Chinese Americans’ Family History of Colorectal Cancer Communication With Primary Care Physicians

Abstract

Background

Colorectal cancer (CRC) is the third most common cancer for Chinese Americans. Family history (FH) plays an important role in clinical practice for CRC prevention. Nevertheless, Chinese Americans’ FH of CRC communication with primary care physicians (PCPs) are still unknown.

Aims

This study examined Chinese Americans’ behavior and the underlying psychological factors for FH of CRC communication with PCPs.

Method

A total number of 742 Chinese Americans completed a survey developed based on the health belief model, the theory of planned behavior, and the social cognitive theory. Data were analyzed using structural equation modeling.

Results

Majority of the Chinese American participants (75.3%) had never discussed FH of CRC with their PCPs. Lack of inquiries from the PCPs was the main barrier. Structural equation modeling results suggested a good model fit between our theoretical model and the survey data (comparative fit index [CFI] = .946, root mean square error of approximation [RMSEA] = .070, and standardized root mean square residual [SRMR] = .020). Participants’ FH of CRC communication with PCPs was positively associated with their intention (β = .30, p < .001), which was positively correlated to attitudes (β = .29, p < .001) and self-efficacy in discussing FH of CRC with PCPs (β = .57, p < .001). Their attitudes were positively associated with perceived susceptibility to CRC (β = .08, p < .05) and the perceived benefits of communicating FH of CRC (β = .52, p < .001).

Conclusions

Given that most Chinese Americans in this study did not communicate their FH of CRC with their PCPs, it is important to promote such behavior among Chinese Americans. Our structural equation modeling findings can guide future interventions and education for this underserved racial/ethnic minority group.

Keywords

Chinese Americans colorectal cancer communication family history physicians

Get full access to this article

View all access options for this article.

References

American Cancer Society Califormia Department of Public Health California Cancer Registry. (2017). California Cancer Facts & Figures 2017. https://www.ccrcal.org/download/68/special-reports-for-all-cancers/3334/california-cancer-facts-and-figures-2017.pdf

Bandura

(1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.

Chen

L. S.

Talwar

Zhao

(2016). Chinese Americans’ views and use of family health history: A qualitative study. PLOS ONE, 11(9), Article e0162706. https://doi.org/10.1371/journal.pone.0162706

Choi

Cho

Lee

Kim

(2004). The relationships among quality, value, satisfaction and behavioral intention in health care provider choice: A South Korean study. Journal of Business Research, 57(8), 913–921. https://doi.org/10.1016/S0148-2963(02)00293-X

Churchill

G. A.

Jr. (1979). A paradigm for developing better measures of marketing constructs. Journal of Marketing Research, 16(1), 64–73. https://doi.org/10.1177/002224377901600110

de Hoog

C. L.

Portegijs

P. J.

Stoffers

H. E

. (2014). Family history tools for primary care are not ready yet to be implemented. A systematic review. European Journal of General Practice, 20(2), 125–133. https://doi.org/10.3109/13814788.2013.840825

El-Gabalawy

Mackenzie

C. S.

Thibodeau

M. A.

Asmundson

G. J.

Sareen

(2013). Health anxiety disorders in older adults: Conceptualizing complex conditions in late life. Clinical Psychology Review, 33(8), 1096–1105. https://doi.org/10.1016/j.cpr.2013.08.010

Fishbein

Ajzen

(1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Addison-Wesley.

Glanz

Rimer

B. K.

Lewis

F. M.

(2002). Health behavior and health education: Theory, research, and practice. Jossey-Bass.

10.

Gupta

Yick

A. G.

(2001). Preliminary validation of the acculturation scale on Chinese Americans. Journal of Social Work Research and Evaluation, 2(1), 43–56.

11.

Hastings

K. G.

Jose

P. O.

Kapphahn

K. I.

Frank

A. T. H.

Goldstein

B. A.

Thompson

C. A.

Eggleston

Cullen

M. R.

Palaniappan

L. P.

(2015). Leading causes of death among Asian American subgroups (2003–2011). PLOS ONE, 10(4), Article e0124341. https://doi.org/10.1371/journal.pone.0124341

12.

Hickey

K. T.

Katapodi

M. C.

Coleman

Reuter-Rice

Starkweather

A. R.

(2017). Improving utilization of the family history in the electronic health record. Journal of Nursing Scholarship, 49(1), 80–86. https://doi.org/10.1111/jnu.12259

13.

Hoeffel

Rastogi

Shahid

(2012). The Asian population: 2010. U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau.

14.

L. T.

Bentler

P. M.

(1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118

15.

Hudson

S. V.

Ohman-Strickland

P. A.

Bator

O’Malley

Gundersen

Lee

H. S.

Crabtree

B. F.

Miller

S. M.

(2016). Breast and prostate cancer survivors’ experiences of patient-centered cancer follow-up care from primary care physicians and oncologists. Journal of Cancer Survivorship, 10(5), 906–914. https://doi.org/10.1007/s11764-016-0537-4

16.

Kelly

K. M.

Shedlosky-Shoemaker

Atkins

Tworek

Porter

(2015). Improving family history collection. Journal of Health Communication, 20(4), 445–452. https://doi.org/10.1080/10810730.2014.977470

17.

Kim

Hopkins

K. H.

(2017). A validation study of the revised personal safety decision scale. Research on Social Work Practice, 27(5), 607–615. https://doi.org/10.1177/1049731515590483

18.

Kline

(2016). Principles and practice of structural equation modeling (4th ed.). Guilford Press.

19.

