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Satagopan JM, Dharamdasani T, Mathur S, Kohler RE, Bandera EV, Kinney AY. Experiences and lessons learned from community-engaged recruitment for the South Asian breast cancer study in New Jersey during the COVID-19 pandemic. PLoS One 2023; 18:e0294170. [PMID: 37956167 PMCID: PMC10642833 DOI: 10.1371/journal.pone.0294170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND South Asians are a rapidly growing population in the United States. Breast cancer is a major concern among South Asian American women, who are an understudied population. We established the South Asian Breast Cancer (SABCa) study in New Jersey during early 2020 to gain insights into their breast cancer-related health attitudes. Shortly after we started planning for the study, the COVID-19 disease spread throughout the world. In this paper, we describe our experiences and lessons learned from recruiting study participants by partnering with New Jersey's community organizations during the COVID-19 pandemic. METHODS We used a cross-sectional design. We contacted 12 community organizations and 7 (58%) disseminated our study information. However, these organizations became considerably busy with pandemic-related needs. Therefore, we had to pivot to alternative recruitment strategies through community radio, Rutgers Cancer Institute of New Jersey's Community Outreach and Engagement Program, and Rutgers Cooperative Extension's community health programs. We recruited participants through these alternative strategies, obtained written informed consent, and collected demographic information using a structured survey. RESULTS Twenty five women expressed interest in the study, of which 22 (88%) participated. Nine (41%) participants learned about the study through the radio, 5 (23%) through these participants, 1 (4.5%) through a non-radio community organization, and 7 (32%) through community health programs. Two (9%) participants heard about the study from their spouse. All participants were born outside the US, their average age was 52.4 years (range: 39-72 years), and they have lived in the US for an average of 26 years (range: 5-51 years). CONCLUSION Pivoting to alternative strategies were crucial for successful recruitment. Findings suggest the significant potential of broadcast media for community-based recruitment. Family dynamics and the community's trust in our partners also encouraged participation. Such strategies must be considered when working with understudied populations.
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Affiliation(s)
- Jaya M. Satagopan
- Department of Biostatistics and Epidemiology, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Tina Dharamdasani
- Department of Biostatistics and Epidemiology, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Shailja Mathur
- Department of Family and Community Health Sciences, Cooperative Extension, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Racquel E. Kohler
- Department of Health Behavior, Society & Policy, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Elisa V. Bandera
- Cancer Epidemiology and Health Outcomes, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
| | - Anita Y. Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States of America
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Visaria A, Nagaraj B, Shah M, Kethidi N, Modak A, Shahani J, Chilakapati R, Raghuwanshi M. Low Amount and Intensity of Leisure-time Physical Activity in Asian Indian Adults. Am J Health Promot 2021; 36:440-449. [PMID: 34911346 DOI: 10.1177/08901171211059807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE We sought to describe leisure-time, aerobic, and muscle strengthening physical activity (PA) patterns in U.S. Asian Indians, in comparison to other races/ethnicities. DESIGN, SETTING, AND SAMPLE We utilized the 2011-2018 National Health Interview Surveys, a set of cross-sectional, nationally representative surveys of the U.S. noninstitutionalized population. Our study population included 257 652 adults who answered PA questions. MEASURES PA was classified per 2008 U.S. guidelines and continuously per estimated metabolic equivalents (METs). Race was classified into White, Black, Asian Indian, Other Asian, and American Indian/Alaskan Native/Multiracial. ANALYSIS We used survey design-adjusted, multivariable logistic regression to determine odds of sufficient and highly active physical activity levels, adjusting for predisposing, enabling, need, and health care service factors as guided by the Anderson Model. We also used linear regression to determine racial differences in average MET-minutes/week. Analysis was additionally stratified by comorbidity status. RESULTS While Asian Indians (N = 3049) demonstrated similar odds of sufficient aerobic PA as Whites (aOR [95% CI]: .97 [.88,1.07]), Asian Indians had 22% lower odds of meeting highly active aerobic PA levels (.78 [.71,0.87]) and 18% lower odds of meeting sufficient muscle strengthening PA levels (.82 [.73,0.91]). This translated to an average 172 (95% CI: 45 300) fewer MET-minutes. Furthermore, this decrease in MET-minutes/week was especially apparent in those without hypertension (β[95% CI]: -164 [-314,-15]) without diabetes (-185 [-319,-52]), and low/normal BMI (-422 [-623,-222]). CONCLUSION Asian Indians, especially those without comorbidities, are less likely to engage in high-intensity physical activity than Whites.
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Affiliation(s)
- Aayush Visaria
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Bharath Nagaraj
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Megh Shah
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Nikhit Kethidi
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Anurag Modak
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA.,Center for Advanced Biotechnology and Medicine, 33244Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Jai Shahani
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Rachana Chilakapati
- Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Maya Raghuwanshi
- Division of Endocrinology, Department of Medicine, 33244Rutgers New Jersey Medical School, Newark, NJ, USA
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Hypertension, diabetes, and corresponding annual clinical testing utilization: Comparison between Asian Indians and other races/ethnicities. Prev Med 2021; 153:106761. [PMID: 34348134 DOI: 10.1016/j.ypmed.2021.106761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/20/2021] [Accepted: 07/30/2021] [Indexed: 01/21/2023]
Abstract
Asian Indians are at increased risk of developing cardiometabolic diseases. We sought to determine differences between Asian Indians and other races/ethnicities in hypertension and diabetes prevalence and associated annual blood pressure (BP) and fasting blood glucose (FBG) testing. A total of 257,652 adults ≥18 years from the 2011-2018 U.S. National Health Interview Surveys (NHIS) were included. BP and FBG testing in the past 12 months was defined dichotomously (yes/not yes). Racial/ethnic groups included non-Hispanic White (NHW), non-Hispanic Black (NHB), Asian Indian, Other Asians, and Hispanic/Multiracial. We used logistic regression, adjusting for covariates and the survey design. Analyses were completed from 08/2020-06/2021. Asian Indians (N = 3049) had 21% and 99% higher odds of hypertension and diabetes, respectively, than NHWs (aOR [95% CI]; hypertension: 1.21[1.04,1.40], diabetes: 1.99[1.64,2.41]). Accordingly, Asian Indians without diabetes had significantly higher odds of FBG screening than NHWs (Asian Indian: 1.41[1.25,1.59], NHB: 0.99 [0.95,1.04], Other Asian: 1.07[0.98, 1.18], Hispanic: 1.13[1.07,1.20]). Asian Indians without hypertension had a 14% insignificant increase in BP testing compared to NHWs (1.14[0.97,1.33]). Predictors of testing in Asian Indians included older age, doctor's visit, graduate-level education, insurance coverage, and history of hypertension or diabetes. NHBs with diabetes and Hispanics with hypertension had lower odds of FBG testing (0.75[0.66,0.84]) and BP testing (0.85[0.79,0.92]), respectively, than NHWs. Asian Indians have higher odds of diabetes and hypertension than NHWs and higher, but relatively lower, odds of FBG and BP testing. Increasing routine BP and FBG testing in Asian Indians in younger adults may allow for earlier detection of high-risk individuals.
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Abdi HI, Hoover E, Fagan SE, Adsul P. Cervical Cancer Screening Among Immigrant and Refugee Women: Scoping-Review and Directions for Future Research. J Immigr Minor Health 2021; 22:1304-1319. [PMID: 32350683 DOI: 10.1007/s10903-020-01014-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study is to explore existing research on determinants of cervical cancer screening among immigrants and refugees in the U.S. A scoping review was conducted on 77 studies targeting immigrant and/or refugee women in the U.S., investigating factors related to cervical cancer screening. Sixty-three percent of studies were conducted in the past ten years, and included 122,345 women. Studies predominately explored knowledge, beliefs and barriers related to cervical cancer and screening. Common beliefs included fear of cancer, treatment and death. Participants perceived pap smears to be associated with embarrassment, pain and fear. Barriers to screening were reported in three categories: psychosocial (shame and embarrassment), communication (inability to speak in English), and barriers related to access (lack of insurance or primary care provider). Study findings indicate research focused at the individual-level and future research should focus on exploring multilevel influences on cancer screening uptake.
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Affiliation(s)
- Hamdi I Abdi
- Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware St. S.E., Minneapolis, MN, 55455, USA
| | | | | | - Prajakta Adsul
- Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Comprehensive Cancer Center, 1 University of New Mexico, 2325 Camino de Salud, Albuquerque, NM, 87131, USA.
