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Examining the Determinants of Colorectal Cancer Screening Practices among Asian Americans.

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Title:Examining the Determinants of Colorectal Cancer Screening Practices among Asian Americans.
Authors:Kim, Sophia B.
Contributors:Social Welfare (department)
Date Issued:May 2017
Publisher:University of Hawaiʻi at Mānoa
Abstract:Asian Americans (AA) are documented to have low colorectal cancer (CRC) screening rates.
Recent studies have further revealed screening disparities among AA subgroups. Focused
research on CRC screening among AA subgroups are needed to more effectively address the
CRC burden experienced by this growing racial/ethnic population. The purpose of this
dissertation was to examine the determinants of CRC screening among AA. Study 1 was a
systematic review of the determinants to CRC screening among AA subgroups using the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study 2 used
the 2012 Hawai‘i Behavioral Risk Factor Surveillance System dataset and examined the
associations between CRC screening and ethnicity, controlling for socio-demographic and
healthcare variables using multiple logistic regression. Study 3 used the 2009 California Health
Interview Survey dataset and examined the associations between physician’s recommendation
and ethnicity, controlling for socio-demographic, cultural, and healthcare related variables using
multiple logistic regression. All reported odds ratios were considered statistically significant at
the p ≤ 0.05 level. Study 1 found different determinants to CRC screening between the AA
subgroups. Study 2 revealed ethnic and gender variances in CRC screening among the AA
subgroups. Chi-square analyses showed gender variances in CRC screening among the total
women sample and Japanese compared to their respective counterparts. Multiple logistic
regression results further revealed ethnic and gender variances in CRC screening even after
controlling for other covariates. Study 3 revealed that having high limited English proficiency
decreased the odds for physician’s recommendation for Chinese; being employed decreased the
odds for Filipino; and having insurance decreased the odds for Korean.
Wide array of determinants influence AA subgroups’ colorectal cancer screening practice
(CCSP). Implications for policy, social work practice, and future research are evident from this
dissertation. Researchers should remain cognizant of unique factors that play an influential role
in subgroup’s decision to complete CRC screening; and further investigate potentially important
but understudied and misunderstood determinants of CCSP presented in this dissertation. In turn,
intervention efforts should be tailored to highlight the cultural strengths of each distinct subgroup
and to address their unique needs and barriers to CRC screening.
Description:Ph.D. Thesis. University of Hawaiʻi at Mānoa 2017.
URI:http://hdl.handle.net/10125/62789
Rights:All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
Appears in Collections: Ph.D. - Social Welfare


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