Chinese immigrants (CIs) had low colorectal cancer (CRC) screening rates. Macro-level health determinants may affect CIs' CRC screening; however, this is not well established. Thus, this research looked at the macro-level social factors of CRC screening among CIs. The POET theoretical framework guided this study, which includes four components: population (P), organization (O), environment (E), and technology (T). A convergent mixed method was used to investigate whether sociodemographic, acculturation, religious social capital, and mobile media-based cancer information seeking may predict CIs' endoscopic screening, and how these variables impact it. A validated survey and an interview covering the same factors were utilized to collect quantitative and qualitative data from three local Chinese American churches. 101 church-going CIs completed questionnaires and 29 were interviewed. The three macro-level determinants of screening behavior were modeled using logistic regression. The interview data were analyzed using a framework analysis, which included familiarizing with the data, establishing a coding framework, coding, organizing categories and quotes, and mapping and interpretation. The majority of participants were over 50, employed, married, insured, well educated, and earning over $50,000/year. 54.46% of participants had Endoscopic screening. Doctor recommendation, higher Sunday worship attendance, and mobile media-based cancer information seeking were all significantly associated with endoscopic screening (p < .05). The qualitative investigation showed that a doctor's recommendation was essential. Mobile media eases endoscopic screening fear and empowers participants. The endoscopic screening was less impacted by high religious social capital among churchgoers. The findings show that improving endoscopic screening among CIs requires multilevel interventions. Doctors should provide culturally and linguistically appropriate screening recommendations. Chinese American churches may help by sharing endoscopic screening information and emotional support. Mobile media should be used to raise CI screening awareness and ease screening fears.
If this is your thesis or dissertation, and want to learn how to access it or for more information about readership statistics, contact us at STARS@ucf.edu
Doctor of Philosophy (Ph.D.)
College of Community Innovation and Education
School of Public Administration
Public Affairs; Health Services Management and Research
Length of Campus-only Access
Doctoral Dissertation (Open Access)
Cao, Xian, "Macro-level Factors Impacting Colorectal Cancer Screening Behavior Among Church-going Chinese Immigrants in the U.S.: A Convergent Mixed-method Study" (2022). Electronic Theses and Dissertations, 2020-. 984.