Department of Family Science and Social Work, Miami University, Oxford, OH, United States of America.
Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States of America.
PLoS One. 2019 Nov 6;14(11):e0224505. doi: 10.1371/journal.pone.0224505. eCollection 2019.
Breast cancer is the most common cancer among Asian women in the U.S. The first objective was to investigate predictors (including ethnicity) of never having a mammogram in middle-aged and older Chinese, Vietnamese, and Korean immigrant women (main effects). The second objective was to explore whether relationships between predictors and never having a mammogram varied across the three groups (moderation effects of ethnicity).
Merged (2005-2007-2009-2011) California Health Interview Survey data were utilized. Unweighted sample was 3,710 Asian women ages 40 years and older (Chinese = 1,389; Vietnamese = 1,094; Korean = 1,227). Replicate weighted total sample size was 1,710,233 (Chinese = 940,000; Vietnamese = 410,000; Korean = 360,000). Replicate-weighted multivariate logistic regression was applied. Interaction effects (moderator role of ethnicity) were also examined, using multivariate logistic regression, for the second objective.
For the first objective, odds of never having a mammogram were higher for women who were Korean (Ref = Vietnamese), unmarried, or a non-U.S. citizen. Odds were lower in women ages 50-59 or 60-69 (Ref = 70-85). Regarding the second objective, only for Chinese women, odds of never having a mammogram were lower as the number of physician visits got higher.
Culturally-sensitive outreach and services should be developed to target higher-risk groups. Patient-centered healthcare strategies tailored for the three groups could be effective. For Chinese women, in particular, regular information sessions or education programs could be provided for enhancing their physician visits.
乳腺癌是美国亚洲女性中最常见的癌症。首要目标是调查中年和老年华裔、越南裔和韩裔移民女性中从未进行过乳房 X 光检查的预测因素（包括族裔）（主要效应）。第二个目标是探索预测因素与从未进行乳房 X 光检查之间的关系是否因族裔而有所不同（族裔的调节效应）。
利用合并的（2005-2007-2009-2011 年）加利福尼亚健康访谈调查数据。未加权样本为 3710 名年龄在 40 岁及以上的亚裔女性（华裔=1389；越南裔=1094；韩裔=1227）。重复加权总样本量为 1710233 人（华裔=940000；越南裔=410000；韩裔=360000）。采用重复加权多变量逻辑回归进行分析。还使用多变量逻辑回归检查了第二个目标的交互效应（族裔的调节作用）。
对于第一个目标，韩裔（参照越南裔）、未婚或非美国公民的女性从未进行过乳房 X 光检查的可能性更高。年龄在 50-59 岁或 60-69 岁的女性（参照 70-85 岁）的可能性较低。关于第二个目标，仅对于华裔女性，随着就诊次数的增加，从未进行过乳房 X 光检查的可能性降低。
应制定以文化为敏感的外展和服务，以针对高风险群体。针对这三个群体制定以患者为中心的医疗保健策略可能会有效。特别是对于中国女性，可以提供定期的信息会议或教育计划，以增加她们的就诊次数。
