Analyzing factors enabling colorectal cancer screening adherence in Korean Americans using the Andersen's Behavioral Model of Health Services Utilization

Abstract

Purpose/objectives: Korean Americans (KAs) report suboptimal colorectal cancer (CRC) screening adherence. This study investigated factors that enable KAs to adhere to CRC screening guidelines using the Andersen's Behavioral Model of Health Services Utilization.

Design: Cross-sectional survey using self-reported measures of CRC screening behaviors.

Sample and methods: Purposive sampling was used to recruit 433 KAs aged 50–75 from the Atlanta metropolitan area who completed questionnaires measuring predisposing (i.e., gender, age, marital status, and educational attainment), enabling (income, health insurance, regular annual health checkups, doctor's recommendation English proficiency, CRC knowledge, self-efficacy for CRC screening, and decisional balance in CRC screening), and need (family cancer history and self-reported health status) factors associated with CRC screening.

Findings: A multiple logistic regression model including all 14 predictor variables revealed that several enabling factors (i.e., income, regular annual health checkups, doctor’s recommendation, self-efficacy, and decisional balance) independently predicted increased CRC screening adherence in KAs. No predisposing or need factors independently predicted CRC screening.

Conclusions and implications for psychosocial providers or policy: To increase CRC screening adherence among KAs, psychosocial interventions should target on improving their self-efficacy and decisional balance regarding CRC screening, while policy interventions should focus on promoting health providers’ CRC screening recommendations during routine health checkups.

Keywords:

• colorectal cancer screening adherence
• decisional balance
• Korean Americans
• self-efficacy
• the Behavioral Model of Health Services Utilization

Acknowledgments

The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of NIMHD or NIH.

Conflict of interest

The authors declare no conflict of interest.

Informed consent and patient details

All patient/personal identifiers have been removed or disguised so patient/person(s) described are not identifiable and cannot be identified through information provided.

Additional information

Funding

Dr Jin was supported by the National Institute on Minority Health and Health Disparities (NIMHD) (Grant Number U54MD008173), a component of the National Institutes of Health (NIH).