Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1161-1172 |
| Number of pages | 12 |
| Journal | Health Psychology |
| Volume | 36 |
| Issue number | 12 |
| Early online date | 20 Jul 2017 |
| DOIs | |
| Publication status | Published - Dec 2017 |
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Bibliographical note
©American Psychological Association, 2017. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. Please do not copy or cite without author's permission. The final article is available, upon publication, at: https://dx.doi.org/10.1037/hea0000525Cite this
South Asian Ethnicity, Socioeconomic Status, and Psychological Mediators of Faecal Occult Blood Colorectal Screening Participation: A Prospective Test of a Process Model. / Orbell, Sheina; Szczepura, Ala; Weller, David; Gumber, Anil; Hagger, Martin.
In: Health Psychology, Vol. 36, No. 12, 12.2017, p. 1161-1172.Research output: Contribution to journal › Article
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TY - JOUR
T1 - South Asian Ethnicity, Socioeconomic Status, and Psychological Mediators of Faecal Occult Blood Colorectal Screening Participation: A Prospective Test of a Process Model
AU - Orbell, Sheina
AU - Szczepura, Ala
AU - Weller, David
AU - Gumber, Anil
AU - Hagger, Martin
N1 - ©American Psychological Association, 2017. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. Please do not copy or cite without author's permission. The final article is available, upon publication, at: https://dx.doi.org/10.1037/hea0000525
PY - 2017/12
Y1 - 2017/12
N2 - Objective: Although ethnicity and socioeconomic status (SES) correlate with health inequality, efforts to explain variance in health behavior attributable to these factors are limited by difficulties in population sampling. We used ethnicity identification software to test effects of psychological beliefs about screening as mediators of ethnicity and SES on faecal occult blood colorectal screening behavior in a no-cost health care context. Method: Adults aged 50–67 years (N = 1,678), of whom 28% were from minority South Asian religiolinguistic ethnic groups (Hindu-Gujarati/Hindi, Muslim-Urdu and Sikh-Punjabi), participated in a prospective survey study. Subsequent screening participation was determined from medical records. Results: Screening nonparticipation in the most deprived SES quintile was 1.6 times that of the least deprived quintile. Nonparticipation was 1.6 times higher in South Asians compared with non-Asians. A process model in which psychological variables mediated effects of ethnicity and SES on uptake was tested using structural equation modeling. Self-efficacy and perceived psychological costs of screening were, respectively, positive and negative direct predictors of uptake. Paths from Hindu, Muslim, and Sikh ethnicity, and SES on uptake were fully mediated by lower self-efficacy and higher perceived psychological costs. Paths from South Asian ethnicity to participation via self-efficacy and psychological costs were direct, and indirect via SES. Conclusion: SES is implicated, but does not fully account for low colorectal screening uptake among South Asians. Targeting increased self-efficacy and reduced perceived psychological costs may minimize health inequality effects. Future research should test independent effects of SES and ethnicity on lower self-efficacy and higher psychological costs.
AB - Objective: Although ethnicity and socioeconomic status (SES) correlate with health inequality, efforts to explain variance in health behavior attributable to these factors are limited by difficulties in population sampling. We used ethnicity identification software to test effects of psychological beliefs about screening as mediators of ethnicity and SES on faecal occult blood colorectal screening behavior in a no-cost health care context. Method: Adults aged 50–67 years (N = 1,678), of whom 28% were from minority South Asian religiolinguistic ethnic groups (Hindu-Gujarati/Hindi, Muslim-Urdu and Sikh-Punjabi), participated in a prospective survey study. Subsequent screening participation was determined from medical records. Results: Screening nonparticipation in the most deprived SES quintile was 1.6 times that of the least deprived quintile. Nonparticipation was 1.6 times higher in South Asians compared with non-Asians. A process model in which psychological variables mediated effects of ethnicity and SES on uptake was tested using structural equation modeling. Self-efficacy and perceived psychological costs of screening were, respectively, positive and negative direct predictors of uptake. Paths from Hindu, Muslim, and Sikh ethnicity, and SES on uptake were fully mediated by lower self-efficacy and higher perceived psychological costs. Paths from South Asian ethnicity to participation via self-efficacy and psychological costs were direct, and indirect via SES. Conclusion: SES is implicated, but does not fully account for low colorectal screening uptake among South Asians. Targeting increased self-efficacy and reduced perceived psychological costs may minimize health inequality effects. Future research should test independent effects of SES and ethnicity on lower self-efficacy and higher psychological costs.
U2 - 10.1037/hea0000525
DO - 10.1037/hea0000525
M3 - Article
VL - 36
SP - 1161
EP - 1172
JO - Health Psychology
JF - Health Psychology
SN - 0278-6133
IS - 12
ER -