Colorectal Cancer Screening Behaviours of South Asian Immigrants in Canada: An Exploratory Mixed Methods Study
Bibliographic record
Abstract
An exploratory sequential mixed method study was conducted to explore factors that influence colorectal cancer (CRC) screening uptake and to develop an empirically-based cross culturally adapted survey to better understand uptake in average risk South Asian (SA) immigrants. Phase I was a scoping study that reviewed relevant cancer screening literature. Phase II was a focus group study with SA immigrants to explore beliefs, attitudes, and reasons for CRC screening decision-making. Phase III involved survey development by incorporating Phase I and II findings, critically appraising candidate measures, cross culturally translating and adapting into Urdu, and pre-testing using cognitive interviews. Narrative and thematic analysis of scoping study literature uncovered four themes: (1) beliefs and attitudes including centrality of family, holistic health care, fatalism, screening as unnecessary, and emotion-laden perceptions; (2) lack of knowledge; (3) barriers to access; and (4) gender differences. Focus group thematic analysis revealed three themes: (1) beliefs and attitudes such as benefits of screening; (2) knowledge and awareness of CRC and screening, experiential learning, and recommendations; and (3) support and accessibility, particularly linked to physicians. In survey development, candidate measures with good conceptual matches were identifed in the literature. Modifications were made to the Urdu survey. After pre-testing, revisions addressed general design, culture, and gender issues. This study enhanced understanding of factors that influenced cancer screening and provided insights on socio-cultural context, beliefs, attitudes, barriers, and strategies to promote CRC screening among SA immigrants in Canada. Collectively, the findings informed survey development. Future research will pilot-test the surveys and conduct reliability and validity testing. These findings can inform public health and cancer control efforts to develop relevant strategies to improve CRC screening among SA immigrants. The English and Urdu language survey will be used to advance understanding of factors that influence CRC screening among SA immigrants in Ontario, Canada.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.008 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".