Factors Predicting Physician Referral of Cancer Screening and Participation in Clinical Trials for Chinese and Haitian Immigrants

Chau Trinh-Shevrin DrPH, Francesca Gany MD MS, Eunah Chung MPH, John Kim, Edouard Hazel MD, Sun-Hoo Foo MD, Rachel Andre, Zeling Chau, Kah Wan, Therza Torchon

Background: The New York City Chinese and Haitian immigrant communities represent unique and vulnerable populations for cancer prevention and early detection efforts. Medical access for many Chinese and Haitians is impeded by language and cultural barriers, financial difficulties, lack of any or adequate health insurance, and lack of community-based clinics, especially for the Haitian community. Chinese and Haitian immigrants are less likely to utilize cancer prevention, screening, and treatment programs. Chinese and Haitian immigrants, compared with other immigrant groups and the general population, receive cancer diagnoses at later stages. Focus groups with Chinese and Haitian immigrants suggest that physicians can play an important role in increasing their clients’ willingness to undergo cancer screening and treatment, as well as to participate in clinical trials. These immigrants also reported seeking care from private physicians with a preference for physicians of their own ethnic background compared with those from other racial and ethnic backgrounds.

Methods: This study is examining physician barriers to referring Chinese and Haitian immigrants for cancer screening and treatment, and participation into clinical trials. A multi-theoretical framework was used to develop and analyze a survey that is examining the determinants of physician referral for NYC Chinese and Haitian immigrants in to cancer screening, treatment and clinical trials. In particular, the Stages of Change Model was used to evaluate providers’ willingness and readiness to modify practice behaviors and the capacity for change to occur. A database of physicians serving the Chinese and Haitian communities was developed and a random sample of 150 physicians was selected for the study.

Results: The study was piloted among Chinese and Haitian physicians. Final survey administration continues to await IRB approval.