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Vu M, Huynh VN, Berg CJ, Allen CG, Nguyen PLH, Tran NA, Srivanjarean Y, Escoffery C. Hepatitis B Testing Among Vietnamese in Metropolitan Atlanta: The Role of Healthcare-Related and Acculturation-Related Factors. J Community Health 2021; 46:767-776. [PMID: 33180219 PMCID: PMC8113341 DOI: 10.1007/s10900-020-00947-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Compared to other racial/ethnic groups, U.S. Vietnamese have higher Hepatitis B infection prevalence, which is a major liver cancer risk factor. Increased testing could reduce this disparity. It is critical to understand subgroups of U.S. Vietnamese least likely to have been tested for Hepatitis B and design appropriate interventions. We examined healthcare- and acculturation-related factors influencing Hepatitis B testing among U.S. Vietnamese. METHODS Survey data of 100 U.S. Vietnamese attending health fairs/programs hosted by community-based organizations (2017-2018) were analyzed. Healthcare-related predictors included insurance and past 2-year checkup. Acculturation-related predictors included Vancouver Acculturation Index, percentage of lifetime in the U.S., and Vietnamese and English fluency. We conducted a multiple logistic regression controlling for age, sex, education, and household income. RESULTS The sample was an average 37.5 years old and 61.6% female. Insurance coverage was reported by 83.0%. Average percentage of lifetime in the U.S. was 56.8%. Seventy percent reported having received Hepatitis B testing. Hepatitis B testing was associated with health insurance (aOR = 2.61, 95% CI = [1.05-6.47], p = .04) but not any acculturation-related predictors CONCLUSION: Improving insurance coverage and options can be a strategy to increase Hepatitis B testing among U.S. Vietnamese. More education regarding Hepatitis B (e.g., via community-based, culturally-appropriate, lay health worker-led programs) is needed to ensure that individuals are aware of their testing status and pursue appropriate healthcare decisions.
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Affiliation(s)
- Milkie Vu
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
| | - Victoria N Huynh
- Emory College of Arts & Sciences, Emory University, Atlanta, GA, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, D.C, USA
| | - Caitlin G Allen
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
| | | | - Ngoc-Anh Tran
- Nguyen Hue High School for the Gifted, Hanoi, Vietnam
| | | | - Cam Escoffery
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA
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Understanding the participation of breast screening among women born in predominantly Muslim countries living in Victoria, Australia from record-linkage data. PLoS One 2020; 15:e0237341. [PMID: 32764828 PMCID: PMC7413407 DOI: 10.1371/journal.pone.0237341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/23/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early detection of breast cancer can improve survival rates and decrease mortality rates. This study investigates whether there are significant differences in participation in breast screening among women born in Muslim countries compared to women born in Non-Muslim countries and Australia. METHODS Screening data from January 1st, 2000 to December 31st, 2013 from the Breast Screen Victoria Registry (BSV) was linked with hospital records from the Victorian Admitted Episodes Dataset (VAED). Countries having more than 50% of their population as Muslim were categorised as Muslim countries. Age adjusted rates were calculated for women born in Muslim and Non-Muslim countries and compared with the Australian age adjusted rates. Logistic regression assessed the association between screening status and other factors which include country of birth, marital status, age and socio-economic status. RESULTS Women born in Muslim countries (Odds Ratio (OR) = 0.70, 95%CI = 0.68-0.72) and in other Non-Muslim countries (OR = 0.87, 95%CI = 0.86-0.88) had lower odds of participation in breast screening than Australian born women. Women aged 60-64 years (OR = 1.42, 95%CI = 1.40-1.44) had higher odds of participation in the BreastScreen program than 50-54 age group. CONCLUSION This study provides valuable insights to understanding breast screening participation among women born in Muslim countries residing in Victoria. This population level study contributes to the broader knowledge of screening participation of women born in Muslim countries, an understudied population group in Australia and across the world. This study has implications for breast screening programs as it highlights the need for culturally sensitive approaches to support breast screening participation among women born in Muslim countries.
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Lee HY, Beltran R, Kim NK, Lee DK. Racial Disparities in Cervical Cancer Screening: Implications for Relieving Cervical Cancer Burden in Asian American Pacific Islander Women. Cancer Nurs 2020; 42:458-467. [PMID: 30624249 DOI: 10.1097/ncc.0000000000000642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND While cervical cancer is considered preventable and the overall Papanicolaou (Pap) test utilization rate has gradually increased in the United States, certain Asian American Pacific Islander (AAPI) women consistently rate lower in Pap test receipt compared with non-Latina whites (NLWs), leading to a higher cervical cancer mortality rate for various AAPI women. Few studies, however, have focused on female AAPI college students' cervical cancer screening behavior in comparison with NLW students. OBJECTIVE This study aimed to investigate cervical cancer screening behaviors among college-aged females by (1) determining AAPIs' and NLWs' screening rates, (2) assessing their knowledge about Pap tests, and (3) discovering factors associated with Pap test receipt. Andersen's Health Behavioral Model was used as a theoretical framework. METHODS Using a simple random sampling strategy, 2270 female students (15% AAPIs, 85% NLWs) completed an online health survey. RESULTS Results indicate AAPI students had significantly lower Pap test knowledge and Pap test receipt rate compared with NLW students. Age, nativity, human papillomavirus vaccination completion, frequency of obstetrician/gynecologist (OB/GYN) visits, and the number of sexual partners were associated with AAPI students' lower rate of Pap test receipt, whereas the Pap test receipt rate for NLW students was influenced by the same factors with the addition of having increased prior knowledge about Pap tests. CONCLUSION Results show the importance of OB/GYN visits in obtaining Pap tests for AAPI and NLW students. IMPLICATION FOR PRACTICE Health practitioners should pay attention to students' race/ethnicity in their practice and provide corresponding ethnic group-specific preventive care.
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Affiliation(s)
- Hee Yun Lee
- Author Affiliations: School of Social Work, University of Alabama, Tuscaloosa (Dr Lee); and School of Social Work (Ms Beltran), Department of Educational Psychology (Mr Kim), and School of Medicine (Mr Lee), University of Minnesota, Twin Cities
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Adunlin G, Cyrus JW, Asare M, Sabik LM. Barriers and Facilitators to Breast and Cervical Cancer Screening Among Immigrants in the United States. J Immigr Minor Health 2019; 21:606-658. [PMID: 30117005 DOI: 10.1007/s10903-018-0794-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
To summarize the literature on barriers and facilitators to breast and cervical cancer screening among immigrants to the US. A literature review was conducted for studies on breast and cervical cancer screening among immigrant populations. A thematic analysis of 180 studies identified a variety of barriers and facilitators to screening at the personal and system levels. Personal barriers included lack of knowledge and insurance coverage, high cost of care, and immigration status. System barriers included poor access to services, lack of interpreter services, and insensitivity to patient needs. Facilitators to screening included knowledge of disease, access to information sources, physician recommendation, and social networks. Cultural norms and resource availability at the individual and system levels influence screening among immigrants. Health insurance coverage was found to be an important predictor of preventative screening use. Future research should seek to identify the best way to address this and other barriers to cancer screening among immigrants groups.
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Affiliation(s)
- Georges Adunlin
- McWhorter School of Pharmacy, Samford University, 2100 Lakeshore Dr, Homewood, AL, 35229, USA.
| | - John W Cyrus
- Tompkins-McCaw Library, Virginia Commonwealth University, 509 N 12th St, Richmond, VA, 23298-0430, USA
| | - Matthew Asare
- Department of Public Health, Baylor University, One Bear Place #97313, Waco, TX, 76798-7313, USA
| | - Lindsay M Sabik
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, USA
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Yeasmeen T, Kelaher M, Brotherton JM, Malloy MJ. Understanding the participation in cervical screening of Muslim women in Victoria, Australia from record-linkage data. J Cancer Policy 2019. [DOI: 10.1016/j.jcpo.2019.100201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Gor B, Nepal VP, Dongardive R, Dorai VK, Pande M. Is Socioeconomic Advantage Associated With Positive Health Behaviors and Health Outcomes Among Asian Indians? Health Serv Res Manag Epidemiol 2019; 6:2333392819830371. [PMID: 30891469 PMCID: PMC6416674 DOI: 10.1177/2333392819830371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 01/21/2023] Open
Abstract
Objective The South Asian Health Needs Assessment was conducted to collect health status information on the rapidly growing Asian Indian (AI) community in the Houston area. Many were highly educated and reported high income levels, factors usually associated with better health outcomes. This study examined the relationship between socioeconomic advantage and the health behaviors and health outcomes of AIs. Methods We analyzed cross-sectional survey data from a convenience sample of 1416 AIs. Income was categorized as low, medium, and high. Descriptive statistics were generated by income categories and weighted multinomial regression analyses were conducted to examine the association of income with health behaviors and outcomes, adjusting for age, sex, health insurance, and years in the United States. Results Income was positively associated with better self-rated health, higher body mass index, moderate physical activity, having shingles vaccine, and cervical cancer screening. Income was inversely associated with perceived stress and heart disease. However, income was not significantly associated with alternative therapies, cigarette smoking, alcohol consumption, self-reported overweight/obesity, fruit and vegetable consumption, diabetes, high blood pressure, high cholesterol and screening for breast, prostate, and colon cancer. Conclusions Socioeconomic advantage was not consistently associated with positive health outcomes or desired health behaviors among AIs. We speculate that other factors, including cultural beliefs and acculturation may also impact health behaviors and health outcomes in this group. Further studies examining the influence of these variables on health behaviors and health outcomes are warranted.
