Preventive Health Care Behavior Among Albanian American Population; The Albanian Heath Initiative: A Study by the Albanian American Medical Society©

Background: Preventive health care measures among immigrants and minority groups are generally underutilized. While there is data available regarding healthcare utilization among several ethnic minorities in the USA, little is known regarding health behavior among Albania American communities. Objectives: To assess the rate of preventive health screening measures among Albanian American immigrants. Methods: Cross sectional analysis of data obtained through anonymous surveys offered to Albanian-American adults over eighteen years of age. Results: Of the 175 participants, 52% were females in the age range of 18-80 years. Body Mass Index (BMI) measured as Kg/ m2 was 29.0 ± 0.62 (± SEM) versus 26.3±0.73 for men and women respectively, P < 0.01. Of the above participants of 50 years of age and older, 62% had screening colonoscopy and 49% had hepatitis C screening test irrespective of their gender. Out of the eligible female participants, 68% had a pap smear and 71% had a mammogram. Conclusion: Preventive health measures such as colonoscopy, mammography and hepatitis C screening, were somewhat comparable to USA population including minority groups. There was a higher rate of marriage among our Albanian cohort (67.5%), compared to that reported in the USA (50.0% reported in 2013). Interestingly, colonoscopy screening rate was higher among USA born and married Albanians. Introduction Health care service utilization, particularly preventive health care measures are generally underutilized among immigrant and minority populations in the United States [1-5]. These vulnerable populations usually present in advanced stages of diseases secondary to poor screening measures particularly for common preventable diseases such as colon, breast and cervical cancers as well as other chronic illnesses such as diabetes, hypertension and hypercholesterolemia. While there is available data regarding healthcare utilization among several ethnic minorities, little is known about health behavior among Albania American communities. Citation: Lukolic I, Veseli G, Lulaj E, Çoku L, Çelaj S, et al. (2018) Preventive Health Care Behavior Among Albanian American Population; The Albanian Heath Initiative: A Study by The Albanian American Medical Society©. J Community Med Public Health 2: 136. DOI: 10.29011/2577-2228.100036 2 Volume 2; Issue 03 J Community Med Public Health, an open access journal ISSN: 2577-2228 Objectives To assess the rate of preventive screening measures among Albanian Americans for common preventable disorders and to identify barriers to health care utilization among this population. Methods Cross sectional analysis of data obtained through anonymous surveys offered to Albanian-American adults over eighteen years of age was used. The surveys were available in both English and Albanian languages. These surveys were conducted in large community centers, places of worship, as well as community events. The survey included demographic, socioeconomic, as well as data on health care utilization, and behavior. The surveyed communities where generally located in cities such as Detroit, Boston, Philadelphia and New York metropolitan areas. Data were analyzed using the SPSS® version 21. We used measures of central tendencies and dispersion for continuous variables and frequency distribution for categorical variable. Using logistic regression model we assessed the predictors of health behavior. Results Of the 175 participants surveyed 85% were foreign born, 52% were females, age range of 18-80 years. Men had significantly higher Body Mass Index (BMI) compared to women. BMI (Kg/m2) were 29.0 ± 0.62 (± SEM) versus 26.3±0.73 for men and women respectively, P < 0.01. 57.7% of the cohort reported having a college degree or higher. 67.5 % of the study cohort was married while 24% were single. Out of the single population 4.1 % were divorced and 4.1% were widowed. 12.6% of those surveyed reported current tobacco smoking and 12.5% reported feeling depressed. Of those above the age of 50 years, 62% had screening colonoscopy and 49 % had hepatitis C screening test. Of eligible female participants 68% had a pap smear and 71% had a mammogram. Colonoscopy rate was higher among married, compared to nonmarried (68% Vs 32 % for married and unmarried respectively), P < 0.01. Rate of colonoscopy was also significantly higher among those born in the USA, compared to foreign born Albanians (55% Vs 45% for USA born and foreign-born Albanians respectively), P = 0.036. In a logistic regression model, the odds ratio OR of having a colonoscopy was higher among married individuals and remained highly significant after adjusting for various potential confounders including Sex, Obesity, birth place, smoking, depression and level of education and alcohol use OR = 4.8 (1.87-12.66) (95% CI), P = 0.004. Conclusion Among Albanian immigrants in the USA preventive health measures were somewhat comparable to USA population. Colonoscopy rate for Albanians was 62% (USA rate 54.1-75.2%). Mammography rate among Albanians was 71% (USA rate 64.173.2%). Pap smear rate among Albanian women was 68% (USA rate 68-77.9%), Our study also confirms previously published reports indicating that married adults are more likely to participate in colorectal cancer screening than the non-married individuals [6,7]. Our study indicates higher rate of marriage among Albanian 67.5%, compared to that reported in the USA (50.0% reported in 2013) [8]. However, despite higher marriage rate, colonoscopy rate for Albanian Americans is comparable to that reported in the USA. Our study suggests a higher BMI (Kg/m2) among Albanian men, compared to men in the USA (29.0 vs 27.6) for Albanian and USA men respectively. However, Albanian women tended to be skinnier with a lower BMI, compared to USA women (26.3 Vs 27.19) for Albanian and USA women respectively [8]. Acknowledgments This work is sponsored in part by the Brooklyn Health Disparities Center NIH grant #P20 MD006875.


