
references.citation: Med Care. 2008 Sep;46(9 Suppl 1):S51-61
references.pmid: 18725834
references.citation: Asian Pac J Cancer Prev. 2010;11(4):1125-31
references.pmid: 21133636
references.citation: Dig Dis Sci. 2012 Jun;57(6):1586-97
references.pmid: 22302244
references.citation: Br J Cancer. 2013 Apr 16;108(7):1508-14
references.pmid: 23470470
references.citation: MMWR Suppl. 2012 Jun 15;61(2):51-6
references.pmid: 22695464
references.citation: J Adv Nurs. 2004 Oct;48(2):187-94
references.pmid: 15369499
references.citation: Asian Pac J Cancer Prev. 2011;12(11):3133-9
references.pmid: 22394003
references.citation: Arch Physiol Biochem. 2008 Feb;114(1):84-98
references.pmid: 18465362
references.citation: Dig Dis Sci. 2012 Jun;57(6):1576-85
references.pmid: 22350783
references.citation: Clin Gastroenterol Hepatol. 2012 May;10(5):501-6
references.pmid: 22239959
references.citation: J Gen Intern Med. 2008 Jan;23(1):45-50
references.pmid: 18030538
references.citation: Cancer. 2005 Dec 15;104(12 Suppl):2940-7
references.pmid: 16276538
references.citation: Cancer Causes Control. 2012 May;23(5):691-702
references.pmid: 22460700
references.citation: J Rural Health. 2013 Winter;29(1):78-87
references.pmid: 23289658
references.citation: CA Cancer J Clin. 2013 Jan;63(1):11-30
references.pmid: 23335087
references.citation: Am J Gastroenterol. 2011 Nov;106(11):1911-21; quiz 1922
references.pmid: 21912438