Effects of Neighborhood Ethnic Density and Psychosocial Factors on Colorectal Cancer Screening Behavior Among Asian American Adults, Greater Philadelphia and New Jersey, United States, 2014–2019

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Bhimla, Aisha ; Mann-Barnes, Tyrell ; Park, Hemi ; Yeh, Ming-Chin ; Do, Phuong ; Aczon, Ferdinand ; Ma, Grace X.
• Description:
  Introduction
  
  We examined how neighborhood ethnic composition influences colorectal cancer (CRC) screening behavior in Asian American adults and explored whether associations between psychosocial predictors, including knowledge, self-efficacy, and barriers affecting CRC screening behavior, varied by level of neighborhood ethnic composition.
  
  Methods
  
  Filipino, Korean, and Vietnamese Americans (N = 1,158) aged 50 years or older were included in the study. Psychosocial factors associated with CRC screening, CRC screening behavior, and sociodemographic characteristics were extracted from participants’ data. Neighborhood ethnic composition was characterized as the census-tract–level percentage of Asian residents. Participants’ addresses were geocoded to the census tract level to determine whether they resided in an ethnically dense neighborhood. Multilevel logistic regression models were run with and without interaction terms.
  
  Results
  
  In mixed-effects logistic regression model 1, residing in an ethnically dense neighborhood was associated with lower odds of CRC screening (odds ratio [OR] = 0.65; 95% CI, 0.45–0.93; P = .02) after controlling for age, sex, education, ethnic group, and neighborhood socioeconomic status. Greater perceived barriers to CRC screening (OR = 0.62; 95% CI, 0.50–0.77; P < .001) resulted in significantly lower odds of obtaining a CRC screening, while higher self-efficacy (OR = 1.17, 95% CI, 1.11–1.23, P < .001) was associated with higher odds. In model 2, among those residing in a high ethnic density neighborhood, greater barriers to screening were associated with lower odds of having obtained a CRC screening (OR = 0.53; 95% CI, 0.30–0.96; P = .04).
  
  Conclusion
  
  We found that residing in an ethnically dense neighborhood indicated higher disparities in obtaining CRC screenings. Future studies should examine socioeconomic and cultural disparities, as well as disparities in the built environment, that are characteristic of ethnically dense neighborhoods and assess the impact of these disparities on CRC screening behaviors.
  
  
• Subjects:
  Adult Asian Census Tract Colorectal Neoplasms Early Detection Of Cancer Ethnicity Humans Residence Characteristics Socioeconomic Factors
• Source:
  Prev Chronic Dis. 2021; 18
• DOI:
  http://dx.doi.org/10.5888/pcd18.210062
• ISSN:
  1545-1151
• Pubmed ID:
  34591753
• Pubmed Central ID:
  PMC8522502
• Document Type:
  Journal Article
• Funding:
  R01 MD010627/MD/NIMHD NIH HHSUnited States/ ; U54 CA221704/CA/NCI NIH HHSUnited States/
• Place as Subject:
  New Jersey ; Philadelphia, PA
• Location:
  North America
• Volume:
  18
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:a6073be92c24b22f317621106648ead9e813256f4fbb06eb4662803fd61750526cd0d6febc1d7b53bee59b12736ed0730cbc2524df8ff4611e926516c2bace80
• Download URL:
  https://stacks.cdc.gov/view/cdc/111393/cdc_111393_DS1.pdf
• File Type:
  [PDF - 750.63 KB ]