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Beyene DA, Ayele SG, Wubneh HD, Tsige AW. Male support for cervical cancer screening in Debre Berhan City Ethiopia a community based cross sectional survey. Sci Rep 2024; 14:18302. [PMID: 39112655 PMCID: PMC11306371 DOI: 10.1038/s41598-024-69439-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024] Open
Abstract
Male partner involvement strongly influences a woman's decision to undergo cervical cancer screening. Women of low socioeconomic status are disproportionately affected by cervical cancer. Women living in low-and middle-income countries often encounter resistance from their partners regarding participation in cervical cancer screening. The lack of men's support for sexual and reproductive health programs, including cervical cancer screening, creates a barrier to women's utilization of health services. To assess Ethiopian men's awareness, knowledge, perceptions, and attitudes toward cervical cancer screening and their support to their female partners during screening. A community-based cross-sectional survey was conducted from June 20, 2023, to August 04, 2023. A multistage sampling procedure was used to recruit 614 male survey participants. Descriptive statistics were used to summarize sociodemographic data. Univariate and multivariate regression analyses were performed to measure the associations between the dependent and independent variables. A p-value of less than 0.05 was considered statistically significant. In this survey, 58.5% (359) of participants supported their partners for cervical cancer screening. More than half 55.9% (343) of the participants had an awareness of cervical cancer disease and 47.2% (290) participants knew the risk factors associated with the development of cervical cancer. In addition to that, 66.8% (410) of men have a positive attitude towards screening and encourage their wives to get screened if they notice symptoms of cervical cancer. Regarding the perceptions of cervical cancer, 37.0% (227) of male participants believed that their female partners were at risk of developing the disease, while 38.3% (235) of men believed that cervical cancer screening was only necessary if the woman showed symptoms. Completion of higher education (AOR = 3.75, 95% CI 1.60-8.79, p = 0.002), living with other people (AOR = 0.09, 95% CI 0.03-0.29, p < 0.0001), not being tested for HIV (AOR = 0.26, 95% CI 0.10-0.74, p = 0.011), and having information about cervical cancer (AOR = 3.33, 95% CI 1.36-8.15, p = 0.009) were statistically significantly associated with men's support for their partners in cervical cancer screening. Men's awareness, knowledge, and perceptions of cervical cancer screening were low. On the other hand, men have a positive attitude towards screening and encourage their wives to get screened if they notice symptoms of cervical cancer. This survey will serve as a basis for the development of further strategies and action plans to promote and support male participation in cervical cancer screening in Ethiopia. This can be achieved through the development of strategic plans, including public campaigns, raising awareness among social and community leaders, involving non-governmental organizations focusing on women's health, and community education.
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Affiliation(s)
- Dessale Abate Beyene
- Department of Pharmacy, Asrat Woldeyes Health Science Campus, Debre Berhan University, P.O. Box 445, 1000, Debre Berhan, Ethiopia.
| | - Siraye Genzeb Ayele
- Department of Midwifery, School of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Henok Dessie Wubneh
- School of Medicine, College of Medicine and Health Sciences, University of Gonder, Gonder, Ethiopia
| | - Abate Wondesen Tsige
- Department of Pharmacy, Asrat Woldeyes Health Science Campus, Debre Berhan University, P.O. Box 445, 1000, Debre Berhan, Ethiopia
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Hamilton FL, Pleasant V. Obstetrics and Gynecology Care in Latinx Communities. Obstet Gynecol Clin North Am 2024; 51:105-124. [PMID: 38267122 DOI: 10.1016/j.ogc.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
The Latinx community represents the largest racial minority population in the nation. There are significant barriers to care and treatment as it relates to obstetrics and gynecology. Understanding cultural considerations is essential to improving care in this community. Public health strategies as well as policies to address racial health disparities facing the Latinx community are explored in this article.