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Affiliation(s)
| | | | | | - V K Dorai
- Indian American Cancer Network, Houston, TX, USA
| | - Mala Pande
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Park J, Kim H, Yang W, Lee H, Park SM. Cervical Cancer Screening and Its Associated Factors Among North Korean Defectors Living in South Korea. J Immigr Minor Health 2019; 20:66-72. [PMID: 27738961 DOI: 10.1007/s10903-016-0510-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
North Korean defectors (NKD) have many health problems related to insufficient nutrition, trauma from escaping, and being exposed to infectious diseases, but little research exists on their cancer screening. A total of 638 NKD participated in this cross-sectional survey. South Korean natives (SKN) who participated in the Korean National Health and Nutrition Examination Survey V were selected using age matching to each NKD. Fisher's exact tests and logistic regression were used for data analysis. The cervical cancer screening rate of NKD was significantly lower than for SKN (42 and 70 %, respectively; P < .001). The adjusted proportions of cervical cancer screening for NKD in all age groups under 60 years (P < .01) and having education beyond high school (P < .001) were significantly lower than that of SKN. NKD who had education under a high school level were more likely to have cervical cancer screening compared to NKD with education beyond a high school level (OR 1.81, 95 % CI 1.12-2.93). NKD were less likely to receive appropriate cervical cancer screening compared to SKN, especially those aged 30-39 years or married. Tailored interventions for NKD are needed to improve cervical cancer screening compliance.
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Affiliation(s)
- Jeongok Park
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - HeesSook Kim
- Department of Nursing, Dongnam Health University, Suwon-si, Gyeonggi-do, South Korea
| | - Wonhee Yang
- University of North Carolina at Chapel Hill, Doctoral Student, Biostatistics, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - HaeWon Lee
- Institute for Health and Unification Studies, School of Medicine, Seoul National University, Seoul, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences and Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
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Saleem A, Steadman KJ, Fejzic J. Utilisation of Healthcare Services and Medicines by Pakistani Migrants Residing in High Income Countries: A Systematic Review and Thematic Synthesis. J Immigr Minor Health 2018; 21:1157-1180. [PMID: 30499044 DOI: 10.1007/s10903-018-0840-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Migration, as a global phenomenon, gives rise to many challenges for healthcare professionals providing care to migrant populations. Migrants originating from diverse cultural backgrounds have unique beliefs and healthcare needs, and their utilisation of healthcare services and medicines is influenced by a number of factors. This review aims to assess the factors influencing the utilisation of healthcare services and medicines among Pakistani migrants residing in high income countries. The databases searched included PubMed/Medline, Scopus, EMBASE, Web of Science, CINAHL, and IPA. Of the 2566 publications initially obtained, 37 met the inclusion criteria. They included eight countries-the United Kingdom, United States of America, Canada, Denmark, Norway, Australia, United Arab Emirates and Cyprus. Eight descriptive themes emerged and two analytical constructs were established, as a result of thematic synthesis of included publications. The profile of utilisation of healthcare services and medicines among Pakistani migrants was multifaceted and influenced by their individual circumstances (socioeconomic characteristics; personal beliefs, preferences, and experiences; individual culture and religion; family and friends; and language and communication), and host country characteristics (work environment; healthcare organisation, access and affordability; and health professionals' education, practices, and preferences). Awareness of population-specific characteristics of migrant communities is important to promote and implement culturally appropriate healthcare practices and service provision.
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Affiliation(s)
- Ahsan Saleem
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Brisbane, QLD, 4102, Australia.
| | - Kathryn J Steadman
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Brisbane, QLD, 4102, Australia
| | - Jasmina Fejzic
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Brisbane, QLD, 4102, Australia
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Anderson de Cuevas RM, Saini P, Roberts D, Beaver K, Chandrashekar M, Jain A, Kotas E, Tahir N, Ahmed S, Brown SL. A systematic review of barriers and enablers to South Asian women's attendance for asymptomatic screening of breast and cervical cancers in emigrant countries. BMJ Open 2018; 8:e020892. [PMID: 29982210 PMCID: PMC6042536 DOI: 10.1136/bmjopen-2017-020892] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The aim of this review was to identify the cultural, social, structural and behavioural factors that influence asymptomatic breast and cervical cancer screening attendance in South Asian populations, in order to improve uptake and propose priorities for further research. DESIGN A systematic review of the literature for inductive, comparative, prospective and intervention studies. We searched the following databases: MEDLINE/In-Process, Web of Science, EMBASE, SCOPUS, CENTRAL, CDSR, CINAHL, PsycINFO and PsycARTICLES from database inception to 23 January 2018. The review included studies on the cultural, social, structural and behavioural factors that influence asymptomatic breast and cervical cancer screening attendance and cervical smear testing (Papanicolaou test) in South Asian populations and those published in the English language. The framework analysis method was used and themes were drawn out following the thematic analysis method. SETTINGS Asymptomatic breast or cervical screening. PARTICIPANTS South Asian women, including Bangladeshi, Indian, Pakistani, Sri Lankan, Bhutanese, Maldivian and Nepali populations. RESULTS 51 included studies were published between 1991 and 2018. Sample sizes ranged from 25 to 38 733 and participants had a mean age of 18 to 83 years. Our review showed that South Asian women generally had lower screening rates than host country women. South Asian women had poorer knowledge of cancer and cancer prevention and experienced more barriers to screening. Cultural practices and assumptions influenced understandings of cancer and prevention, emphasising the importance of host country cultures and healthcare systems. CONCLUSIONS High-quality research on screening attendance is required using prospective designs, where objectively validated attendance is predicted from cultural understandings, beliefs, norms and practices, thus informing policy on targeting relevant public health messages to the South Asian communities about screening for cancer. PROSPERO REGISTRATION NUMBER CSD 42015025284.
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Affiliation(s)
| | - Pooja Saini
- NIHR Collaboration for Leadership in Applied Health Research and Care, University of Liverpool, Liverpool, UK
- School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, UK
| | - Deborah Roberts
- Royal Liverpool and Broadgreen Hospital NHS Trust, Liverpool, UK
| | - Kinta Beaver
- School of Health Sciences, University of Central Lancashire, Preston, UK
| | | | - Anil Jain
- The Nightingale Centre and Genesis Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
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Hagopian GS, Lieber M, Dottino PR, Margaret Kemeny M, Li X, Overbey J, Clark LD, Beddoe AM. The impact of nativity on cervical cancer survival in the public hospital system of Queens, New York. Gynecol Oncol 2018; 149:63-69. [PMID: 29605052 DOI: 10.1016/j.ygyno.2017.11.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 11/20/2017] [Accepted: 11/27/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We studied cervical cancer patients who presented to the Public Hospital System in ethnically-diverse Queens, New York from 2000 to 2010 with the purpose of examining the relationship between nativity (birthplace) and survival. METHODS A retrospective review of tumor registries was used to identify patients diagnosed with cervical cancer between January 1, 2000 and December 31, 2010. Using electronic medical records, data from 317 patients were available for this analysis. RESULTS The majority of patients were born outside the United States (US) (85.5% versus 14.5%). One hundred patients (31.5%) were born in Latin America, 105 in the Caribbean Islands (33.1%), 48 in Asia (15.1%), 8 in the South Asia (2.5%), 10 in Russia/Eastern Europe (3.2%) and 46 (14.5%) in the United States. Patients presented at varying stages of disease: 51.4% at stage I, 19.6% at stage II, 19.6% at stage III, and 8.5% at stage IV. Kaplan-Meier estimated survival curves stratified by birthplace demonstrated significant differences in survival distributions among the groups using the log-rank test (P<0.0001). The most favorable survival curves were observed among patients born in Latin America and Asia whereas the least favorable was demonstrated in US-born patients. Time to death was analyzed using the Cox proportional hazards model. Adjusting for age at diagnosis, insurance status, stage and treatment modality, nodal metastases and hydronephrosis, birthplace was significantly associated with survival time (P<0.0001). CONCLUSION An immigrant health paradox was defined for foreign-born Latino and Asian patients presenting with cervical cancer to the Public Hospital System of Queens, New York as patients born in Latin America and Asia were less likely to die at any given time compared to those born in the United States.
