Little is known about cancer screening utilization and barriers to adherence to NCI guidelines for Chinese Americans. California has the largest number of Chinese in the country, and of this population, more than 50% are from the San Francisco Bay Area. We propose to measure breast, cervical and colorectal cancer screening utilization and correlates of cancer early detection among Chinese Americans in San Francisco. These cancers are targeted because of their prevalence in the population and the availability of effective procedures for their early detection. The purpose of this developmental study is to identify barriers and aids to cancer screening among both consumers and medical providers serving this population. With these findings, we will develop written recommendations for culturally tailored, community and clinic-based interventions designed to increase the use of cancer screening among Chinese Americans and a research plan for evaluating these interventions. Data will be collected through surveys constructed to assess cancer screening knowledge, attitudes, behavioral intentions, and practices of consumers and physicians. Consumers will be identified through two medical facilities in San Francisco's Chinatown and through census tracts in the Chinese community. A random sample of patients from lists of registrants at the facilities, and a two-stage probability sample of household units within randomly chosen census blocks from census tracts will be drawn. Each consumer sample will include 100 women from each of three age groups, 20-39, 40-54, and 55-74 and 100 men each from the age groups, 40-54 and 55- 74 for a total sample of 1000 consumers, all of whom will be interviewed in their homes by trilingual, bicultural interviews. Second, approximately 50 primary care physicians serving the two medical facilities will be interviewed to ascertain their beliefs and use of screening. Interviewing both patients and physicians will permit comparison of these two closely related perspectives. The community survey will assess the representativeness of the patients attending medical facilities, and describe factors related to cancer screening among individuals who are not served by the medical facilities. An Advisory Committee representing Chinese physicians and community leaders will assist in the interpretation of findings and their translation into intervention guidelines.
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