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Affiliation(s)
- Felicia L Hamilton
- Department of Obstetrics & Gynecology, OB/Gyn Practice Committee, MedStar Washington Hospital Center, Georgetown University Medical Center, 110 Irving Street, Northwest Room 5B-45A, Washington, DC 20010, USA.
| | - Versha Pleasant
- Department of Obstetrics and Gynecology, Cancer Genetics & Breast Health Clinic, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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Okafor IP, Kukoyi FO, Kanma-Okafor OJ, Izuka MO. Male involvement in female partners' screening for breast and cervical cancers in Southwest Nigeria. PLoS One 2023; 18:e0284141. [PMID: 37163507 PMCID: PMC10171596 DOI: 10.1371/journal.pone.0284141] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/25/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Breast and cervical cancers are in the top 10 most common cancers in women globally and the most common cancers in Nigerian women. The incidences have been rising steadily over the years. Involvement of men as key players in reproductive health issues has been receiving global attention especially in low and middle-income countries. AIM To assess male involvement in their female partners' screening for breast and cervical cancers in Southwest, Nigeria. METHOD This was a community-based, cross-sectional study that employed a multi-stage sampling method to select 254 men who were married or in steady relationships in Lagos State, Southwest Nigeria. Data were collected from June to October 2018 using a semi-structured interviewer-administered questionnaire, analyzed using Epi Info version 3.5.1 and summarized with mean and standard deviation. Chi-square test was used for bivariate statistics, and the p-value of ≤0.05 was considered statistically significant. Multivariable logistic regression was used for predictor variables of male involvement in screening. RESULTS 29.5% of the respondents had good knowledge of breast and cervical cancers and screening and majority (85.5%) had a positive attitude towards screening. Only few, 19.3% and 15.7% had provided money for breast and cervical cancer screening respectively. Most men, 75% and 87.4% respectively had not accompanied their wife/female partner for breast and cervical cancer screening, while almost half (49.2%) and one-third (33.5%) respectively, had encouraged their female partners to screen for breast and cervical cancers. Overall, only about half, 138 (54.3%) of the men were considered 'involved' in their female partners' screening for breast and cervical cancers. Male involvement was significantly associated with screening for female cancers (χ2 = 77.62, p = 0.001). Older age group (AOR = 2.64, 95% CI: 1.3-4.9), higher educational attainment (AOR = 3.51, 95% CI: 1.14-10.73), and positive attitude (AOR = 2.48, 95% CI:1.16-5.33) were found to be the predictors of male involvement. CONCLUSION Community-based programs for males, especially the younger and less educated, should be implemented to increase their involvement. It is also suggested that mass media messages be spread and online platforms be explored in order to increase men's awareness and participation in female cancer screening.
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Affiliation(s)
- Ifeoma Peace Okafor
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Mushin, Lagos, Nigeria
| | - Folayemi Oyinkansola Kukoyi
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Mushin, Lagos, Nigeria
| | - Oluchi Joan Kanma-Okafor
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Mushin, Lagos, Nigeria
| | - Michael Orji Izuka
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Mushin, Lagos, Nigeria
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Shrestha AD, Andersen JG, Gyawali B, Shrestha A, Shrestha S, Neupane D, Ghimire S, Campbell C, Kallestrup P. Cervical cancer screening utilization, and associated factors, in Nepal: a systematic review and meta-analysis. Public Health 2022; 210:16-25. [PMID: 35863158 DOI: 10.1016/j.puhe.2022.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 05/23/2022] [Accepted: 06/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To systematically appraise the existing published literature on cervical cancer screening utilization, and associated barriers and facilitators, in Nepal. STUDY DESIGN Systematic literature review and meta-analysis. METHODS PubMed/MEDLINE, CINAHL, Scopus, Embase, and, Google Scholar were systematically searched using Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. All quantitative and qualitative studies reporting cervical cancer screening (using the Pap smear test or visual inspection with acetic acid or human papillomavirus test) utilization, barriers, and facilitators for screening were identified. A meta-analysis was performed to estimate Nepal's pooled cervical cancer screening utilization proportion. RESULTS The search yielded 97 records, of which 17 studies were included. Fifteen studies were quantitative and two were qualitative. Of the 17 studies, six were hospital-based and six were community-based. The pooled cervical cancer screening utilization proportion (using Pap smear test) among Nepalese women was 17% from the studies in the hospital settings, and 16% in the community. Six studies reported barriers to cervical cancer screening, of which four reported embarrassments related to the gynecological examination and a low level of knowledge on cervical cancer. Three (of four) studies reported health personnel, and two studies reported screening services-related facilitators for cervical cancer screening. CONCLUSION Our review reported that cervical cancer screening utilization (16%) is more than four times lower than the national target (70%) in Nepal. Multiple barriers such as low levels of knowledge and embarrassment are associated with cervical cancer screening utilization. Health personnel's gender, counseling, and privacy of screening services were commonly reported facilitators. These findings could help to inform future research, and policy efforts to increase cervical cancer screening utilization in Nepal.
