Predictors of colorectal cancer testing using the California Health Inventory Survey

Modiri, Alexandra N.; Makipour, Kian; Gómez, Javier; Friedenberg, Frank K.

doi:10.3748/wjg.v19.i8.1247

Cited by 17 publications

(14 citation statements)

References 27 publications

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“…Screening recommendations given by Western medical doctors significantly increased patient CRC screening (27,28). An analysis of the 2009 California Health Interview Survey with 30,857 respondents reported that the strongest predictor for having received CRC screening in the past 5 years was physician recommendation (29). The findings in this study suggest that TCM providers may have a similar effect on screening behavior.…”

Section: Discussionmentioning

confidence: 99%

Engaging Traditional Medicine Providers in Colorectal Cancer Screening Education in a Chinese American Community: A Pilot Study

Wang¹,

Burke²,

Tsoh³

et al. 2014

Prev. Chronic Dis.

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IntroductionAlthough colorectal cancer (CRC) screening is effective in preventing colon cancer, it remains underused by Asian Americans. Because Chinese Americans often use traditional Chinese medicine (TCM), we conducted a pilot study to explore the feasibility and acceptability of having TCM providers deliver education about CRC screening.MethodsFour TCM providers (2 herbalists and 2 acupuncturists) were trained to deliver small-group educational sessions to promote CRC screening. Each provider recruited 15 participants aged 50 to 75. Participants completed a baseline survey on CRC-related knowledge, attitudes, and behaviors and then attended one 2-hour educational session delivered by the providers in Cantonese or Mandarin. Three months later, participants completed a postintervention survey.ResultsSixty participants were recruited from the San Francisco Chinatown neighborhood. The average age was 62.4 years. Most participants had limited English proficiency (96.7%), annual household income less than $20,000 per year (60%), and low educational attainment (65.1% < high school education). At postintervention (n = 57), significant increases were found in having heard of CRC (from 52.6% to 79.0%, P < .001) and colon polyps (from 64.9% to 84.2%, P < .001). Knowledge regarding screening frequency recommendations also increased significantly. The rate of ever having received any CRC screening test increased from 71.9% to 82.5% (P <.001). The rate of up-to-date screening increased from 70.2% to 79.0% (P = .04).ConclusionThe findings suggest that TCM providers can be trained to deliver culturally and linguistically appropriate outreach on CRC screening within their community. Participants reached by TCM providers increased CRC knowledge and self-reported CRC screening.

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Section: Discussionmentioning

confidence: 99%

Engaging Traditional Medicine Providers in Colorectal Cancer Screening Education in a Chinese American Community: A Pilot Study

Wang¹,

Burke²,

Tsoh³

et al. 2014

Prev. Chronic Dis.

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“…12 Regrettably, though colon cancer screening and investigative technologies have begun to proliferate, one out of every five Americans with colon cancer has stage IV disease at the time of their diagnosis. 3–5 Many people with such late stage disease that has typically metastasised to the liver or lungs could benefit greatly from palliative chemotherapy. Synthetic randomised trial-based evidence has demonstrated its comforting as well as modest survival-enhancing effects, but it seems that only about half of those people with distally metastasised colon cancer in the USA ever receive such palliative care.…”

Section: Introductionmentioning

confidence: 99%

Palliative chemotherapy among people living in poverty with metastasised colon cancer: facilitation by primary care and health insurance

Gorey

Bartfay

Kanjeekal

et al. 2016

BMJ Support Palliat Care

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Background Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California. Methods We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models. Results Palliative chemotherapy was received by less than half of the participants (45%). Facilitating effects of primary care (RR=1.23) and health insurance (RR=1.14) as well as an impeding effect of specialised care (RR=0.86) were observed. Primary care physician (PCP) supply took precedence. Adjusting for poverty, PCP supply was the only significant and strong predictor of chemotherapy (OR=1.62, 95% CI 1.02 to 2.56). The threshold for this primary care advantage was realised in communities with 8.5 or more PCPs per 10 000 inhabitants. Only 10% of participants lived in such well-supplied communities. Conclusions This study’s observations of facilitating effects of primary care and health insurance on palliative chemotherapy for metastasised colon cancer clearly suggested a way to maximise Affordable Care Act (ACA) protections. Strengthening America’s system of primary care will probably be the best way to ensure that the ACA’s full benefits are realised. Such would go a long way towards facilitating access to palliative care.

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“…However, several studies have reported lower healthcare utilization and lower satisfaction among patients with longer travel times to healthcare facilities [16,30]. Therefore, healthcare strategies that ensure adequate availability of trained medical professionals and hospitals or that provide local referral centers within neighborhoods could significantly improve CRC outcomes in White communities [10,15,24]. Recent changes to the healthcare landscape in the U.S. associated with the Affordable Care Act (ACA) may provide a unique opportunity to develop healthcare policies designed to improve health outcomes and reduce health disparities.…”

Section: Discussionmentioning

confidence: 99%

Availability of Healthcare Resources and Colorectal Cancer Outcomes Among Non-Hispanic White and Non-Hispanic Black Adults

et al. 2015

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This study aims to examine if access to healthcare, measured through the availability of medical resources at the neighborhood level, influences colorectal cancer (CRC) stage, treatment and survival using the Surveillance Epidemiology and Ends Result (SEER) dataset (November 2012), linked with the 2004 Area Resource File. A cross-sectional study was conducted to determine the association between availability of healthcare resources and CRC outcomes among non-Hispanic Black (n = 9162) and non-Hispanic White patients (n = 97,264). CRC patients were identified using the SEER*Stat program, and individual socio-demographic, clinical, and county-level healthcare access variables were obtained for each patient. Among NH-W patients, residence in counties with lower number of oncology hospitals was associated with increased odds of late stage diagnosis (OR 1.09, 95 % CI 1.04-1.14), reduced odds of receiving surgery (OR 0.83, 95 % CI 0.74-0.92) and higher hazard rates (HR 1.09, 95 % CI 1.06-1.12). There were no significant associations among NH-B patients. Increased availability of healthcare resources improves CRC outcomes among NH-W patients. However, future studies are required to better understand healthcare utilization patterns in NH-B neighborhoods, and identify other important dimensions of healthcare access such as affordability, acceptability and accommodation.

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Predictors of colorectal cancer testing using the California Health Inventory Survey

Abstract: Using CHIS we identified California citizens most likely to undergo colon cancer testing. The strongest variable associated with testing for all groups was physician recommendation.

Cited by 17 publications

References 27 publications

Engaging Traditional Medicine Providers in Colorectal Cancer Screening Education in a Chinese American Community: A Pilot Study

Engaging Traditional Medicine Providers in Colorectal Cancer Screening Education in a Chinese American Community: A Pilot Study

Palliative chemotherapy among people living in poverty with metastasised colon cancer: facilitation by primary care and health insurance

Availability of Healthcare Resources and Colorectal Cancer Outcomes Among Non-Hispanic White and Non-Hispanic Black Adults

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