title: The sociocultural health behavioral model and disparities in colorectal cancer screening among Chinese Americans.
abstract: OBJECTIVE
  The purpose of this study was to validate a Sociocultural Health Behavior Model using a structural equation analysis to determine the direction and magnitude of the interdependence of model components in relation to health behavior associated with colorectal cancer (CRC) screening among Chinese Americans.
  
  
  METHODS
  A cross-sectional design included a sample of 311 Chinese American men and women age 50 and older. The initial step involved use of confirmatory factor analysis which included the following variables: access/satisfaction with health care, enabling, predisposing, cultural, and health belief factors. Structural equation modeling analyses were conducted on factors for CRC screening.
  
  
  RESULTS
  Education and health insurance status were significantly related to CRC screening. Those with less than a high school education and without health insurance were more likely to be "never screened" for CRC than those having more education and health insurance. The path analysis findings also lend support for components of the Sociocultural Health Belief Model and indicated that there was a positive and significant relationship between CRC screening and the enabling factors, between cultural factors and predisposing, enabling, and access/satisfaction with health care factors and between enabling factors and access/satisfaction with health care.
  
  
  CONCLUSIONS
  The model highlights the significance that sociocultural factors play in relation to CRC screening and reinforced the need to assist Chinese with poor English proficiency in translation and awareness of the importance of CRC screening. The use of community organizations may play a role in assisting Chinese to enhance colorectal cancer screening rates.
authors.affiliation: Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, USA ; Center for Asian Health, Temple University, Philadelphia, PA, USA.
authors.forename: Grace X
authors.initials: GX
authors.lastname: Ma
authors.affiliation: Department of Public and Community Health, University of Maryland, College Park, Maryland, USA.
authors.forename: Min Qi
authors.initials: MQ
authors.lastname: Wang
authors.affiliation: Center for Asian Health, Temple University, Philadelphia, PA, USA ; School of Medicine, Temple University, Philadelphia, PA.
authors.forename: Xiang S
authors.initials: XS
authors.lastname: Ma
authors.affiliation: Center for Mental Health and Aging, Department of Psychology, The University of Alabama, USA.
authors.forename: Giyeon
authors.initials: G
authors.lastname: Kim
authors.affiliation: Center for Asian Health, Temple University, Philadelphia, PA, USA.
authors.forename: Jamil
authors.initials: J
authors.lastname: Toubbeh
authors.affiliation: Center for Asian Health, Temple University, Philadelphia, PA, USA ; Department of Health, East Stroudsburg University, East Stroudsburg, PA, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Shive
keywords: Cancer screening; Chinese Americans; Colorectal cancer; Sociocultural health behavior model; Structural equation modeling