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Affiliation(s)
- George S Hagopian
- Department of Obstetrics and Gynecology, Elmhurst Hospital Center, Elmhurst, Queens, NY, United States; Department of Obstetrics and Gynecology, Queens Hospital Center, Jamaica, Queens, NY, United States; Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Queens Cancer Center, Queens Hospital Center, Jamaica, Queens, NY, United States.
| | - Molly Lieber
- Division of Global Health, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, NY, New York, United States
| | - Peter R Dottino
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - M Margaret Kemeny
- Queens Cancer Center, Queens Hospital Center, Jamaica, Queens, NY, United States; Department of Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, United States
| | - Xilian Li
- Department of Radiation Oncology, Queens Hospital Center, United States; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, NY, New York, United States
| | - Jessica Overbey
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, New York, United States
| | - Li-Duen Clark
- Department of Obstetrics and Gynecology, Queens Hospital Center, Jamaica, Queens, NY, United States
| | - Ann Marie Beddoe
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Division of Global Health, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, NY, New York, United States
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Jing H, Song J, Zheng J. Discoidin domain receptor 1: New star in cancer-targeted therapy and its complex role in breast carcinoma. Oncol Lett 2018; 15:3403-3408. [PMID: 29467865 DOI: 10.3892/ol.2018.7795] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 09/07/2017] [Indexed: 12/13/2022] Open
Abstract
Discoidin domain receptor 1 (DDR1) is a receptor tyrosine kinase activated by various types of collagens that performs a critical role in cell attachment, migration, survival and proliferation. The functions of DDR1 in various types of tumor have been studied extensively. However, in breast carcinoma, the roles of collagen-evoked DDR1 remain ill defined. Although a number of studies have reported that DDR1 promotes apoptosis and inhibits migration in breast carcinoma, it has also been reported to be associated with tumor cell survival, chemoresistance to genotoxic drugs and the facilitation of invasion. The present review summarizes current progress and the complex effects of DDR1 in the field of breast carcinoma, and presents DDR1 as a promising therapeutic target.
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Affiliation(s)
- Hui Jing
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China
| | - Jingyuan Song
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China.,Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Xuzhou, Jiangsu 221002, P.R. China
| | - Junnian Zheng
- Cancer Institute, Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China.,Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Xuzhou, Jiangsu 221002, P.R. China.,Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P.R. China
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16
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Hulme J, Moravac C, Ahmad F, Cleverly S, Lofters A, Ginsburg O, Dunn S. "I want to save my life": Conceptions of cervical and breast cancer screening among urban immigrant women of South Asian and Chinese origin. BMC Public Health 2016; 16:1077. [PMID: 27733161 PMCID: PMC5062908 DOI: 10.1186/s12889-016-3709-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 09/23/2016] [Indexed: 11/13/2022] Open
Abstract
Background Breast and cervical cancer screening rates remain low among immigrant women and those of low socioeconomic status. The Cancer Awareness: Ready for Education and Screening (CARES) project ran a peer-led multi-lingual educational program between 2012 and 2014 to reach under and never-screened women in Central Toronto, where breast and cervical cancer screening rates remain low. The objective of this qualitative study was to better understand how Chinese and South Asian immigrants – the largest and most under-screened immigrant groups according to national and provincial statistics - conceive of breast and cervical cancer screening. We explored their experiences with screening to date. We explicitly inquired about their perceptions of the health care system, their screening experiences with family physicians and strategies that would support screening in their communities. Methods We conducted 22 individual interviews and two focus groups in Bengali and Mandarin with participants who had attended CARES educational sessions. Transcripts were coded through an iterative constant comparative and interpretative approach. Results Themes fell into five major, overlapping domains: risk perception and concepts of preventative health and screening; health system engagement and the embedded experience with screening; fear of cancer and procedural pain; self-efficacy, obligation, and willingness to be screened; newcomer barriers and competing priorities. These domains all overlap, and contribute to screening behaviours. Immigrant women experienced a number of barriers to screening related to ‘navigating newness’, including transportation, language barriers, arrangements for time off work and childcare. Fear of screening and fear of cancer took many forms; painful or traumatic encounters with screening were described. Female gender of the provider was paramount for both groups. Newly screened South Asian women were reassured by their first encounter with screening. Some Chinese women preferred the anonymous screening options available in China. Women generally endorsed a willingness to be screened, and even offered to organize women in their community hubs to access screening. Conclusions The experience of South Asian and Chinese immigrant women suggests that under and never-screened newcomers may be effectively integrated into screening programs through existing primary care networks, cultural-group specific outreach, and expanding access to convenient community -based screening.
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Affiliation(s)
- Jennifer Hulme
- Emergency Department, University Health Network, University of Toronto, Toronto, Canada. .,Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
| | - Catherine Moravac
- Postgraduate Medical Education, University of Toronto, Toronto, Canada
| | - Farah Ahmad
- Faculty of Health, School of Health Policy and Management, York University, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shelley Cleverly
- Postgraduate Medical Education, University of Toronto, Toronto, Canada.,Centre for Health Promotion, Department of Public Health Sciences, University of Toronto, Toronto, Canada
| | - Aisha Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada.,Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Department of Family and Community Medicine, St. Michael Hospital, Toronto, Canada
| | - Ophira Ginsburg
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Women's College Research Institute, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Sheila Dunn
- Women's College Research Institute, Toronto, Canada.,Women's College Hospital, Toronto, Canada
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17
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Crawford J, Ahmad F, Beaton D, Bierman AS. Cancer screening behaviours among South Asian immigrants in the UK, US and Canada: a scoping study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:123-153. [PMID: 25721339 DOI: 10.1111/hsc.12208] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/12/2014] [Indexed: 06/04/2023]
Abstract
South Asian (SA) immigrants settled in the United Kingdom (UK) and North America [United States (US) and Canada] have low screening rates for breast, cervical and colorectal cancers. Incidence rates of these cancers increase among SA immigrants after migration, becoming similar to rates in non-Asian native populations. However, there are disparities in cancer screening, with low cancer screening uptake in this population. We conducted a scoping study using Arksey & O'Malley's framework to examine cancer screening literature on SA immigrants residing in the UK, US and Canada. Eight electronic databases, key journals and reference lists were searched for English language studies and reports. Of 1465 identified references, 70 studies from 1994 to November 2014 were included: 63% on breast or cervical cancer screening or both; 10% examined colorectal cancer screening only; 16% explored health promotion/service provision; 8% studied breast, cervical and colorectal cancer screening; and 3% examined breast and colorectal cancer screening. A thematic analysis uncovered four dominant themes: (i) beliefs and attitudes towards cancer and screening included centrality of family, holistic healthcare, fatalism, screening as unnecessary and emotion-laden perceptions; (ii) lack of knowledge of cancer and screening related to not having heard about cancer and its causes, or lack of awareness of screening, its rationale and/or how to access services; (iii) barriers to access including individual and structural barriers; and (iv) gender differences in screening uptake and their associated factors. Findings offer insights that can be used to develop culturally sensitive interventions to minimise barriers and increase cancer screening uptake in these communities, while recognising the diversity within the SA culture. Further research is required to address the gap in colorectal cancer screening literature to more fully understand SA immigrants' perspectives, as well as research to better understand gender-specific factors that influence screening uptake.
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Affiliation(s)
- Joanne Crawford
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Department of Nursing, Brock University, St. Catharines, Ontario, Canada
| | - Farah Ahmad
- School of Health Policy and Management, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Dorcas Beaton
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Measurement Stream, Institute for Work & Health, Toronto, Ontario, Canada
| | - Arlene S Bierman
- Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, Institute of Health Policy, Management and Evaluation, Department of Medicine and Public Health, University of Toronto, Toronto, Ontario, Canada
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18
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Gandhi PK, Gentry WM, Kibert JL, Lee EY, Jordan W, Bottorff MB, Huang IC. The relationship between four health-related quality-of-life indicators and use of mammography and Pap test screening in US women. Qual Life Res 2015; 24:2113-28. [PMID: 25804316 PMCID: PMC4531104 DOI: 10.1007/s11136-015-0968-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2015] [Indexed: 01/13/2023]
Abstract
PURPOSE Limited evidence is available to explain the role of four components of health-related quality of life (HRQoL) on breast and cervical cancer screening. The objective of this study was to determine the relationship between four HRQoL aspects and use of mammography and Pap test screening in US women. METHODS Data were obtained from the 2012 Behavioral Risk Factor Surveillance System (BRFSS). The outcome variables were receiving mammogram <2 versus ≥2 years in women aged 50-74 years, and receiving Pap test <3 versus ≥3 years in women aged 18-64 years. Eight logistic regression models were conducted to test the role of four HRQoL aspects (general health status, physical HRQoL, mental HRQoL, and activity limitation) on the two screening variables, after adjusting for covariates. Statistical analysis accounted for the complex sampling design of the BRFSS, and the a priori alpha error was set at p ≤ 0.05. RESULTS Among respondents, approximately 74 and 78 % of the women received mammography and Pap test, respectively. Three HRQoL aspects (general health status, physical HRQoL, and activity limitation) were significantly associated with mammography use (all p values < 0.05), whereas two HRQoL aspects (general health status and physical HRQoL) were significantly associated with Pap test (p values ≤ 0.05). All significant relationships demonstrated higher cancer screening rates among individuals with better HRQoL. CONCLUSIONS HRQoL is an important factor associated with use of mammography and Pap test. Future studies should explore the mechanisms associated with an individual's HRQoL and use HRQoL assessment as an avenue to influence adherence to use of mammography and Pap tests.
