title: Low rate of dermatology outpatient visits in Asian-Americans: an initial survey study for associated patient-related factors.
abstract: BACKGROUND
  Asian-Americans represent the fastest growing minority group in the United States, but are under-represented patients in outpatient dermatology clinics. At the same time, skin cancer rates in individuals of Asian descent are increasing, but skin cancer detection appears to be delayed in Asian-Americans compared to white individuals. Some health-care provider related factors for this phenomenon have been reported in the literature, but the patient-related factors are unclear.
  
  
  METHODS
  This exploratory study to identify patient-related factors associated with dermatology visits in Asian-Americans was performed after Institutional Review Board (IRB) approval. An anonymous, online survey utilizing validated items was conducted on adults who self-identified as Asian-American in Northern California. Univariate and multivariate logistic regression for dermatology visits as indicated by responses to the question of "ever having had skin checked by a dermatologist" were performed on survey responses pertaining to demographic information, socioeconomic factors, acculturation, knowledge of melanoma warning signs and SSE belief and practice.
  
  
  RESULTS
  89.7% of individuals who opened the online survey completed the items, with 469 surveys included in the analysis. Only 60% reported ever performing a SSE, and only 48% reported ever having a skin examination by a dermatologist. Multivariate models showed that "ever performing SSE" (p<0.0001), marital status (p=0.02), family history of skin cancer (p=0.03) and generation in the United States (p=0.02) were significant predictors of the primary outcome of "ever had skin checked by a dermatologist".
  
  
  CONCLUSIONS
  Identification of patient-related factors that associate with dermatology clinic visits in Asian-Americans is important so that this potential gap in dermatologic care can be better addressed through future studies.
authors.forename: Bharathi
authors.initials: B
authors.lastname: Lingala
authors.forename: Shufeng
authors.initials: S
authors.lastname: Li
authors.forename: Ashley
authors.initials: A
authors.lastname: Wysong
authors.forename: Allison K
authors.initials: AK
authors.lastname: Truong
authors.forename: David
authors.initials: D
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Stanford University, Pavilion C, 2nd Floor, 450 Broadway St, Redwood City 94063, CA, USA. alschang@stanford.edu.
authors.forename: Anne Lynn S
authors.initials: AL
authors.lastname: Chang
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001213:Asian; D002140:California; D003880:Dermatology / Q000706:statistics & numerical data*; D042241:Early Diagnosis; D019538:Health Care Surveys / Q000379:methods; D006801:Humans; D020407:Internet; D009819:Office Visits / Q000706:statistics & numerical data; D012878:Skin Neoplasms / Q000175:diagnosis*
references.citation: Int J Dermatol. 2008 Oct;47(10):993-1003
references.pmid: 18986343
references.citation: J Am Acad Dermatol. 2011 Feb;64(2):282-9
references.pmid: 21163550
references.citation: Br J Dermatol. 2003 Jun;148(6):1161-6
references.pmid: 12828744
references.citation: Arch Dermatol. 2012 Oct;148(10):1142-51
references.pmid: 22801744
references.citation: Cancer Causes Control. 1997 Mar;8(2):246-52
references.pmid: 9134249
references.citation: Arch Dermatol. 2009 May;145(5):552-6
references.pmid: 19451499
references.citation: Cancer Epidemiol Biomarkers Prev. 2009 Nov;18(11):3018-23
references.pmid: 19861521
references.citation: J Am Acad Dermatol. 1999 Dec;41(6):945-9
references.pmid: 10570378
references.citation: Int J Clin Oncol. 2001 Jun;6(3):109-16
references.pmid: 11706778
references.citation: Int J Dermatol. 2010 Feb;49(2):126-34
references.pmid: 20465635
references.citation: J Am Acad Dermatol. 2013 Jun;68(6):e169-75
references.pmid: 23545369
references.citation: J Am Acad Dermatol. 2009 Sep;61(3):426-32
references.pmid: 19628302
references.citation: J Am Acad Dermatol. 2014 Apr;70(4):748-762
references.pmid: 24485530
references.citation: J Am Acad Dermatol. 2011 Nov;65(5 Suppl 1):S26-37
references.pmid: 22018064
references.citation: Soc Sci Med. 2013 Nov;96:17-23
references.pmid: 24034947
references.citation: J Community Health. 2014 Apr;39(2):201-12
references.pmid: 24002493
references.citation: Cancer. 2000 Jul 15;89(2):342-7
references.pmid: 10918164
references.citation: J Natl Cancer Inst. 1996 Jan 3;88(1):17-23
references.pmid: 8847720
references.citation: Am J Med. 2010 May;123(5):439-45
references.pmid: 20399321
references.citation: J Am Acad Dermatol. 2013 Apr;68(4):576-584
references.pmid: 23182066
references.citation: Surg Clin North Am. 2003 Apr;83(2):275-82
references.pmid: 12744610
references.citation: J Am Acad Dermatol. 2006 Jan;54(1):105-14
references.pmid: 16384764
references.citation: Am J Prev Med. 1999 Oct;17(3):169-75
references.pmid: 10987631