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Bhimla A , Mann-Barnes T , Park H , Yeh MC , Do P , Aczon F , Ma GX
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
Prev Chronic Dis. 2021 Sep 30;18 :E90
PMID: 34591753   
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Abstract
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.
Notes
1545-1151 Bhimla, Aisha Mann-Barnes, Tyrell Park, Hemi Yeh, Ming-Chin Do, Phuong Aczon, Ferdinand Ma, Grace X R01 MD010627/MD/NIMHD NIH HHS/United States U54 CA221704/CA/NCI NIH HHS/United States Journal Article United States Prev Chronic Dis. 2021 Sep 30;18:E90. doi: 10.5888/pcd18.210062.