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Affiliation(s)
- Pranav K Gandhi
- Department of Pharmacy Practice, South College School of Pharmacy, 400 Goodys Lane, Knoxville, TN, 37922, USA,
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19
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Jafari M, Nakhaee N, Goudarzi R, Zehtab N, Barouni M. Participation of the Women Covered by Family Physicians in Breast Cancer Screening Program in Kerman, Iran. Asian Pac J Cancer Prev 2015; 16:4555-61. [PMID: 26107203 DOI: 10.7314/apjcp.2015.16.11.4555] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mammography screening is a method for reducing breast cancer mortality in women over 40 years old . A participation rate of at least 70% is a prerequisite for screening programs. This study aimed at determining the participation rate of women in breast cancer screening in Iran. MATERIALS AND METHODS The study population in this prospective research consisted of 35 to 69 years old women in the villages and towns Kerman District, in 2013. The data were collected by a well-validated risk assessment questionnaire. The questionnaires were completed with the help of health workers and technicians in the health centers, who were trained on breast cancer screening program. RESULTS As a whole, 19,651 women were invited to complete the questionnaire, of whom 15,794 women (80.37%) completed it. In the urban region, of 3150 eligible women 2728 women (86.60%) participated in the study. The acceptance rates for mammography in rural and urban regions were 34.95% and 8.75%, respectively. CONCLUSIONS Finally, 3.8% and 16.34% of 35 to 69 years old women in the urban regions were mammographed, respectively. CONCLUSION The low participation of eligible women in breast cancer screening program alerts us against including the program in the health insurance package.
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20
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Bedi M, Devins GM. Cultural considerations for South Asian women with breast cancer. J Cancer Surviv 2015; 10:31-50. [DOI: 10.1007/s11764-015-0449-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 03/19/2015] [Indexed: 12/21/2022]
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21
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Marván ML, Ehrenzweig Y, Catillo-López RL. Fatalistic Beliefs and Cervical Cancer Screening Among Mexican Women. Health Care Women Int 2014; 37:140-54. [PMID: 25256106 DOI: 10.1080/07399332.2014.959169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Fatalistic beliefs about cervical cancer were studied in 464 Mexican women, and how such beliefs relate to participation in cervical cancer screening was evaluated. Rural women were less likely than urban women to have had a Pap test and more likely to believe that the illness is due to bad luck or fate. These were also the beliefs most associated with nonscreening among rural women, whereas for urban women the belief most associated with nonscreening was "there is not much I can do to prevent cervical cancer."
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Affiliation(s)
- Ma Luisa Marván
- a Institute of Psychological Research, Universidad Veracruzana , Xalapa , Veracruzana , Mexico
| | - Yamilet Ehrenzweig
- a Institute of Psychological Research, Universidad Veracruzana , Xalapa , Veracruzana , Mexico
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22
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Poonawalla IB, Goyal S, Mehrotra N, Allicock M, Balasubramanian BA. Attitudes of South Asian Women to Breast Health and Breast Cancer Screening: Findings from a Community Based Sample in the United States. Asian Pac J Cancer Prev 2014; 15:8719-24. [DOI: 10.7314/apjcp.2014.15.20.8719] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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23
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Moudatsou MM, Kritsotakis G, Alegakis AK, Koutis A, Philalithis AE. Social capital and adherence to cervical and breast cancer screening guidelines: a cross-sectional study in rural Crete. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:395-404. [PMID: 24450830 DOI: 10.1111/hsc.12096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2013] [Indexed: 06/03/2023]
Abstract
Breast and cervical cancers are among the leading causes of female mortality. The reasons that make women adhere, or not, to screening guidelines are not only related to individual and health characteristics but are also placed in a wider social and cultural context. Social capital might facilitate the dissemination of relevant knowledge of and the adherence to cancer screening guidelines. This cross-sectional study explored the associations of individual-level social capital with breast and cervical cancer screening and the knowledge for the existence of relevant screening tests (Pap test and mammography) in the municipality of Gorgolaini, a rural area in Crete, Greece. A random sample of 131 of the 592 women of the 2001 electoral register were invited to participate in the study and 125 completed the Social Capital Questionnaire and two questions on self-reported health knowledge and behaviour (participation rate 95.4%). Women were eligible to participate if they were aged 35-75, had lived in the area for the last 10 years and were of Greek origin. Multiple logistic regressions were performed to establish associations among each social capital factor (total, participation in the community, value of life, tolerance for diversity, feelings of safety, family/friends connections) and knowledge of and adherence to breast and cervical cancer screening guidelines after adjustment for confounders. Our results suggest that early detection of breast and cervical cancers may be facilitated when taking into account the social context of the population.
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Affiliation(s)
- Maria M Moudatsou
- Department of Medicine, Faculty of Social Medicine, University of Crete, Heraklion, Greece
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24
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Gür K, Kadıoğlu H, Sezer A. Breast Cancer Risks and Effectiveness of BSE Training among Women Living in a District of İstanbul. THE JOURNAL OF BREAST HEALTH 2014; 10:154-160. [PMID: 28331662 DOI: 10.5152/tjbh.2014.2046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 03/22/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study to determine the risks associated with breast cancer in women who live in a neighborhood in Istanbul, and to evaluate the effectiveness of breast self-examination (BSE) training. MATERIALS AND METHODS This study was designed by using a half-experimental model, with women over the age of 18 who visited the community health center in a district of Istanbul, during March/April 2012. Sample selection was not implemented, and 169 women who voluntarily participated in the study were included. Data was collected by face-to-face interview technique with "Demographic Survey Form", "Breast Cancer Risk Assessment Form" and "BSE Training Assessment Scale". After risk assessment, women who wanted to learn BSE (n=109) were given a practical training program lasting approximately 20 minutes that was prepared together with expert consults. RESULTS 32.1% of the participants regularly performed BSE. Out of those who do not use regular self-examination, 15.4% thought BSE was unnecessary, 44% was afraid to examine herself, and 40.7% did not know how to apply BSE. The mean breast cancer risk score was 135.64±61.33. There were statistically significant differences between breast cancer risk score and the educational status, marital status, and menstrual status. A statistically significant difference was found in pre- and post-training BSE Training Assessment Scale scores. CONCLUSION The breast cancer risk score was low among women included in this study. However, the vast majority of women did not perform BSE, and those who did were using either irregular or improper practice. It was detected that implementation of planned and in-person training programs were quite effective.
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Affiliation(s)
- Kamer Gür
- Department of Public Health Nurse, Marmara University Faculty of Health Scienses, İstanbul, Turkey
| | - Hasibe Kadıoğlu
- Department of Public Health Nurse, Marmara University Faculty of Health Scienses, İstanbul, Turkey
| | - Ayşe Sezer
- Department of Public Health Nurse, Marmara University Faculty of Health Scienses, İstanbul, Turkey
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25
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Froment MA, Gomez SL, Roux A, DeRouen MC, Kidd EA. Impact of socioeconomic status and ethnic enclave on cervical cancer incidence among Hispanics and Asians in California. Gynecol Oncol 2014; 133:409-15. [PMID: 24674831 PMCID: PMC5746172 DOI: 10.1016/j.ygyno.2014.03.559] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 03/13/2014] [Accepted: 03/18/2014] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study aimed to evaluate the incidence of cervical cancer by nativity [United States (US) versus non-US], neighborhood socioeconomic status and ethnic enclave among Hispanics and Asians in California. METHODS Using data from the California Cancer Registry, information on all primary invasive cervical cancer (Cca) patients diagnosed in California from January 1, 1990 through December 31, 2004 was obtained. We analyzed the influence of enclave, socioeconomic status and nativity on Cca incidence. RESULTS Among the 22,189 Cca cases diagnosed between 1990 and 2004, 50% were non-Hispanic white, 39% Hispanic and 11% Asian women, and 63% US-born. Seventy percent of the Cca cases were squamous cell carcinoma, 19% adenocarcinoma and 11% other histologies. Higher incidence of Cca was observed in high enclave (76%) and low socioeconomic status (70%) neighborhoods. By ethnic group, US-born women showed lower rates of squamous cell carcinoma compared to foreign-born women. Hispanics living in low socioeconomic and high enclave had 12.7 times higher rate of Cca than those living in high socioeconomic, low enclave neighborhoods. For Asian women incidence rates were 6 times higher in the low socioeconomic, high enclave neighborhoods compared to those living in high socioeconomic, low enclave neighborhoods. CONCLUSION More targeted outreach to increase Pap smear screening and human papilloma virus vaccination for women living in high enclave neighborhoods can help decrease the incidence of Cca in these groups of women.
