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Original assignment: Select a problem of importance to your practice (this might be related to your DNP scholarly project). How can epidemiology be used to improve this situation? Is there a type of observational study that has addressed this problem in the nursing literature? If so, please cite example. If not, what would you design to address your problem?
Peer to respond to:
Low adherence to colonoscopy among the Asian population can be attributed to several factors, including cultural beliefs, language barriers, and limited access to healthcare. Many Asian cultures emphasize modesty and may view medical procedures, especially those involving intimate areas, as invasive and embarrassing. This cultural stigma can deter individuals from seeking preventive care such as colonoscopies. Additionally, language barriers can prevent effective communication between healthcare providers and patients, leading to misunderstandings about the importance of colonoscopies and how they are performed. Limited access to healthcare, whether due to socioeconomic factors or lack of insurance, also plays a significant role in reducing adherence rates.
Epidemiology can improve this situation by identifying the specific barriers and facilitators to colonoscopy adherence within the Asian population. By conducting targeted research, epidemiologists can gather data on prevalence rates, risk factors, and health outcomes related to colorectal cancer in this group. This information can then inform public health interventions tailored to the unique needs and preferences of the Asian community. For example, culturally sensitive educational campaigns and translation services can be developed to improve understanding and acceptance of colonoscopies. Additionally, community health programs can be implemented to provide easier access to screening and follow-up care.
One type of observational study that has addressed this problem in the nursing literature is the cross-sectional study by Lee et al. (2014, 2018). They conducted a cross-sectional study examining the factors associated with colorectal cancer screening among Asian Americans. They found that lower screening rates were associated with lack of physician recommendation, lower health literacy, and cultural barriers. This study highlights the importance of understanding the multifaceted reasons behind low adherence to colonoscopy and provides a foundation for developing targeted interventions. Another systemic review study by Tong et al. (2015) analyzed multiple studies and found that Asian Americans consistently had lower colorectal cancer screening rates compared to the general U.S. population. The review emphasized the need for culturally tailored interventions to improve screening rates among Asian Americans.
References
Lee, H. Y., Lundquist, M., Ju, E., Luo, X., & Townsend, A. (2014). Colorectal cancer screening disparities in Asian Americans and Pacific Islanders: Which groups are most vulnerable? Ethnicity & Health, 16(6), 527-542. https://doi.org/10.1080/13557858.2011.602392
Lee, H.Y., Lundquist, M., Ju, E., Luo, X., Townsend, A. (2018). “Disparities in Colorectal Cancer Screening Among Asian Americans and Pacific Islanders.” American Journal of Preventive Medicine, 54(5), 701-709. DOI: 10.1016/j.amepre.2018.01.038
Tong, E.K., Nguyen, T.T., Lo, P., Stewart, S.L., McPhee, S.J. (2015). “Colorectal Cancer Screening Among Asian Americans: A Systematic Review.” Journal of Cancer Education, 30(4), 819-827. DOI: 10.1007/s13187-014-0734-y
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