Skip to main content
SpringerLink
Log in

A Qualitative Study of Cancer Information Seeking Among English-as-a-Second-Language Older Chinese Immigrant Women to Canada: Sources, Barriers, and Strategies

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Little is known about the cancer information seeking experiences of Chinese immigrants despite reported disparities in cancer burden and use of cancer screening. This research used semi-structured interviews to the explore cancer information seeking preferences and experiences of 50 English-as-a-second-language older Chinese immigrant women to Canada with different levels of health literacy. Directed content analysis was used to identify three main themes: sources of cancer information, barriers to cancer information seeking, and strategies used during information seeking. Health literacy did not distinguish the women on any of the major themes. The women expressed strong preferences for interpersonal and interactive cancer information from their physician and trusted others, such as friends and family. Barriers to cancer information seeking included language difficulties and limited time with physicians. The results emphasize the need for cancer information that reinforces cultural norms, language familiarity, and other values specific to cultural identities, such as interpersonally oriented values.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gomez SL, Quach T, Horn-Ross PL, Pham JT, Cockburn M, Chang ET, Keegan TH, Glaster SL, Clarke CA (2010) Hidden breast cancer disparities in Asian women: disaggregating incidence rates by ethnicity and migrant status. Am J Public Health 100:S125–S131

    Article  PubMed  Google Scholar 

  2. Li CI, Malone KE, Daling JR (2003) Differences in breast cancer stage, treatment, and survival by race and ethnicity. Arch Intern Med 163(1):49–56

    Article  PubMed  Google Scholar 

  3. Miller BA, Chu KC, Hankey BF, Ries LA (2008) Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S. Cancer Causes Control 19(3):227–256

    Article  PubMed  Google Scholar 

  4. Jackson SL, Hislop TG, Teh C, Yasui Y, Tu SP, Kuniyuki A, Jackson JC, Taylor VM (2003) Screening mammography among Chinese Canadian women. Can J Public Health 94(4):275–280

    PubMed  Google Scholar 

  5. Taylor VM, Yasui Y, Burke N, Nguyen T, Acorda E, Thai H, Qu P, Jackson JC (2004) Pap testing adherence among Vietnamese American women. Cancer Epidemiol Biomark Prev 13(4):613–619

    Google Scholar 

  6. Sadler GR, Ryujin LT, Ko CM, Nguyen E (2001) Korean women: breast cancer knowledge, attitudes and behaviors. BMC Public Health 1:7–15

    Article  PubMed  CAS  Google Scholar 

  7. Sun Z, Xiong H, Kearney A, Zhang J, Liu W, Huang G et al (2010) Breast cancer screening among Asian immigrant women in Canada. Cancer Epidemiol 34(1):73–78

    Article  PubMed  Google Scholar 

  8. Kandula NR, Wen M, Jacobs EA, Lauderdale DS (2006) Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites: cultural influences or access to care? Cancer 107(1):184–192

    Article  PubMed  Google Scholar 

  9. Jerant AF, Fenton JJ, Franks P (2008) Determinants of racial/ethnic colorectal cancer screening disparities. Arch Intern Med 168(12):1317–1324

    Article  PubMed  Google Scholar 

  10. Redmond N, Baer HJ, Clark CR, Lipsitz S, Hicks LS (2010) Sources of health information related to preventive health behaviors in a national study. Am J Prev Med 38(6):620–627

    Article  PubMed  Google Scholar 

  11. Lambert SD, Loiselle CG (2007) Health information seeking behavior. Qual Health Res 17(8):1006–1019

    Article  PubMed  Google Scholar 

  12. Wang JH, Mandelblatt JS, Liang W, Yi B, Ma IJ, Schwartz MD (2009) Knowledge, cultural, and attitudinal barriers to mammography screening among nonadherent immigrant Chinese women: ever versus never screened status. Cancer 115(20):4828–4838

    Article  PubMed  Google Scholar 

  13. Arora NK, Hesse BW, Rimer BK, Viswanath K, Clayman ML, Croyle RT (2008) Frustrated and confused: the American public rates its cancer-related information-seeking experiences. J Gen Intern Med 23(3):223–228

    Article  PubMed  Google Scholar 

  14. Kakai H, Maskarinec G, Shumay DM, Tatsumura Y, Tasaki K (2003) Ethnic differences in choices of health information by cancer patients using complementary and alternative medicine: an exploratory study with correspondence analysis. Soc Sci Med 56(4):851–862

    Article  PubMed  Google Scholar 

  15. Nguyen GT, Bellamy SL (2006) Cancer information seeking preferences and experiences: disparities between Asian Americans and Whites in the Health Information National Trends Survey (HINTS). J Health Commun 11(Supp.1):173–180

    Article  PubMed  Google Scholar 

  16. Institute of Medicine Committee on Health Literacy (2004) Health literacy: a prescription to end confusion. National Academies Press, Washington D.C

    Google Scholar 

  17. Nutbeam D (2000) Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int 1(5):259–267

    Article  Google Scholar 

  18. Shaw A, Ibrahim S, Reid F, Ussher M, Rowlands G (2009) Patients’ perspectives of the doctor-patient relationship and information giving across a range of literacy levels. Patient Educ Couns 75(1):114–120

    Article  PubMed  Google Scholar 

  19. von Wagner C, Semmler C, Good A, Wardle J (2009) Health literacy and self-efficacy for participating in colorectal cancer screening: the role of information processing. Patient Educ Couns 75(3):352–357

