title: Health Examination Is Not a Priority for Less Acculturated Asian Americans.
abstract: This study examines the associations between acculturation and three health examination behaviors (physical, dental, and eye exams) among 846 Chinese, Korean, and Vietnamese Americans. The study was part of a randomized, community-based trial on liver cancer prevention that targeted Asian Americans in Washington DC metropolitan area. Acculturation was assessed using Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, acculturation clusters, and length of stay. Health examination behaviors in the last 2 years were self-reported. Potential confounders such as age, gender, ethnicity, income, marital status, self-rated health status, health insurance, and having a regular physician were adjusted. Increased acculturation was associated with greater receipt of preventive services when acculturation was measured by SL-ASIA and acculturation clusters. Compared to those in the "Asian" cluster, those in the "American" cluster and "bicultural" clusters were more likely to have physical exams (American odds ratio (OR) = 1.83, 95 % confidence interval (CI) 0.99, 3.88; bicultural OR = 1.11; 95 % CI 0.72, 1.70), dental exams (American OR = 1.99, 95 % CI 1.09, 3.65; bicultural OR = 1.83, 95 % CI 1.21, 2.78), and eye exams (American OR = 4.48, 95 % CI 2.67, 7.66; bicultural OR = 1.92, 95 % CI 1.31, 2.81). A gradient was observed in these associations with the American cluster having stronger associations than the bicultural cluster. Interaction was found between acculturation and gender for receipt of a physical exam. Future studies are needed to further explicate how access to health care impacts the association between acculturation and health examinations among Asian Americans.
authors: Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 2234C School of Public Health Building, 4200 Valley Drive, College Park, MD, 20742, USA. sunmin@umd.edu.
authors: Sunmin
authors: http://orcid.org/0000-0001-9652-9475
authors: S
authors: Lee
authors: Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 2234C School of Public Health Building, 4200 Valley Drive, College Park, MD, 20742, USA.
authors: David H
authors: DH
authors: Chae
authors: Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 2234C School of Public Health Building, 4200 Valley Drive, College Park, MD, 20742, USA.
authors: Mary Y
authors: MY
authors: Jung
authors: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors: Lu
authors: L
authors: Chen
authors: Thomas Jefferson University, Philadelphia, PA, USA.
authors: Hee-Soon
authors: HS
authors: Juon
keywords: Acculturation; Asian Americans; Ophthalmology; Physical examination; Preventive health services