Colorectal cancer knowledge, attitudes, screening, and communication among Japanese American families: An exploratory, community-based participatory research in Chicagoland

OBJECTIVE: Individuals of Japanese descent (Nikkei) have significantly high risk for colorectal cancer (CRC). Communication about health issues often is lacking among Nikkei families. Two academic institutions and a social service agency in Chicagoland conducted community-based participatory research to explore whether mailing educational materials to Nikkei parents and/or adult offspring would improve CRC knowledge, attitudes and screening, as well as communication between parent and offspring regarding CRC. METHODS: Inclusion criteria for Nikkei parents included age 50-85, no prior CRC screening/diagnosis, and no basic functional limitations. Criteria for adult offspring included age 18+, no prior CRC screening/diagnosis, and residing with or seeing the parent regularly. Parent-offspring dyads were randomized into three cohorts defined by the “target recipient(s)” of CRC brochures: parent (Cohort-1); offspring (Cohort-2); and parent and offspring (Cohort-3). Baseline in-person and follow-up telephone surveys were conducted. RESULTS: Among 53 dyads contacted, 29 were ineligible primarily due to prior CRC screening. Most parents were 60+ year-old mothers with good self-reported health who visited their physicians regularly. Most adult offspring were daughters not living with the parent. Although CRC knowledge improved after the mailing in all cohorts, attitudes toward CRC screening became more negative, especially among offspring. Several parents in Cohort-1 and 3, but no parents in Cohort-2, reported an intention to be screened. Barriers to screening were identified. No improvement on communication was reported in any cohorts. CONCLUSION: Mailing brochures may improve CRC knowledge but additional interventions are needed to improve CRC attitudes, screening adherence, and family communication about CRC.