    Article  Google Scholar 

  20. Statistics Canada (2009) Building our competencies: Canadian results of the international adult literacy and skills survey. Catalogue no. 89-617-XIE. Ottawa. http://www.statcan.ca/bsolc/english/bsolc?catno=89-617-X. Accessed 8 July 2009

  21. Statistics Canada (2008) Canada’s ethnocultural mosaic. Statistics Canada catalogue no. 97-562-XWE2006001. Ottawa. April 9. Analysis series, 2006 census. http://www.statcan.gc.ca/bsolc/olc-cel/olc-cel?catno=97-562-X2006001&lang=eng. Accessed 19 July 2009

  22. Todd LE, Hoffman-Goetz L, Harvey E (2010) Predicting breast and colon cancer screening among English-as-a-second-language older Chinese immigrant women to Canada. J Cancer Educ. doi:10.1007/s/13187-010-0141-7

    Google Scholar 

  23. Todd LE, Hoffman-Goetz L (2010) Predicting health literacy among English-as-a-second-language older Chinese immigrant women to Canada: comprehension of colon cancer prevention information. J Cancer Educ. doi:10.1007/S13187-010-0162-2

  24. Sandelowski M (1995) Sample size in qualitative research. Res Nurs Health 18(2):179–183

    Article  PubMed  CAS  Google Scholar 

  25. Parker RM, Baker DW, Williams MV, Nurss JR (1995) The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med 10(10):537–541

    Article  PubMed  CAS  Google Scholar 

  26. Hsieh HF, Shannon SE (2005) Three approaches to qualitative content analysis. Qual Health Res 15(9):1277–1288

    Article  PubMed  Google Scholar 

  27. Chen CJ, Kendall J, Shyu YI (2010) Grabbing the rice straw: health information seeking in Chinese immigrants in the United States. Clin Nurs Res. doi:10.1177/1054773810372542

    PubMed  Google Scholar 

  28. Britigan DH, Murnan J, Rojas-Guyler L (2009) A qualitative study examining Latino functional health literacy levels and sources of health information. J Commun Health 34(3):222–230

    Article  Google Scholar 

  29. Hesse BW, Nelson DE, Kreps GL, Croyle RT, Arora NK, Rimer B, Viswanath K (2005) Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey. Arch Intern Med 165(22):2618–2624

    Article  PubMed  Google Scholar 

  30. Meissner HI, Potosky AL, Convissor R (1992) How sources of health information relate to knowledge and use of cancer screening exams. J Commun Health 17(3):153–165

    Article  CAS  Google Scholar 

  31. Ahmad F, Shik A, Vanza R, Cheung A, George U, Stewart DE (2004) Popular health promotion strategies among Chinese and East Indian immigrant women. Women Health 40(1):21–40

    Article  PubMed  Google Scholar 

  32. Liu R, So L, Quan H (2007) Chinese and white Canadian satisfaction and compliance with physicians. BMC Fam Pract 21(8):11–20

    Article  Google Scholar 

  33. Lee M (1998) Breast and cervical cancer: early detection in Chinese American women. Asian Am Pac Isl J Health 6(2):351–357

    PubMed  Google Scholar 

  34. Pang EC, Jordan-Marsh M, Silverstein M, Cody M (2003) Health-seeking behaviors of elderly Chinese Americans: shifts in expectations. Gerontologist 43(6):864–874

    PubMed  Google Scholar 

  35. Tu SP, Taylor V, Yasuai Y, Chun A, Yip MP, Acorda E, Li L, Bastani R (2006) Promoting culturally appropriate colorectal cancer screening through a health educator: a randomized control trial. Cancer 107(5):959–966

    Article  PubMed  Google Scholar 

  36. Neuhauser L, Kreps GL (2008) Online cancer communication: meeting the literacy, cultural and linguistic needs of diverse audiences. Patient Educ Couns 71(3):365–377

    Article  PubMed  Google Scholar 

  37. Woodall ED, Taylor VM, Teh C, Li L, Acorda E, Tu SP, Yasui Y, Hislop G (2009) Sources of health information among Chinese immigrants to the Pacific Northwest. J Cancer Educ 24(4):334–340

    Article  PubMed  Google Scholar 

  38. Statistics Canada (2008) Canadian internet use survey. The daily. June 2008. http://www.statcan.gc.ca/daily-quotidien/080612/dq080612b-eng.htm. Accessed 20 June 2010

Download references

Acknowledgements

The authors gratefully acknowledge C. Wu for the Chinese translation and interpretation, the women who participated in this study, and our community partner (the Cancer Prevention and Early Detection Network of Waterloo Region). This work was funded by the Social Sciences and Humanities Research Council of Canada.

Author information

Authors and Affiliations

  1. Department of Health Studies and Gerontology, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada, N2L 3G1

    Laura Todd & Laurie Hoffman-Goetz

Authors
  1. Laura Todd
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laurie Hoffman-Goetz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laurie Hoffman-Goetz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Todd, L., Hoffman-Goetz, L. A Qualitative Study of Cancer Information Seeking Among English-as-a-Second-Language Older Chinese Immigrant Women to Canada: Sources, Barriers, and Strategies. J Canc Educ 26, 333–340 (2011). https://doi.org/10.1007/s13187-010-0174-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-010-0174-y

Keywords

Search

Navigation