Health Information and Cancer Screening Differences for Asian Americans

This study examined differences between Asian and non-Asian Americans in sources of health information and cancer screening. A nationally representative sample of 6,722 adults in the US, including those who speak, Spanish, Chinese, Vietnamese and Korean was selected. Questionnaire items included demographic variables, health status, cancer screening, health care experiences, health information sources, and use of an interpreter in the patient-provider interaction. Asians used the internet more for health information, preferred a physician from their own race, had friends or relatives and staff persons serve as interpreters, and less likely to call a health care provider and pharmacist, to need an interpreter, have had a complete physical exam, pap test, mammogram, and colorectal exam, within the last two years, than non-Asian Americans. Difficulty speaking with a physician led to 2.2 times greater risk of never getting a physical exam and 4.3 times greater risk of never getting a prostate exam. Development of sources of health information relevant to Asian Americans may enhance their decision making prior to and in conjunction with receiving medical care services

Asian American Subgroup Differences in Sources of Health Information and Predictors of Screening Behavior

This study examined Asian subgroup differences in sources of health information and cancer screening, comparison of Asians and Whites in screening, and the association between health information and screening behavior. A nationally representative sample of 6,722 adults in the US, including those who speak, Chinese, Vietnamese and Korean was selected. Questionnaire items developed by the Commonwealth Fund included demographic variables, health status, cancer screening, health care experiences, health information sources, and use of an interpreter in the patient-provider interaction. There were differences between subgroups in source of health information. Indians from India were more likely to use the World Wide Web than Chinese, Koreans, and Filipinos. There were differences in ease of reading or understanding instructions on the prescription bottle, information booklets provided by physicians, and in difficulty speaking with a physician. There were differences in getting a general physical and a pap test between Asian ethnic subgroups and between Asians and Whites. Certain sources of health information were positively correlated with specific screening tests. Development of particular sources of health information relevant to specific Asian subgroups and for specific screening tests may enhance their decision making prior to and in conjunction with receiving medical care services

Racial Differences in Preventive and Complementary Health Behaviors and Attitudes

Screening tests have been developed for many diseases—the presence of cancer, especially—but are differentially utilized among racial/ethnic groups. In addition to standard medical screening techniques, some patients opt to use Complementary and Alternative Medicine (CAM) for prevention and treatment. The purpose of the current study is to examine racial/ethnic disparities in primary and secondary preventive health behaviors, determine differences in use of complementary and alternative health regimens, and determine which health attitudes and health self-management factors are associated with use of complementary alternative medicine. If differences among ethnic/racial groups in perceived health status, preventive health care behaviors, and use of CAM can be more fully understood, then health professionals will be able to better tailor health promotion interventions and integrate these factors

Racial/Ethnic Disparities of Cancer, Metabolic Syndrome, and Lifestyle Behaviors in People under 50: A Cross-Sectional Study of Data from the National Health and Nutrition Examination Survey

Introduction: Recent epidemiological studies have suggested a trend of increasing preva- lence of metabolic syndrome (MetS) and certain types of cancer among adults under age 50. How MetS is associated with cancer in adults under the age of 50, however, remains unclear. Furthermore, it remains unknown whether associations between MetS and cancer vary by racial/ethnic group and whether modifiable lifestyle factors influence MetS–cancer relationships. Methods: We used data from the 2011–2018 National Health and Nutrition Examination Survey (NHANES) to define a case-control sample to examine potential racial/ethnic disparities associated with MetS and cancer of any type. We used a chi-square test and binary logistic regression to examine the MetS and cancer association. Results: From a total sample of 10,220 cases, we identified 9960 no-cancer cases and 260 cancer cases. Binary logistic regression results showed that MetS was significantly associated with a cancer risk among non-Hispanic whites (odds ratio = 1.48, 95% confidence interval = 1.00–2.19); however, it was not associated with a risk among non-Hispanic Blacks, Hispanic/Latinos, or Asian Americans. We also found several significant predictors of cancer, including age, gender, tobacco use, and sleep duration, with their roles varying by racial/ethnic subgroup. Conclusion: The findings of this study indicate that racial/ethnic differences are involved in the association between MetS and cancer, and highlight the potential mediating effects of lifestyle and behavioral factors. Future research should leverage the existing longitudinal data or data from cohort or case-control studies to better examine the causal link between MetS and cancer among racial/ethnic minoritie

Hepatitis B screening among Chinese Americans: a structural equation modeling analysis