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Affiliation(s)
- Marie-Anne Froment
- Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA, USA.
| | - Scarlett L Gomez
- Cancer Prevention Institute of California, Fremont, CA, USA; Department of Health Research and Policy, School of Medicine, Stanford, CA, USA
| | - Audrey Roux
- Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada
| | | | - Elizabeth A Kidd
- Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA, USA
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26
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Guimond ME, Salman K. Modesty matters: cultural sensitivity and cervical cancer prevention in muslim women in the United States. Nurs Womens Health 2013; 17:210-6; quiz 217. [PMID: 23773193 DOI: 10.1111/1751-486x.12034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Muslim women represent a growing minority in the United States, and sensitivity to their cultural and religious values (modesty, in particular) is important, because lack of sensitivity to modesty is a barrier for Muslim women to obtain cervical cancer screening and prevention. This article presents current recommendations for screening, highlights the need for prevention strategies for children (e.g., HPV vaccination), addresses the limited amount of research on this population and suggests strategies to discuss and encourage cervical cancer screening and prevention among Muslim women.
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27
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Lofters AK, Gozdyra P, Lobb R. Using geographic methods to inform cancer screening interventions for South Asians in Ontario, Canada. BMC Public Health 2013; 13:395. [PMID: 23622426 PMCID: PMC3640962 DOI: 10.1186/1471-2458-13-395] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 04/11/2013] [Indexed: 11/30/2022] Open
Abstract
Background Literature suggests that South Asians in Ontario, Canada are under-screened for breast, cervical and colorectal cancer. Accordingly, we are involved in a community-engaged multi-phase study aimed at increasing cancer screening for this vulnerable group. In the work described in this manuscript, we aimed to use visual displays of spatial analyses to identify the most appropriate small geographic areas in which to pilot targeted cancer screening interventions for Ontario’s South Asian community. Methods We used Geographic Information Systems (GIS), including Local Indicators of Spatial Association (LISA) using GeoDa software, and population-level administrative data to create multi-layered maps of: i) rates of appropriate cancer screening, ii) the percentage of residents of South Asian ethnicity, and iii) the locations of primary care practices and community health centres by census tract in the Peel Region of Ontario (population: 1.2 million). The maps were shared with partner health service and community service organizations at an intervention development workgroup meeting to examine face validity. Results The lowest rates of appropriate cancer screening for census tracts across the region were 51.1% for cervical cancer, 48.5% for breast cancer, and 42.5% for colorectal cancer. We found marked variation both in screening rates and in the proportion of South Asians residents by census tract but lower screening rates in the region were consistently associated with larger South Asian populations. The LISA analysis identified a high-risk area consisting of multiple neighbouring census tracts with relatively low screening rates for all three cancer types and with a relatively large South Asian population. Partner organizations recognized and validated the geographic location highlighted by the LISA analysis. Many primary care practices are located in this high-risk area, with one community health centre located very nearby. Conclusions In this populous region of Ontario, South Asians are more likely to reside in areas with lower rates of appropriate breast, cervical and colorectal cancer screening. We have identified a high-risk area appropriate for both patient- and provider-focused interventions. Geographic Information Systems, in particular LISA analyses, can be invaluable when working with health service and community organizations to define areas with the greatest need for interventions to reduce health inequities.
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Affiliation(s)
- Aisha K Lofters
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada.
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28
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Somanchi M, Juon HS, Rimal R. Predictors of screening mammography among Asian Indian American women: a cross-sectional study in the Baltimore-Washington metropolitan area. J Womens Health (Larchmt) 2013; 19:433-41. [PMID: 20141384 DOI: 10.1089/jwh.2008.0873] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess adherence to screening mammography guidelines and examine predictors of having a mammogram in the past 2 years among immigrant Asian Indian women (AIW) aged > or = 40 years. METHODS Face-to-face surveys of 418 AIW in the Baltimore-Washington metropolitan area were conducted. Subjects were recruited through Asian Indian (AI) religious and other community-based organizations. RESULTS Of the 418 AIW surveyed, 83% had ever had a mammogram, and 70% had obtained a mammogram within the past 2 years. AIW who had lived in the United States for > 10 years had a higher rate of obtaining a mammogram (75.4%) within the past 2 years than did those who had lived in the United States for < or = 10 years (24.6%). In multiple logistic regression analysis, length of stay in the United States, marital status, knowledge of mammogram guidelines, age, having health insurance, physician recommendations, and number of relatives who had a mammogram were positively associated with having a mammogram within the past 2 years. Physician ethnicity and not having a healthcare provider were negatively associated with having a mammogram within the past 2 years. CONCLUSIONS This study lays a foundation for designing guidelines for interventions to improve mammography screening behaviors among AIW women. Increasing the use of mammogram to the levels recommended by guidelines will require a two-pronged approach directed at both AIW and AI physicians.
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Affiliation(s)
- Meena Somanchi
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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Lee HY, Ju E, Vang PD, Lundquist M. Breast and cervical cancer screening disparity among Asian American women: does race/ethnicity matter [corrected]? J Womens Health (Larchmt) 2013; 19:1877-84. [PMID: 20831437 DOI: 10.1089/jwh.2009.1783] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Ethnic minorities are frequently considered as one homogeneous group in research, and this trend is particularly true for Asian Americans. This article seeks to uncover the intragroup differences in cancer screening behavior among subgroups of Asian American women by disaggregating them into six subgroups. The subgroups were compared with non-Latina white women to examine differences in breast and cancer screening rates and relevant factors associated with receiving these screenings. METHODS Three-year merged data from the 2001, 2003, and 2005 California Health Interview Survey (CHIS) were used to investigate the subgroup differences. Samples for the current study were restricted to non-Latina white and Asian American women whose age was ≥ 18 years (n = 58,000) for cervical cancer screening and ≥ 40 years (n = 43,518) for breast cancer screening at the time of the interview. RESULTS Results showed marked differences in cancer screening rates among Asian American subgroups and between cancer types. Cervical cancer screening rates were noticeably higher than breast cancer screening rates in all groups. The Korean group consistently showed the lowest rates of both cancer screenings. Japanese ranked the highest (79.5%) in breast cancer screening but the second lowest (79.7%) in cervical cancer screening. Enabling factors, such as having private health insurance and a usual source of care, were found to be the strongest predictors of receiving both breast and cervical cancer screening. Screenings for both types of cancer increased if a woman was married or was born in the United States. CONCLUSIONS The findings of this study illustrate the heterogeneity that exists among Asian American subgroups in their cancer screening behaviors. Further development of culturally relevant and ethnic-specific cancer prevention strategies and policies that address the subgroup differences within the larger racial/ethnic population are needed. Public health outreach and cancer education should be prioritized to the Asian American women who are more recent arrivals in the United States and have minimal access to healthcare.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, University of Minnesota, Twin Cities, Saint Paul, Minnesota 55108, USA.
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Simou E, Maniadakis N, Pallis A, Foundoulakis E, Kourlaba G. Factors associated with the use of pap smear testing in Greece. J Womens Health (Larchmt) 2012; 19:1577-85. [PMID: 20626266 DOI: 10.1089/jwh.2009.1907] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to describe the rate of Papanicolaou (Pap) smear test use among women participating in a breast cancer screening program in Greece and to determine related factors. METHODS Between March 2004 and July 2009, 9682 women aged between 40 and 69 years were recruited into the program. Baseline sociodemographic and lifestyle characteristics were recorded, together with familial medical history and the last time they had undergone a Pap test. RESULTS Almost 7% of the participants had never had a Pap test, and 28.8% had not had one within the last 3 years. Factors that were found to be independently associated with never receiving a Pap test or with not having one within the last 3 years included age, educational status, marital status, area of residence, health insurance, nationality, oral contraceptive use, cancer family history, body mass index (BMI), and stability of menstrual cycle. CONCLUSIONS The rate of Pap test use is high among women who reside in Greece, although it is possible that this rate is a little overestimated. Specific programs should be developed and implemented that aim to increase awareness of the benefits of regular cervical cancer screening among specific subgroups of women.
