Abstract
Objective:To assess Chinese American primary care physicians’ knowledge, attitude, and barriers to recommending colorectal cancer (CRC) screening to their Chinese American patients.Methods:Chinese American primary care physicians serving Chinese American patients in two metropolitan areas were invited to complete a mailed survey on CRC screening knowledge, attitudes toward shared decision making and CRC screening, and CRC screening recommendation patterns.Results:About half of the 56 respondents did not know CRC incidence and mortality figures for Chinese Americans. Those aged 50 and younger, graduating from U.S. medical schools, or working in non-private settings had higher knowledge scores (p < 0.01). Physicians graduating from U.S. medical schools had more favorable attitudes toward shared decision making (p < 0.01). Lack of health insurance, inconsistent guidelines, and insufficient time were the most frequently cited barriers to recommending CRC screening.Conclusions:Most Chinese American physicians had knowledge, attitude, and communication barriers to making optimal CRC screening recommendations.
Highlights
About half of the 56 respondents did not know colorectal cancer (CRC) incidence and mortality figures for Chinese Americans
The Chinese are the largest sub-group of Asian Americans and Pacific Islanders (AAPI), the fastest growing and most culturally diverse minority population in the US.[1]
The Chinese have lower CRC incidence than Whites, when they do develop CRC, there are disparities in outcome, with the Chinese being diagnosed at later stages than other AAPI groups and Whites, suggesting missed screening opportunities.[4]
Summary
Chinese American primary care physicians serving Chinese American patients in two metropolitan areas were invited to complete a mailed survey on CRC screening knowledge, attitudes toward shared decision making and CRC screening, and CRC screening recommendation patterns. Study protocols were approved by the Institutional Research Board of Georgetown University Eligible physicians were those who: (1) were Chinese Americans, (2) practiced in the metropolitan Washington, D.C. or Philadelphia areas, (3) practiced primary care (in family medicine, general practice, internal medicine, or geriatrics), (4) had Chinese American patients aged 50 and older, and (5) could communicate with patients in Chinese (Mandarin, Cantonese, etc.). The survey questionnaire, after being piloted on three Chinese American physicians, and the consent form were mailed to physicians in July and August 2006. Those not mailing or faxing the survey back in three weeks were followed up with a second mailing via registered mail with returned receipt.
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