Cognitive mediators linking social support networks to colorectal cancer screening adherence

• Published in: Journal of behavioral medicine Vol. 29; no. 5; pp. 449 - 460
• Main Authors: HONDA, Keiko, KAGAWA-SINGER, Marjorie
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.10.2006; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Asian Americans - psychology; Biological and medical sciences; Colorectal cancer; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - psychology; Communication; Connecticut; Culture; Disease prevention; Epidemiology; Ethnicity; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Illness and personality; Influence; Internal-External Control; Japanese Americans; Male; Mass Screening - psychology; Medical sciences; Medical screening; Middle Aged; New Jersey; New York; Patient Acceptance of Health Care - psychology; Personality, behavior and health; Physician-Patient Relations; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Social Conformity; Social Support; Social Values; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surveys and Questionnaires; Tumors; United States; North America; America; New York; New Jersey; Connecticut; Human; Social environment; Rectal disease; cancer screening; Compliance; Colorectal cancer; Social network; social linkage; Malignant tumor; Medical screening; Japanese; Ethnic group; Social cognition; Colonic disease; Digestive diseases; Intestinal disease; Adult; Elderly; Public health; Social support
• ISSN: 0160-7715; 1573-3521
• DOI: 10.1007/s10865-006-9068-1

This paper argues that normative considerations are more important than attitudinal factors in engaging colorectal cancer screening, and tests a model explaining how unique cultural expressions of social networks influence screening adherence. Structural equation modeling was used to understand colorectal cancer screening in a population-based sample of 341 Japanese Americans aged 50 and over. The model accounted for 25% of the variance in screening adherence. Adherence was most strongly associated with family/friend subjective norms about colorectal cancer screening use. Emotional family support, but not the size of the networks, was indirectly related to adherence via increased family/friend subjective norms, while emotional friend support was directly related to adherence. While usual source of care was directly associated with adherence, better provider-patient communication was directly and indirectly associated with adherence via increased perceived benefits. The findings of this study support strengthening informal support networks to enhance adherence among Japanese Americans at risk.