{"id":476,"date":"2017-05-23T05:10:27","date_gmt":"2017-05-23T05:10:27","guid":{"rendered":"http:\/\/magazines.uthscsa.edu\/tribute\/?p=476"},"modified":"2018-09-27T14:37:36","modified_gmt":"2018-09-27T14:37:36","slug":"moonju_lee","status":"publish","type":"post","link":"https:\/\/magazines.uthscsa.edu\/schools\/2017\/05\/23\/moonju_lee\/","title":{"rendered":"Breaking Barriers"},"content":{"rendered":"

Research Dedicated to Preventing Cancer in Korean Americans<\/h2>\n

By Teri Speece
\nImagine you knew you were predisposed to certain types of cancers\u2014but you found it so hard to find a physician, communicate your symptoms, understand medical advice and pay the costs of screening that you ended up doing nothing about it.<\/p>\n

Moonju Lee, Ph.D., M.S.N, RN, assistant professor in the School of Nursing, is tackling this issue. Her research addresses emigrants from the Republic of Korea, a rapidly growing U.S. population with some of the highest incidences of colorectal cancer worldwide, yet some of the lowest rates of colorectal cancer screening.<\/p>\n

\u201cAccording to the American Cancer Society, colorectal cancer\u00a0is the most commonly diagnosed cancer among Korean-American\u00a0men and the second most common cancer in Korean-American women,\u201d Dr. Lee said. \u201cBut, their cancer screening rates are extremely low compared to other Asian American ethnic groups and the overall U.S. population.\u201d<\/p>\n

\u201cIt\u2019s very hard to find Korean-American data, because most national statistics represent Asian Americans or Asian Americans\/Pacific Islanders in aggregate, except in California and Hawaii, where they do break them out,\u201d she said. \u201cBut individual Asian groups have different health issues, languages, immigration histories and demographic profiles.\u201d<\/p>\n

Dr. Lee\u2019s research into Korean-American health behaviors arose from 17 years\u2019 experience in critical care oncology nursing, six years of research and clinical work in community health and her personal experience emigrating from Korea 20 years ago.<\/p>\n

For her Ph.D. from the University of Arizona, she completed her dissertation on barriers to and facilitators of colorectal cancer screening among Korean Americans aged 50 and older. That study involved conducting a survey in the Greater Los Angeles area, mainly Los Angeles and Orange counties, which contain the highest number of Korean Americans in the United States.<\/p>\n

Her current study builds on that data using surveys and individual interviews to confirm the previous results and also explore sociocultural beliefs about cancer screening and the experiences of U.S. health care services utilization among Korean Americans in Dallas, Houston, Austin and San Antonio. Dr. Lee conducted 500 surveys and 18 in-depth interviews.<\/p>\n

Dr. Lee is currently analyzing survey data but has found important themes from her analysis of the interview study:<\/p>\n

Health care providers aren\u2019t recommending screenings. This finding is prevalent in both California and\u00a0Texas, with every one of the 18 Texas participants citing they had\u00a0never received colorectal cancer screening recommendations from\u00a0their doctors. While data indicates the lack of insurance coverage\u00a0to be a factor, even the participants who had insurance coverage said they did not receive a recommendation\u2014a finding Dr. Lee hopes to explore further in future research.<\/p>\n

She suspects a significant difference in communication styles between American doctors and Korean doctors may contribute to this result.
\n\u201cA Korean physician\u2019s communication style is to force by telling\u00a0their patients, \u2018You have to do your cancer screening.\u2019 In Korean culture, doctors are an authority, and when the doctor tells them to do something, they say, \u2018No matter whether I can afford it or not, I have to do it,\u2019\u2009\u201d she said.<\/p>\n

\u201cIn the United States, many physicians present it as a choice:<\/p>\n

\u2018If you want, you can have your cancer screening done.\u2019 They leave\u00a0the decision-making to the patient,\u201d said Dr. Lee. \u201cThis difference\u00a0in communication styles is an important factor contributing to patients\u2019 decision-making. So the patient says, \u2018If I don\u2019t have any\u00a0symptoms, why do I need to be tested?\u2019 \u201d<\/p>\n

The U.S. health care system is costly and difficult to navigate. Most Korean Americans work for small businesses,\u00a0which do not provide health insurance. Those who have insurance\u00a0privately or through the U.S. Patient Protection and Affordable Care Act rarely used it for several reasons, including difficulty navigating the U.S. health care system and language barriers.<\/p>\n

\u201cBasic communication is possible, but Korean patients often\u00a0don\u2019t fully express their feelings or their symptoms, and they don\u2019t\u00a0fully understand what the doctor is talking about,\u201d Dr. Lee said.<\/p>\n

Interview subjects also said they are intimidated by the unfamiliarity of the U.S. health care systems, have difficulty finding health care providers in their network, or find it hard to go to multiple places for services such as checkups, radiology and blood work.<\/p>\n

\u201cThe system is very different from Korea\u2019s, where it is one stop\u00a0for many services. They can do radiology, blood work, pharmacy, specialists\u2014everything in one building on the same day. They are\u00a0very complete and speedy,\u201d she said.<\/p>\n

Other participants cited the unavailability of specialists when they needed them.<\/p>\n

\"\"<\/a>
Dr. Lee interviews Korean Americans for her research with the goal of developing robust health promotion programs to reduce health disparities.<\/figcaption><\/figure>\n

\u201cOne of the saddest stories I heard was from a lady who fell and\u00a0had a fracture. She went to the ER, but they said she had to wait a few weeks or months for an orthopedic specialist. She didn\u2019t go to the doctor for six months,\u201d said Dr. Lee. \u201cShe finally went to Korea to get treated.\u201d<\/p>\n

It\u2019s easier to go home for health care. Dr. Lee\u2019s research also revealed many Koreans prefer to travel back to Korea for routine checkups, screenings and even medication over trying to navigate the U.S. system.<\/p>\n

Korean travel agencies advertise medical tour packages offering\u00a0a cafeteria-style list of services, including health examination, blood work, radiology, and various screenings for $500 to $1,500. \u201cThe packages include many options such as dementia checkup, brain MRI, and many cancer screenings,\u201d she said.<\/p>\n

Some participants also said they used Korea\u2019s national health\u00a0insurance program as an alternative to U.S. health care. \u201cIt\u2019s much\u00a0cheaper and easier to get health care services in Korea compared to the U.S.,\u201d Dr. Lee said. \u201cEven if they don\u2019t have Korea\u2019s National\u00a0Health Insurance plan, they can pay cash to get services.\u201d<\/p>\n

In addition to furthering her research, Dr. Lee\u2019s goal is to develop robust health promotion programs to reduce health disparities in this group and build a healthy Korean-American community using community-based participatory research.<\/p>\n","protected":false},"excerpt":{"rendered":"

Moonju Lee, Ph.D., M.SN., RN, has dedicated her research to understanding why Korean Americans have high incidences of colorectal cancer, but some of the lowest rates of cancer screening. <\/p>\n","protected":false},"author":42,"featured_media":502,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,12],"magazine":[24],"issue-year":[20],"featured-story":[37],"class_list":["post-476","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-community","category-research","magazine-tribute","issue-year-20","featured-story-landing-page"],"yoast_head":"\nBreaking Barriers - Magazines of the Schools at UT Health San Antonio<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/magazines.uthscsa.edu\/schools\/2017\/05\/23\/moonju_lee\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Breaking Barriers - 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