br Results OHIS was positively associated
Results: OHIS was positively associated with information overload and health literacy; information overload was negatively associated with health literacy. Health literacy was positively associated with decisional balance; decisional balance was positively associated with uptake of sigmoidoscopy and colonoscopy.
Conclusion: The findings supported both theoretical frameworks, HLSF and CMM, for OHIS to develop health literacy, leading to CRC screening. These findings highlight the significant roles of information overload and attitudes and beliefs about screening in enhancing health literacy and CRC screening among KAs.
Practice Implications: Practice efforts for facilitating CRC screening among medically underserved older KAs should target improving access to and use of OHIS and culturally-tailored health information delivery.
Cancer is the leading cause of death in the U.S., while the cancer-related death rate has steadily declined over the last two decades . The American Cancer Society estimates that the average lifetime risk of developing cancer is nearly one in two (40.8%) for American men and more than one in three (37.5%) for American women . In response to this, researchers have underscored the need for cancer screening, which can reduce the risk by identifying precancerous Curcumin or detecting cancers in their early stages, thereby saving lives . Cancer institutes also firmly recommend routine cancer screening for people at average risk [4,5].
Despite the risk of cancer and the benefits of screening, cancer screening rates remain low for the general U.S. population. For
* Corresponding author.
E-mail addresses: [email protected] (S.W. Jin), [email protected]
example, the commonly recommended guideline for colorectal cancer (CRC) screening includes having a fecal occult blood test (FOBT) annually, sigmoidoscopy every five years, or colonoscopy every ten years for those aged 50–75 [6,7]. However, a nationally representative household survey recently reported that 62.4% of men and women were up to date with the guideline , which falls short of the national goal (i.e., 70.5%) set by Healthy People 2020 . Further, division of subgroups in the U.S. population by race/ ethnicity revealed a disparity in CRC screening, especially for underrepresented populations [10,11]. In particular, a systematic review study on CRC screening demonstrated Archaea only 25–50% of Korean Americans had ever had any of these tests, while only 10– 40% reported having undergone a screening within the past five or ten years .
Literature has shown that the underutilization of CRC screening among Korean Americans is associated with their low health literacy [13,14]. Health literacy is a critical competence in assuring and promoting individuals’ health through obtaining, processing, and understanding basic health information and services needed
to inform health decisions [15–17]. Prior research found that Korean Americans have lower levels of health literacy than non-Hispanic whites, resulting in suboptimal cancer screening [18–20]. Studies also showed that Korean Americans with limited health literacy are less likely than those with appropriate health literacy to use preventive health care services and adhere to cancer screening guidelines [21–23]. This suggests that there is the need to enhance health literacy in order to facilitate cancer screening among Korean Americans [24–26].
A growing body of research has proposed that health literacy can be affected by online health information seeking (OHIS) . As people have increasingly used Internet-enabled devices to seek health information and the Internet has become a primary medium to find and deliver health information , OHIS is essential to ensuring adequate health literacy and, ultimately, optimal health outcomes [29–31]. Research has shown that limited use of Internet technologies for health information seeking is related to poor health literacy [32–38]. A systematic review study also found that people who poorly evaluate online health information tend to have low health literacy . Furthermore, the Health Information National Trends Survey on adults' use of cancer-related information demonstrated the positive link be-tween engaging and interpreting online health information and health literacy, implying the potential effects of OHIS behaviors on improving cancer screening outcomes [40,41].