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Affiliation(s)
- Effie Simou
- Centre for the Prevention of Breast Cancer, General Oncology Hospital Agioi Anargyroi, Athens, Greece
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Tanjasiri SP, Mouttapa M, Sablan-Santos L, Quitugua LF. What promotes cervical cancer screening among Chamorro women in California? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:725-730. [PMID: 22806217 PMCID: PMC3500582 DOI: 10.1007/s13187-012-0394-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Pacific Islander women represent a significant at-risk population for cervical cancer, yet little is known about the modifiable factors associated with routine Pap testing. Therefore, the aims of this paper are to report and discuss the known and unknown factors associated with cervical cancer screening among Chamorro women in California. This cross-sectional study explored the factors associated with receipt of regular Pap testing among Chamorro women age 18 years and older in California. A self-administered survey was designed and distributed to women in order to understand their knowledge, beliefs and behaviors regarding routine receipt of Pap tests. Only about two-thirds of women had received a Pap test within the past 2 years, which is below the U.S. average of 72 %. Significant predictors included younger age, health insurance coverage, knowledge of screening frequency, and medically correct beliefs regarding risk groups. These factors, however, accounted for less than 16 % of the variance in Pap testing behavior. We discuss the poor predictive value of existing demographic and theoretical variables, and discuss potentially new areas of research that can aid in the development of future intervention studies. Study limitations and implications are also discussed.
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Perspectives on preventive health care and barriers to breast cancer screening among Iraqi women refugees. J Immigr Minor Health 2012; 14:633-9. [PMID: 21901446 DOI: 10.1007/s10903-011-9520-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Since the Iraq war began in 2003, over 4 million Iraqis have been displaced. Little is known about preventive cancer care in this population, but stark disparities have been documented. The purpose of this study was to assess the perspectives of Iraqi women refugees on preventive care and perceived barriers to breast cancer screening. Interviews were conducted in Arabic with twenty Iraqi refugee women by a bilingual (English/Arabic) medical student, transcribed, translated and coded according to established qualitative content and thematic analysis procedures. Psychosocial barriers, culturally mediated beliefs, and health consequences of war were identified as major themes, ultimately showing what factors, alone and collectively, have impeded Iraqi refugee women's ability and motivation to obtain breast cancer screening. To improve cancer prevention and decrease disparities in care in this most vulnerable population, culturally appropriate health education and outreach programs, as well as further community-level targeted studies, are needed.
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Ma GX, Gao W, Lee S, Wang M, Tan Y, Shive SE. Health seeking behavioral analysis associated with breast cancer screening among Asian American women. Int J Womens Health 2012; 4:235-43. [PMID: 22723730 PMCID: PMC3379860 DOI: 10.2147/ijwh.s30738] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The purpose of this community-based study was to apply a Sociocultural Health Behavior Model to determine the association of factors proposed in the model with breast cancer screening behaviors among Asian American women. Methods A cross-sectional design included a sample of 682 Chinese, Korean, and Vietnamese women aged 40 years and older. The frequency distribution analysis and Chi-square analysis were used for the initial screening of the following variables: sociodemographic, cultural, enabling, environmental, and social support. Univariate and multivariate analyses were conducted on factors for breast cancer screening using multinomial logistic regression analysis. Results Correlates to positive breast cancer screening included demographics (ethnicity), cultural factors (living in the United States for 15 years or more, speaking English well), enabling factors (having a regular physician to visit, health insurance covering the screening), and family/social support factors (those who had a family/friend receiving a mammogram). Conclusions The results of this study suggest that breast cancer screening programs will be more effective if they include the cultural and health beliefs, enabling, and social support factors associated with breast cancer screening. The use of community organizations may play a role in helping to increase breast cancer screening rates among Asian American women.
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Affiliation(s)
- Grace X Ma
- Department of Public Health, Center for Asian Health, College of Health Professions, Temple University, Philadelphia, PA, USA
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Preventive Health Services Delivery to South Asians in the United States. J Immigr Minor Health 2012; 14:797-802. [DOI: 10.1007/s10903-012-9610-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Beiki O, Hall P, Ekbom A, Moradi T. Breast cancer incidence and case fatality among 4.7 million women in relation to social and ethnic background: a population-based cohort study. Breast Cancer Res 2012; 14:R5. [PMID: 22225950 PMCID: PMC3496120 DOI: 10.1186/bcr3086] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 12/23/2011] [Accepted: 01/06/2012] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Incidence of breast cancer is increasing around the world and it is still the leading cause of cancer mortality in low- and middle-income countries. We utilized Swedish nationwide registers to study breast cancer incidence and case fatality to disentangle the effect of socioeconomic position (SEP) and immigration from the trends in native Swedes. METHODS A nation-wide cohort of women in Sweden was followed between 1961 and 2007 and incidence rate ratio (IRR) and hazard ratio (HR) with 95% confidence intervals (CIs) were estimated using Poisson and Cox proportional regression models, respectively. RESULTS Incidence continued to increase; however, it remained lower among immigrants (IRR = 0.88, 95% CI = 0.86 to 0.90) but not among immigrants' daughters (IRR = 0.97, 95% CI = 0.94 to 1.01) compared to native Swedes. Case fatality decreased over the last decades and was similar in native Swedes and immigrants. However, case fatality was significantly 14% higher if cancer was diagnosed after age 50 and 20% higher if cancer was diagnosed in the most recent years among immigrants compared with native Swedes. Women with the highest SEP had significantly 20% to 30% higher incidence but had 30% to 40% lower case fatality compared with women with the lowest SEP irrespective of country of birth. Age at immigration and duration of residence significantly modified the incidence and case fatality. CONCLUSIONS Disparities found in case fatality among immigrants by age, duration of residence, age at immigration and country of birth emphasize the importance of targeting interventions on women that are not likely to attend screenings or are not likely to adhere to the therapy suggested by physicians. The lower risk of breast cancer among immigrant women calls for more knowledge about how the lifestyle factors in these women differ from those with high risk, so that preventative measures may be implemented.
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Affiliation(s)
- Omid Beiki
- Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Per Hall
- Department of Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE-171 77, Stockholm, Sweden
| | - Anders Ekbom
- Unit of Clinical Epidemiology, Department of Medicine, SOLNA, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Tahereh Moradi
- Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden
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Baker D. Conceptual parameters of acculturation within the Asian and Pacific Islander American populations: applications for nursing practice and research. Nurs Forum 2011; 46:83-93. [PMID: 21517881 DOI: 10.1111/j.1744-6198.2011.00217.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
TOPIC Asian and Pacific Islander Americans (A&PIAs) are experiencing health inequities. For example, A&PIA is the only racial/ethnic group in America to experience cancer as their leading cause of death. Several studies within the A&PIA population have pointed to acculturation as a significant variable to explain their health and health-seeking behaviors. Acculturation is a key construct in understanding the health of the A&PIA population. OBJECTIVE The purpose of this concept analysis is to provide a current conceptual understanding of the relationship between acculturation and health, especially within the A&PIA populations, which will serve as a pragmatic guideline for nursing practice and research. Understanding the contemporary issues surrounding the conceptual application of acculturation will aid in the development of appropriate programs to reduce health inequities. METHODS Acculturation was explored using the Morse method of concept analysis. An iterative historical and contemporary literature review across the disciplines of anthropology, sociology, psychology, medicine, and nursing was completed. Analytical questions asked of the resultant data provided the theoretical definition, antecedents, key attributes, outcomes, and implications. RESULTS The concept analysis resulted in a new theoretical definition that includes multidimensional concepts of acculturation. Dilemmas in the measurement of key attributes of acculturation include unidirectional and bidirectional analysis, psychometric issues, and the appropriateness of proxy measurements. Outcomes of acculturation on health can be positive or negative and depend on an individual's or group's ability to navigate freely with necessary supports. Results of the conceptual analysis resulted in recommendations for nursing practice and future acculturation research. CONCLUSION While debate continues about the appropriate use and definition of acculturation, researchers agree that it is an important construct in understanding the health of migrating individuals and groups. Currently there is no testable framework that delineates the role of acculturation in health. Further research is indicated to clarify the relationship between acculturation and health.
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Affiliation(s)
- Dian Baker
- Betty Irene Moore School of Nursing, University of California Davis, USA.