Hepatitis B Virus (HBV) disproportionately affects new immigrants from endemic regions such as China. Untreated infections increase health risks for liver diseases including cancer. Yet most of those infected are unaware of their disease limiting prevention and early treatment options. The purpose of this community based study was to evaluate a heuristic model identifying factors contributing to Hepatitis B (HBV) screening among Chinese Americans. A cross-sectional design included a sample of 924 Chinese men and women 18 years of age and older of which 718 had complete data for final analysis. Confirmatory factor analysis verified conceptual indicators including access/satisfaction with health care and enabling, predisposing, cultural, and health belief factors. Structural equation modeling was used to identify direct and indirect predictors of Hepatitis B screening. Bivariate analysis revealed that Chinese respondents who were never screened for HBV were significantly more likely to be below age 40 (69.8%), male (69.2%), had less than a high school education (76.4%), with less than 6 years living in the US (72.8%) and had no health insurance (79.2%). The final model identified enabling factors (having health insurance, a primary health care provider to go to when sick and more frequent visits to a doctor in the last year) as the strongest predictor of HBV screening (coefficient = 0.470, t = 7.618, p < .001). Predisposing factors (education variables) were also significantly related to HBV screening. Cultural factors and Satisfaction with Health care were associated with HBV screening only through their significant relationships with enabling factors. The tested theoretical model shows promise in predicting HBV testing among Chinese Americans. Increasing access to health care by expanding insurance options and improving culturally sensitivity in health systems are critical to reach new immigrants like Chinese for HBV screening. Yet such strategies are consistent with DHHS Action plan for the Prevention and Treatment of Viral Hepatitis. Implementing community-based strategies like partnering with relevant Community-Based Organizations are important for meeting HBV policy targets.https://doi.org/10.1186/s12879-015-0854-

Analysis of isoflavones and flavonoids in human urine by UHPLC

A rapid, ultra high-performance liquid chromatographic (UHPLC) method has been developed and validated for simultaneous identification and analysis of the isoflavones genistein, daidzein, glycitin, puerarin, and biochanin A, and the flavonoids (±)-catechin, (−)-epicatechin, rutin, hesperidin, neohesperidin, quercitrin, and hesperetin in human urine. Urine samples were incubated with β-glucuronidase/sulfatase. UHPLC was performed with a Hypersil Gold (50 × 2.1 mm, 1.9 μm) analytical column. Elution was with a gradient prepared from aqueous trifluoroacetic acid (0.05%) and acetonitrile. UV detection was performed at 254 and 280 nm. The calibration curves were indicative of good linearity (r2 ≥ 0.9992) in the range of interest for each analyte. LODs ranged between 15.4 and 107.0 ng mL−1 and 3.9 and 20.4 ng mL−1 for flavonoids and isoflavones, respectively. Intra-day and inter-day precision (C.V., %) was less than 3.9% and 3.8%, respectively, and accuracy was between 0.03% and 5.0%. Recovery was 70.35–96.58%. The method is very rapid, simple, and reliable, and suitable for pharmacokinetic analysis. It can be routinely used for simultaneous determination of these five isoflavones and seven flavonoids in human urine. The method can also be applied to studies after administration of pharmaceutical preparations containing isoflavones and flavonoids to humans

Evaluating psychosocial and physical activity outcomes following an intervention among Filipino Americans

Background: Physical activity (PA) is a strong contributor to enhancing a healthy lifestyle and preventing numerous chronic diseases. As ethnic minorities engage in low levels of PA, psychosocial and activity-based interventions for sustaining PA are crucial. Methods: The 6-month intervention incorporated culturally tailored educational workshops and weekly PA classes at a community center. Educational workshops were led by six trained community health workers (CHWs). Participants (n=37) completed pre- and post-intervention questionnaires regarding PA related self-efficacy, outcome expectations, social support, enjoyment, self-regulation, goal setting, and overall PA. Results: Following the intervention, study participants exhibited increases in weekly PA levels. Wilcoxon Signed-Rank test revealed higher median scores for Exercise Self-Efficacy Scale (ESES), Identified Regulation, and Intrinsic Motivation. Positive changes were observed for Physical Outcome Expectations, Social Outcome Expectations, Self-Evaluative Outcome Expectations, Physical Activity Enjoyment, Social Support for Exercise Scale – Family, Social Support for Exercise – Friends, and Exercise Goal-Setting. Conclusion: Community-based PA interventions may provide potential benefits to Filipino Americans, an ethnic Asian minority group, in identifying exercise benefits, developing proper exercise goals, increasing motivation, promoting PA behavior, and facilitating long-term PA adherence

Mechanisms of hepatocellular carcinoma progression

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. It is the second leading cause of cancer-related deaths worldwide, with a very poor prognosis. In the United States, there has been only minimal improvement in the prognosis for HCC patients over the past 15 years. Details of the molecular mechanisms and other mechanisms of HCC progression remain unclear. Consequently, there is an urgent need for better understanding of these mechanisms. HCC is often diagnosed at advanced stages, and most patients will therefore need systemic therapy, with sorafenib being the most common at the present time. However, sorafenib therapy only minimally enhances patient survival. This review provides a summary of some of the known mechanisms that either cause HCC or contribute to its progression. Included in this review are the roles of viral hepatitis, non-viral hepatitis, chronic alcohol intake, genetic predisposition and congenital abnormalities, toxic exposures, and autoimmune diseases of the liver. Well-established molecular mechanisms of HCC progression such as epithelial-mesenchymal transition, tumor-stromal interactions and the tumor microenvironment, cancer stem cells, and senescence bypass are also discussed. Additionally, we discuss the roles of circulating tumor cells, immunomodulation, and neural regulation as potential new mechanisms of HCC progression. A better understanding of these mechanisms could have implications for the development of novel and more effective therapeutic and prognostic strategies, which are critically needed