Introduction
Health care service utilization, particularly preventive health care measures are generally underutilized among immigrant and minority populations in the United States [1][2][3][4][5]. These vulnerable populations usually present in advanced stages of diseases secondary to poor screening measures particularly for common preventable diseases such as colon, breast and cervical cancers as well as other chronic illnesses such as diabetes, hypertension and hypercholesterolemia. While there is available data regarding healthcare utilization among several ethnic minorities, little is known about health behavior among Albania American communities.

Objectives
To assess the rate of preventive screening measures among Albanian Americans for common preventable disorders and to identify barriers to health care utilization among this population.

Methods
Cross sectional analysis of data obtained through anonymous surveys offered to Albanian-American adults over eighteen years of age was used. The surveys were available in both English and Albanian languages. These surveys were conducted in large community centers, places of worship, as well as community events. The survey included demographic, socioeconomic, as well as data on health care utilization, and behavior. The surveyed communities where generally located in cities such as Detroit, Boston, Philadelphia and New York metropolitan areas. Data were analyzed using the SPSS ® version 21. We used measures of central tendencies and dispersion for continuous variables and frequency distribution for categorical variable. Using logistic regression model we assessed the predictors of health behavior.

Results
Of the 175 participants surveyed 85% were foreign born, 52% were females, age range of 18-80 years. Men had significantly higher Body Mass Index (BMI) compared to women. BMI (Kg/m 2 ) were 29.0 ± 0.62 (± SEM) versus 26.3±0.73 for men and women respectively, P < 0.01. 57.7% of the cohort reported having a college degree or higher. 67.5 % of the study cohort was married while 24% were single. Out of the single population 4.1 % were divorced and 4.1% were widowed. 12.6% of those surveyed reported current tobacco smoking and 12.5% reported feeling depressed. Of those above the age of 50 years, 62% had screening colonoscopy and 49 % had hepatitis C screening test. Of eligible female participants 68% had a pap smear and 71% had a mammogram.
Colonoscopy rate was higher among married, compared to nonmarried (68% Vs 32 % for married and unmarried respectively), P < 0.01. Rate of colonoscopy was also significantly higher among those born in the USA, compared to foreign born Albanians (55% Vs 45% for USA born and foreign-born Albanians respectively), P = 0.036.
In a logistic regression model, the odds ratio OR of having a colonoscopy was higher among married individuals and remained highly significant after adjusting for various potential confounders including Sex, Obesity, birth place, smoking, depression and level of education and alcohol use OR = 4.8 (1.87-12.66) (95% CI), P = 0.004.

Conclusion
Among Albanian immigrants in the USA preventive health measures were somewhat comparable to USA population. Colonoscopy rate for Albanians was 62% (USA rate 54.1-75.2%). Mammography rate among Albanians was 71% (USA rate 64.1-73.2%). Pap smear rate among Albanian women was 68% (USA rate 68-77.9%), Our study also confirms previously published reports indicating that married adults are more likely to participate in colorectal cancer screening than the non-married individuals [6,7]. Our study indicates higher rate of marriage among Albanian 67.5%, compared to that reported in the USA (50.0% reported in 2013) [8]. However, despite higher marriage rate, colonoscopy rate for Albanian Americans is comparable to that reported in the USA.
Our study suggests a higher BMI (Kg/m 2 ) among Albanian men, compared to men in the USA (29.0 vs 27.6) for Albanian and USA men respectively. However, Albanian women tended to be skinnier with a lower BMI, compared to USA women (26. 3 Vs 27.19) for Albanian and USA women respectively [8].