Barriers to Colonoscopies among Russian Immigrants in New York City

• In Event: 2184 - Section on Medical Sociology Refereed Roundtable Session
  In Refereed Roundtable 60min: Table 16. Immigration, Refugee Status, and Health

Abstract

Background:
Colorectal cancer (CRC) is one of the most preventable cancers. Timely screening can reduce CRC incidence and possibly reduce mortality through early stage diagnosis. There is extensive evidence of disparities in CRC screening. However, almost none of it has focused on Russian-speaking immigrants, who may face special barriers.
Aims:
1. To understand the barriers to timely colonoscopies in the Russian-speaking community in NYC in terms of: Providers, Patients and The health care system
2. To examine the implications of findings for potential interventions to increase colonoscopies among this population

Methodology:
Key informant interviews were performed with 13 providers , community leaders, and scholars serving or familiar with Russian immigrants. Eight focus groups were conducted with 81 Russian-speaking individuals without timely colonoscopies. Groups were segmented by gender and region of origin. Results were coded and analyzed based on grounded theory framework.
Results:
Key informant interviews identified major themes related to CRC screening for Russian-speaking immigrants in NYC, including culture, knowledge and access related barriers including those related to system issues such as access to care or the procedure itself, provider issues such as doctor recommendations and patient related issues such as attitudes towards colonoscopies.

The reasons found for low colonoscopy rates were multiple and interrelated, including distinctive elements of Russian culture which can affect health-related attitudes and behaviors. Potential interventions were suggested by these finding including education campaigns and more persistent efforts by doctors. There is a real need for information both about the procedure and why one should have a colonoscopy.

Conclusion:

Suboptimal colonoscopy rates among Russians may be because of lack of education about the procedure and the need for it despite lack of symptoms and perceived negative attributes of the procedure. This can potentially be addressed through interventions, although more research is needed.

Author

• Ephraim Shapiro