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Factors associated with completion of colonoscopy among Haitian households in Little Haiti, Miami-Dade County, Florida, USA

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Meredith Wilcox, MPH , Division of Research and Data and Information Coordinating Center, Florida International University, Herbert Wertheim College of Medicine, North Miami, FL
Juan Acuna, MD., MSc., FACOG , Division of Research and Information and Data Coordinating Center, Florida International University Herbert Wertheim College of Medicine, Miami, FL
Purnima Madhivanan, MBBS, MPH, Ph.D. , Dept. of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
Background:  Less than two-thirds of U.S. adults recommended for colorectal cancer (CRC) screening are up-to-date in their use of colonoscopy.  This study identified factors associated with colonoscopy use among Haitian (HHs) and non-Haitian households (N-HHs) in Little Haiti, Miami, Florida. 

Methods:  This study utilized cross-sectional data collected between 11/2011-12/2012 in the Little Haiti Benchmark Survey.  Factors associated with colonoscopy use by any household member were identified using logistic regression models. Analyses were stratified by Haitian descent and restricted to households containing minimum one member ≥50 years (n=666).   

Results: Half of households self-identified as Haitian (49%).  Majority of HHs spoke primarily Creole (80.9%). Majority of N-HHs self-identified as African-American (32%) or Hispanic (37%) and spoke English (68%). Fewer HHs than N-HHs had a college degree (20% vs. 30%*) and were retired (19% vs. 27%*); while more were below poverty thresholds (51% vs. 21%*) and uninsured (56% vs. 42%*)(*p<0.05).  Colonoscopy use was lower among HHs than N-HHs (46% vs. 60%, p=0.001).  Independent factors associated with colonoscopy use among HHs included: no health insurance (adjusted odds ratio [AOR]=0.48, p=0.063); compliance with blood stool tests (BST) (AOR=4.29*); and former cigarette smoking (AOR=5.65*)(*p<0.05).  Independent factors among N-HHs included: marriage/cohabitation (AOR=3.55*); unemployment (AOR=0.11*) and employment (AOR=0.18*) (vs. retirement); no health insurance (AOR=0.36*); diagnosed co-morbidities (AOR=2.90*); and compliance with BST (AOR=2.37*) and other cancer screenings (AOR=9.63*)(*p<0.05).

Conclusion:  This is the first study of colonoscopy use within Little Haiti, Miami, Florida. The findings provide a basis for community-based interventions aimed at increasing CRC screening by means of colonoscopy.

Learning Areas:

Chronic disease management and prevention
Epidemiology
Public health or related research

Learning Objectives:
Identify factors associated with previous use of colonoscopy by households of Haitian versus non-Haitian descent in Miami-Dade Country, Florida.

Keyword(s): Cancer Prevention and Screening, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the co-investigator of multiple studies focusing on the use of colonoscopy/screening for colorectal cancer within Miami Dade County. I currently have a manuscript submitted with Gastroenterology (journal) on the use of colonoscopy within communities of North Miami Dade County.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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