Abstract
The purpose of this community-based study was to develop a structural equation model for factors contributing to breast cancer screening among Chinese American women. A cross-sectional design included a sample of 440 Chinese American women aged 40 years and older. The initial step involved use of confirmatory factor analysis, which included the following variables: access/satisfaction with health care, enabling, predisposing, and cultural and health belief factors. Structural equation model analyses were conducted to evaluate factors related to breast cancer screening in Chinese American women. Initial univariate analyses indicated that women without health insurance were significantly more likely to report being never-screened compared to women with health insurance. Structural equation modeling techniques were used to evaluate the utility of the Sociocultural Health Behavior model in understanding breast cancer screening among Chinese American women. Results indicated that enabling and predisposing factors were significantly and positively related to breast cancer screening. Cultural factors were significantly associated with enabling factors and satisfaction with healthcare. Overall, the proposed model explained 34% of the variance in breast cancer screening among Chinese American women. The model highlights the significance of enabling and predisposing factors in understanding breast cancer screening behaviors among Chinese American women. In addition, cultural factors were associated with enabling factors, reinforcing the importance of providing translation assistance to Chinese women with poor English fluency and increasing awareness of the critical role of breast cancer screening. Partnering with community organizations may help to facilitate and enhance the screening rates.
Highlights
Cancer is the number one cause of death among Asian American women [1,2,3]
Initial univariate analyses indicated that women without health insurance were significantly more likely to report being never-screened compared to women with health insurance
Structural equation modeling techniques were used to evaluate the utility of the Sociocultural Health Behavior model in understanding breast cancer screening among Chinese American women
Summary
Cancer is the number one cause of death among Asian American women [1,2,3]. Asian American women have the lowest cancer screening rates of all ethnic groups in the United States [4,5]. Asian Americans overall report: a breast cancer incidence rate of 88.6/100,000 and a mortality rate of 12.6/100,000 women [6]. There are, Asian subgroup differences in incidence of cancer and in cancer screening rates [9]. For Chinese American women in particular, breast cancer is the most frequently diagnosed cancer [3,10]. Chinese American women who have lived in the United States for a longer duration are at higher risk for breast cancer than are new immigrants [11]
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