Krakow

Rising

C. J.

Trivedi

Yoon

D. C.

Vanderpool

R. C.

(2020). Prevalence and correlates of family cancer history knowledge and communication among US adults. Preventing Chronic Disease, 17, Article 200257. https://doi.org/10.5888/pcd17.200257

20.

Yeh

Y. L.

Sun

Chang

Chen

L. S.

(2019). Community-based participatory research: A family health history-based colorectal cancer prevention program among Chinese Americans. Journal of Cancer Education, 35, 485–492. https://doi.org/10.1007/s13187-019-1486-1

21.

Lowery

J. T.

Ahnen

D. J.

Schroy

P. C.

Hampel

Baxter

Boland

C. R.

Burt

R. W.

Butterly

Doerr

Doroshenk

Feero

W. G.

Henrikson

Ladabaum

Lieberman

McFarland

E. G.

Peterson

S. K.

Raymond

Samadder

M. J.

Syngal

. . Smith

(2016). Understanding the contribution of family history to colorectal cancer risk and its clinical implications: A state-of-the-science review. Cancer, 122(17), 2633–2645. https://doi.org/10.1002/cncr.30080

22.

Macafee

D. A. L.

West

Scholefield

J. H.

Whynes

D. K.

(2009). Hospital costs of colorectal cancer care. Clinical Medicine Insights: Oncology, 3, 27–37. https://doi.org/10.4137/CMO.S2362

23.

Muthen

(2017). Mplus user’s guide (8th ed.).

24.

Rocque

Leanza

(2015). A systematic review of patients’ experiences in communicating with primary care physicians: Intercultural encounters and a balance between vulnerability and integrity. PLOS ONE, 10(10), Article e0139577. https://doi.org/10.1371/journal.pone.0139577

25.

Rodriguez

V. M.

Shuk

Arniella

Gonzalez

C. J.

Gany

Hamilton

J. G.

Gold

G. S.

Hay

J. L.

(2017). A qualitative exploration of Latinos’ perceptions about skin cancer: The role of gender and linguistic acculturation. Journal of Cancer Education, 32(3), 438–446. https://doi.org/10.1007/s13187-015-0963-4

26.

Rosenstock

(1974). The health belief model and preventive health behavior. Health Education Monographs, 2(4), 354–386. https://doi.org/10.1177/109019817400200405

27.

Ryan

(2009). Integrated theory of health behavior change: Background and intervention development. Clinical Nurse Specialist, 23(3), 161–170; quiz 171–162. https://doi.org/10.1097/NUR.0b013e3181a42373

28.

Sharma

Romas

J. A.

(2012). Theoretical foundations of health education and health promotion. Jones & Bartlett Learning.

29.

U.S. Census Bureau. (2017). 2017 American community survey 1-year estimates—Chinese alone or in any combination. https://www.census.gov/quickfacts/fact/table/US/PST045219

30.

U.S. Preventive Services Task Force. (2016, June 15). Final recommendation statement: Colorectal cancer: Screening. https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/colorectal-cancer-screening

31.

Viola

A. S.

Stapleton

J. L.

Coups

E. J.

(2019). Associations between linguistic acculturation and skin cancer knowledge and beliefs among U.S. Hispanic adults. Preventive Medicine Reports, 15, Article 100943. https://doi.org/10.1016/j.pmedr.2019.100943

32.

Wang

J. H.

Adams

I. F.

Pasick

R. J.

Gomez

S. L.

Allen

G. X.

Lee

M. X.

Huang

(2013). Perceptions, expectations, and attitudes about communication with physicians among Chinese American and non-Hispanic white women with early stage breast cancer. Support Care in Cancer, 21(12), 3315–3325. https://doi.org/10.1007/s00520-013-1902-8

33.

Weinberg

D. S.

Miller

Rodoletz

Egleston

Fleisher

Buzaglo

Keenan

Marks

Bieber

(2009). Colorectal cancer knowledge is not associated with screening compliance or intention. Journal of Cancer Education, 24(3), Article 225. https://doi.org/10.1080/08858190902924815

34.

Willauer

A. N.

Liu

Pereira

A. A. L.

Lam

Morris

J. S.

Raghav

K. P. S.

Morris

V. K.

Menter

Broaddus

Meric-Bernstam

Hayes-Jordan

Huh

Overman

M. J.

Kopetz

Loree

J. M.

(2019). Clinical and molecular characterization of early-onset colorectal cancer. Cancer, 125(12), 2002–2010. https://doi.org/10.1002/cncr.31994

35.

Wood

M. E.

Stockdale

Flynn

B. S.

(2008). Interviews with primary care physicians regarding taking and interpreting the cancer family history. Family Practice, 25(5), 334–340. https://doi.org/10.1093/fampra/cmn053

36.

Yeh

Y. L.

Kwok

O. M.

Chen

L. S.

(2019). Family health history of colorectal cancer: A structural equation model of factors influencing Chinese Americans’ communication with family members. Translational Cancer Research, 8(Suppl. 4), 355–365. https://doi.org/10.21037/tcr.2019.05.18

37.

C. Y.

(2002). Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes (Vol. 30). University of California, Los Angeles.

38.

Zazove

Plegue

M. A.

Uhlmann

W. R.

Ruffin

M. T.

(2015). Prompting primary care providers about increased patient risk as a result of family history: Does it work? Journal of the American Board of Family Medicine, 28(3), 334–342. https://doi.org/10.3122/jabfm.2015.03.140149

39.

Zlot

A. I.

Silvey

Newell

Coates

R. J.

Leman

(2012). Family history of colorectal cancer: Clinicians’ preventive recommendations and patient behavior. Preventing Chronic Disease, 9, Article 100254. https://doi.org/10.5888/pcd9.100254