Low health literacy and XXXX screening among Chinese Americans in California: a cross-sectional analysis.

@entity1 @entity0 @entity5 @entity14 @entity204
OBJECTIVES: @entity5 is the leading cause of @entity204 among Asian Americans. Chinese Americans comprise the largest Asian American ethnic group. Low health literacy (LHL) is associated with lower @entity5 screening rates, but this association has not been studied in Chinese Americans. We examined the relationship between LHL and meeting US Preventive Service Task Force (USPSTF) guidelines for cervical, colorectal and @entity0 screening among Chinese Americans. DESIGN: Observational study of Chinese respondents in the 2007 California Health Interview Survey, a population-based survey. Interview languages included English, Cantonese and Mandarin. SETTING: California, USA @entity1 : Chinese respondents in age/gender groupings appropriate for USPSTF @entity5 screening guidelines (cervical: @entity1 ages 21-65, n=632; colorectal: @entity1 or @entity1 ages 50-75, n=488; and breast: @entity1 ages 50-74, n=326). OUTCOMES: Relationships were tested using multivariable logistic regression models controlling for healthcare access and demographic factors, including limited English proficiency (LEP). The combined effects of having both LHL and LEP were specifically examined. LHL was measured by 2-items on perceived ease-of-use of written medical materials. All study variables were self-reported. RESULTS: @entity5 screening percentages among Chinese Americans were 77.8% for cervical, 50.9% for colorectal (47.9% for @entity1 and 54.2% for @entity1 ), and 85.5% for breast. LHL was associated with lower odds of meeting @entity0 screening guidelines (OR 0.41; 95% CI 0.20 to 0.82). Respondents with both LHL and LEP were significantly less likely to have up-to-date colorectal (OR 0.49; 95% CI 0.25 to 0.97) and @entity0 screening (OR 0.21; 95% CI 0.08 to 0.54) than those with neither health communication barrier. In all multivariable models, having seen a physician in the past year was a significant predictor of an up-to-date screening. CONCLUSIONS: In Chinese Americans, LHL and LEP were negatively associated with up-to-date breast and @entity14 screening, independent of a recent physician visit. Efforts to promote @entity5 screening among Chinese Americans should consider and address LHL, LEP and physician access barriers.
