This exploratory study examined the involvement of Chinese immigrant parents in children’s elementary and secondary education. Participants were 29 low-income, urban parents of public school children working primarily in the hospitality sector. Parents were interviewed about their academic expectations, knowledge of school performance, parent involvement, and barriers to involvement. Participants reported high academic expectations but only half had knowledge of their children’s school performance. Approximately 35% attended parent—teacher conferences, 14% helped with homework, and 10% volunteered at school. No parents participated in school decision making or community collaborations. Limited English and demanding work schedules were major barriers to involvement. Recommendations for educators are presented.
Chinese Americans underutilize colorectal cancer screening. This study evaluated a physician-based intervention guided by social cognitive theory (SCT) to inform future research involving minority physicians and patients. Twenty-five Chinese-speaking primary care physicians were randomized into intervention or usual care arms. The intervention included two 45-minute in-office training sessions paired with a dual-language communication guide detailing strategies in addressing Chinese patients' screening barriers. Physicians' feedback on the intervention, their performance data during training, and pre-post intervention survey data were collected and analyzed. Most physicians (~85%) liked the intervention materials but ~84% spent less than 20 minutes reading the guide and only 46% found the length of time for in-office training acceptable. Despite this, the intervention increased physicians' perceived communication self-efficacy with patients (p<.01). This study demonstrated the feasibility of enrolling and intervening with minority physicians. Time constraints in primary care practice should be considered in the design and implementation of interventions.
Background Colorectal cancer (CRC) is one of the leading causes of cancer death for Chinese Americans, but their CRC screening rates remain low. Objective We examined subgroups of Chinese-American patients non-adherent to CRC screening guidelines to better inform clinical practices to effectively promote screening. Methods Using latent class analysis (LCA) of data from 327 participants recruited from 18 primary care clinics, we classified non-adherent patients based on sociodemographics, screening barriers, attitudinal and clinical factors for CRC screening. Results The best-fitting LCA model described three distinctive classes: Western Healthcare Class (WHC, 35%), Eastern Healthcare Class (EHC, 18%) and Mixed Healthcare Class (MHC, 46%). WHC patients were highly-educated with average 20 years of U.S. residency, high level of English proficiency, the least Eastern cultural views of care and the greatest exposure to physician recommendations, but reported having no time for screenings. EHC patients were highly-educated seniors and recent immigrants with the least CRC knowledge and the more Eastern cultural views. MHC patients had low level of education, resided in the U.S. for 20 years, and had relatively long relationships with physicians, but their knowledge and cultural views were similar to those of EHC patients. Conclusions Non-adherent Chinese-American patients are heterogeneous. It is essential to have future intervention programs tailored to address specific screening beliefs and barriers for subtypes of non-adherent patients. Implications for Practice Training primary care physicians to recognize patients’ different demographic characteristics and healthcare beliefs may facilitate physician’s communication with patients to overcome their barriers and improve screening behaviors.
Background: Colorectal cancer (CRC) is one of the leading causes of cancer death for Chinese Americans, but the CRC screenings rates remain low among them. Chinese Americans are one of the fast growing populations in the U.S. Chinese who migrated to the U.S. have increased risk for developing CRC. Hence, it is important to increase Chinese Americans' awareness of CRC risk and improve their screening behaviors. There is limited knowledge about the homogeneity of Chinese Americans who are non-adherent to recommended CRC screening guidelines. Research indicates that identifying the subtypes of patients is advantageous for healthcare providers to tailor their communication with patients by focusing on their particular needs and barriers and that can consequently promote their health-seeking behaviors. Objective: We examined the homogeneous subgroups of Chinese-American patients who are non-adherent to CRC screening guidelines to better inform clinical practices to effectively promote screening behaviors. Methods: We used baseline data from an ongoing intervention trial that enrolled non-adherent Chinese-American patients to CRC screening guidelines from 18 primary care clinics from the metropolitan Washington DC, New York, and Philadelphia areas. We used latent class analysis (LCA) to classify 349 non-adherent patients based on their sociodemographics, screening barriers, psychosocial and clinical access factors for CRC screening. After classes were identified, multilevel regression analyses were conducted for class comparison. Results: The mean age of the overall sample was 59 years old (SD=7.41). About half of the sample was female and also about half were college graduate. About 42% reported having received doctor recommendation for CRC screening, but only 10% had screened for CRC. The best-fitting LCA model described three distinctive classes: Western Healthcare Class (WHC, 35%), Eastern Healthcare Class (EHC, 18%) and Mixed Healthcare Class (MHC, 46%). WHC patients were highly-educated with average 20 years of U.S. residency, high level of English proficiency, the least Eastern views of healthcare and the greatest exposure to physician recommendations, but many reported having no time for CRC screenings. EHC patients were highly-educated seniors and recent immigrants with the least CRC knowledge and the strongest traditional views. MHC patients had low level of education, resided in the U.S. for 20 years, and had relatively long relationships with physicians, but their knowledge and Eastern views were similar to those of EHC patients. Conclusions: These findings extend previous literature and demonstrate that there are different sociodemographic and psychosocial factors to account for non-adherent screening behaviors of older Chinese immigrants. Training primary care physicians to understand that there are distinctive heterogeneous subgroups among non-adherent patients and recognize patients' different demographic characteristics (i.e. SES status, years in the U.S.) and healthcare beliefs (e.g. cancer screening) during encounters may facilitate physicians' communication with patients to overcome their barriers and consequently promote their screening behaviors. Citation Format: Carol Strong, Cheng Shuang Ji, Wenchi Liang, Grace Ma, Roger Brown, Judy Huei-yu Wang. Heterogeneous demographic and cultural profiles of nonadherent Chinese-American patients to colorectal cancer screening: A latent class analysis. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A82.
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