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Boxwala FI, Bridgemohan A, Griffith DM, Soliman AS. Factors associated with breast cancer screening in Asian Indian women in metro-Detroit. J Immigr Minor Health 2010; 12:534-43. [PMID: 19629691 PMCID: PMC4276127 DOI: 10.1007/s10903-009-9277-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Few studies have examined social factors related to breast cancer screening in Asian Indian women in the Midwestern US. This cross-sectional, community-based survey utilized constructs of the Health Belief Model to examine factors associated with breast cancer screening among Asian Indian women in metropolitan Detroit, Michigan. Of the 160 participants, 63.8% reported receiving both a clinical breast exam and mammogram within the past 2 years. Women were more likely to screen for breast cancer if they had a college education, lived in the US for more years, perceived that breast cancer screening is useful in detecting breast cancer early, agreed that mammography was important, and received a recommendation by a healthcare provider to get a mammogram. These findings highlight the need for further research on regional differences in breast cancer screening knowledge, behaviors and predictors among Asian Pacific Islanders subgroups such as Asian Indian women who recently immigrated to the US.
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Affiliation(s)
- Fatema I Boxwala
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 109 Observatory St, Ann Arbor, MI 48109, USA
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Sun Z, Xiong H, Kearney A, Zhang J, Liu W, Huang G, Wang PP. Breast cancer screening among Asian immigrant women in Canada. Cancer Epidemiol 2010; 34:73-8. [DOI: 10.1016/j.canep.2009.12.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Revised: 12/01/2009] [Accepted: 12/02/2009] [Indexed: 10/20/2022]
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Abstract
OBJECTIVES To determine differences in screening for routine physical exam and cancers among Chinese, Korean, Vietnamese, and Cambodian Americans. METHODS The sample consisted of 2011 participants. Chi square was used to identify relationships between demographic/acculturation factors and screenings. RESULTS Never-screened rates were high for all Asian subgroups. Never-screened rates for mammography ranged from 20.1% to 78.5% for Pap test, 28% to 75.6% for prostate cancer, 56.7% to 97% for colorectal cancer, 65.3% to 94.9%. Koreans had the highest never screened for health checkups (34.7%). CONCLUSIONS Efforts should be made to comply with screening guidelines among Asian Americans.
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Affiliation(s)
- Grace X Ma
- Department of Public Health, Center for Asian Health, College of Health Professions, Temple University, Philadelphia, PA 19122-0843, USA.
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Glenn BA, Chawla N, Surani Z, Bastani R. Rates and sociodemographic correlates of cancer screening among South Asians. J Community Health 2009; 34:113-21. [PMID: 19145482 DOI: 10.1007/s10900-008-9129-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although the third largest Asian subgroup in the U.S., South Asians have rarely been included in cancer research. The purpose of this study was to assess rates and correlates of cancer screening in a community sample of South Asians. This study was a collaboration between the UCLA School of Public Health and South Asian Network (SAN), a social service organization in Southern California. Data were collected from 344 adults including a substantial portion of immigrants and individuals with low income and education. Few participants received screening within guidelines for colorectal (25%), breast (34%), cervical (57%) and prostate cancer (10%). Health insurance, younger age and increased length of stay in the U.S. predicted a higher likelihood of cancer screening. Women were significantly less likely to have received colorectal cancer screening compared to men. These results will guide SAN's program planning efforts. Future interventions should focus on increasing cancer screening in this population.
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Affiliation(s)
- Beth A Glenn
- Department of Health Services, School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.
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Wong LP, Wong YL, Low WY, Khoo EM, Shuib R. Cervical cancer screening attitudes and beliefs of Malaysian women who have never had a pap smear: a qualitative study. Int J Behav Med 2009; 15:289-92. [PMID: 19005928 DOI: 10.1080/10705500802365490] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Attitudes toward cervical cancer and participation in early detection and screening services are well known to be profoundly affected by cultural beliefs and norms. PURPOSE This study explored the attitudes and sociocultural beliefs on cervical cancer screening among Malaysian women. METHOD In this qualitative study, in-depth interviews were conducted with 20 Malaysian women, ages 21 to 56 years, who have never had a Papanicolaou (Pap) smear. RESULTS Respondents generally showed a lack of knowledge about cervical cancer screening using Pap smear, and the need for early detection for cervical cancer. Many believed the Pap smear was a diagnostic test for cervical cancer, and since they had no symptoms, they did not go for Pap screening. Other main reasons for not doing the screening included lack of awareness of Pap smear indications and benefits, perceived low susceptibility to cervical cancer, and embarrassment. Other reasons for not being screened were related to fear of pain, misconceptions about cervical cancer, fatalistic attitude, and undervaluation of own health needs versus those of the family. CONCLUSION Women need to be educated about the benefits of cervical cancer screening. Health education, counseling, outreach programs, and community-based interventions are needed to improve the uptake of Pap smear in Malaysia.
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Affiliation(s)
- L P Wong
- Health Research Development United, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Coburn N, Fulton J, Pearlman DN, Law C, DiPaolo B, Cady B. Treatment Variation by Insurance Status for Breast Cancer Patients. Breast J 2008; 14:128-34. [DOI: 10.1111/j.1524-4741.2007.00542.x] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Avci IA. Factors associated with breast self-examination practices and beliefs in female workers at a Muslim community. Eur J Oncol Nurs 2008; 12:127-33. [PMID: 18242140 DOI: 10.1016/j.ejon.2007.11.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2007] [Revised: 08/15/2007] [Accepted: 11/04/2007] [Indexed: 11/16/2022]
Abstract
The purpose of this descriptive correlational study was to identify knowledge levels and performance frequency of breast self-examination (BSE) and to examine variables related to breast cancer screening behaviors in a sample of Turkish women. Data were collected from a convenience sample of 103 Muslim female workers at a hazelnut factory in Ordu city, Turkey, using an adapted version of Champion's revised Health Belief Model Scale. Results showed that 26.2% of the women reported knowledge of BSE and 4.3% reported that they perform BSE. Higher health motivation, higher perceived self-efficacy of BSE, marital status, and familial breast cancer history were significantly associated with BSE performance. Higher levels of health motivation and higher perceived self-efficacy of BSE were also significantly associated with knowledge of BSE.
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Affiliation(s)
- Ilknur Aydin Avci
- Nursing Department, Samsun Health School, Ondokuz May University, Public Health Nursing, Turkey.
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Merchant RC, Gee EM, Bock BC, Becker BM, Clark MA. Correlates of women's cancer screening and contraceptive knowledge among female emergency department patients. BMC WOMENS HEALTH 2007; 7:7. [PMID: 17519020 PMCID: PMC1890545 DOI: 10.1186/1472-6874-7-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2006] [Accepted: 05/22/2007] [Indexed: 11/17/2022]
Abstract
Background Lack of knowledge regarding preventive health services for women might impede campaigns to expand these services in the emergency department setting. For 18–55-year-old English-speaking women visiting an urban emergency department, we aimed to: (1) Ascertain their knowledge regarding the applicability, purpose, and recommended intervals of three women's cancer screening and three contraceptive methods; and (2) Determine if patient age, race/ethnicity, medical insurance status, and current or recent usage of these methods are associated with greater or lesser knowledge about them. Methods Emergency department-based survey on recent or current usage and knowledge about Pap smears, breast self-examinations, mammograms, condoms, birth control, and emergency contraception. Analyses included calculation of summary statistics and creation of multivariable logistic regression models. Results Of 1,100 patients eligible for the study, 69.9% agreed to participate. Most of the participants were < age 35, white, single (never married and no partner), Catholic, and had private medical insurance. Participant's recent or current usage of a particular cancer screening or contraceptive method varied by type of method: Pap smear within the past year (69.1%), breast self-exam within the past month (45.5%), mammogram within the past year (65.7% for women age 45–55), condom usage during every episode of sexual intercourse (15.4%), current usage of birth control pills (17.8%), and ever use of emergency contraception (9.3%). The participants correctly answered 87.9% of all survey questions about condoms, 82.5% about birth control pills, 78.5% about breast self-exams, 52.9% about Pap smears, 35.4% about mammograms, and 25.0% about emergency contraception. In multivariable logistic regression models, survey participants who had private medical insurance and those who recently or currently used a given screening or contraceptive method had a greater odds of correctly answering all questions about each cancer screening or contraceptive method. Conclusion Although these female ED patients demonstrated strong knowledge on some women's cancer screening and contraceptive methods, there were several areas of knowledge deficit. Women without private medical insurance and those who have not used a particular cancer screening or contraceptive method demonstrated less knowledge. Reduced knowledge about women's cancer screening and contraceptive methods should be considered during clinical encounters and when instituting or evaluating emergency department-based initiatives that assess the need for these methods.
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Affiliation(s)
- Roland C Merchant
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Erin M Gee
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Beth C Bock
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, USA
| | - Bruce M Becker
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Melissa A Clark
- Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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