Protective and Risk Factors and Gastric Cancer Health Knowledge among Older Korean Immigrants

Overview: This cross-sectional study explored the relationship of cancer health literacy, English proficiency, social support, and gastric cancer health knowledge among 120 older Korean immigrants. By utilizing the hierarchical regression method, this study found that limited health proficiency and social support from friends are significantly associated with gastric cancer health knowledge.Proposal text: Background/Rationale
Gastric cancer is the 5th most prevalent cancer in the world and the 2nd most diagnosed cancer in East Asia and East Asian Americans in the U.S. (Kim et al., 2015). Strikingly, Korean immigrants had a significantly higher gastric cancer rate than other Asians and the highest rates of all racial/ethnic groups in the U.S. (Jin et al., 2016; Lee et al., 2017). This phenomenon was dramatically elevated with age-especially after age 55 (Kim et al., 2015). However, there is a lack of research in this area about this population’s protective and risk factors and gastric cancer literacy. Therefore, this study aimed to explore the roles of health literacy and social support on gastric cancer health literacy among older Korean immigrants.

Methods
This study recruited a total of 120 Korean older adult participants by using the purposive sampling method in 2019. The Knowledge about Gastric Carcinoma was used to measure the gastric cancer health knowledge among participants (Mansour-Ghanaei et al., 2012). To measure the level of social support in participants’ social network, the Lubben Social Network Scale-R was used (Lubben et al., 2001). The 3 Health Literacy Screening Questions (Chew et al., 2008) were used to assess the limited health literacy. This study also used six socio-demographic variables as control variables: age, gender, education, annual household income, length of residency in the US, and family cancer history.

Results
Participants’ mean age was 64.36 years ranging from 65 to 92 (SD = 8.42). About 65% were female, and 30% were widowed. Slightly over 73% of participants had a bachelor’s degree. The hierarchical multivariate regression analysis showed that a high level of social support from friends was significantly associated with a high level of gastric cancer health knowledge (B = 0.27, SE = 0.08, p ≤ .001), and a high level of limited cancer health literacy was significantly associated with a low level of gastric cancer health knowledge (B = -0.36, SE = 0.16, p ≤ .05). In addition, annual household income was significantly associated with the increase of gastric cancer health knowledge (B = 0.51, SE = 0.24, p ≤ .05), while the length of residency in the US was a significant factor correlated with low levels of gastric cancer health knowledge (B = -0.12, SE = 0.04, p ≤ .01).

Conclusions
This study examined the association of limited cancer health literacy, social support, and gastric cancer health knowledge among 120 older Korean immigrants. The study found that participants who had a high level of social support from friends were significantly associated with a high level of gastric cancer health knowledge, and a high level of limited cancer health literacy was significantly associated with a low level of gastric cancer health knowledge. Korean community organizations, social work practitioners, and health care providers need to develop and provide evidence-based gastric cancer educational programs or trainings to the population to increase their knowledge about the gastric cancer and to reduce gastric cancer risks.