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Affiliation(s)
- A D Shrestha
- Center for Global Health, Department of Public Health, Aarhus University, Denmark; COBIN, Nepal Development Society, Bharatpur, Nepal.
| | - J G Andersen
- Center for Global Health, Department of Public Health, Aarhus University, Denmark
| | - B Gyawali
- Global Health Section, Department of Public Health, University of Copenhagen, Denmark
| | - A Shrestha
- Department of Public Health and Community Programs, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal; Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA; Institute for Implementation Science, Kathmandu, Nepal
| | - S Shrestha
- School of Public Health, University of Alabama, Birmingham, AL, USA
| | - D Neupane
- COBIN, Nepal Development Society, Bharatpur, Nepal; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - S Ghimire
- Nepal Cancer Care Foundation, Lalitpur, Nepal
| | - C Campbell
- Usher Institute, University of Edinburgh, EH8 9AG, United Kingdom
| | - P Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Denmark
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Okedo-Alex IN, Uneke CJ, Uro-Chukwu HC, Akamike IC, Chukwu OE. "It is what I tell her that she will do": a mixed methods study of married men's knowledge and attitude towards supporting their wives' cervical cancer screening in rural South-East Nigeria. Pan Afr Med J 2020; 36:156. [PMID: 32874420 PMCID: PMC7436653 DOI: 10.11604/pamj.2020.36.156.21157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/11/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction cervical cancer is a leading cause of death among Nigerian women. Women often require spousal support before attending cervical cancer screening services. This study assessed married men´s knowledge and attitude towards male involvement in cervical cancer screening of their wives. Methods a cross-sectional study using a mixed methods approach was conducted among 245 married men in Izzi, Local Government Area of Ebonyi State, South-East Nigeria. Quantitative data collected using structured, interviewer-administered questionnaires and qualitative data from focus group discussions were triangulated. Data analysis was done using IBM SPSS version 20. Qualitative findings were analysed using thematic analysis. Results the mean knowledge of cervical cancer was 2.06±0.55. Only 2.9% of the respondents had adequate knowledge of risk factors for cervical cancer. Up to 89.8% were willing to approve screening for their spouses. Majority (76.3%) considered screening important in cervical cancer prevention, while 91.4% were willing to pay for the screening test. Most of them exhibited patriarchal tendencies and insisted that their wives must obtain their consent before screening as depicted by the statement “It is what I tell her that she will do”. Previous spousal screening was a predictor of good knowledge (OR = 10.94, 95% CI = 2.44-48.93; P=0.002). Conclusion married men in this study had poor knowledge of cervical cancer. However, they were willing to support cervical cancer screening conditional on their pre-information and consent. Awareness creation activities on cervical cancer screening should incorporate active engagement of husbands in order to promote screening uptake by their wives.
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Affiliation(s)
- Ijeoma Nkem Okedo-Alex
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria.,Department of Community Medicine, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Chigozie Jesse Uneke
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - Henry Chukwuemeka Uro-Chukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
| | - Ifeyinwa Chizoba Akamike
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria.,Department of Community Medicine, Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria
| | - Onyedikachi Echefu Chukwu
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria
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Greibe Andersen J, Shrestha AD, Gyawali B, Neupane D, Kallestrup P. Barriers and facilitators to cervical cancer screening uptake among women in Nepal - a qualitative study. Women Health 2020; 60:963-974. [PMID: 32643576 DOI: 10.1080/03630242.2020.1781742] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The global incidence of cervical cancer is approximately 570,000 cases and 311,000 deaths annually. Almost 90% of cervical cancer deaths occur in low and middle income countries. Screening is the most effective tool in prevention, early diagnosis, and treatment of cervical cancer. Nepal has no national cervical cancer screening programme, and data from 2003 showed that only 2.8% of Nepalese women had ever been screened. We conducted a qualitative study to obtain better insight into barriers and facilitators to cervical cancer screening among women in Nepal to generate data to inform interventions. In February 2019, four focus group discussions with previously screened and non-screened women, and Female Community Health Volunteers and four in-depth interviews with health workers were conducted in Pokhara Metropolitan City. Semi-structured interview guides were used, interviews were audio-recorded, transcribed verbatim, and analyzed using grounded theory approach with open coding. This resulted in five main themes: 1) lack of husband's support for screening, 2) prevalent stigma and discrimination, 3) lack of awareness about screening options, 4) getting screened, and 5) health care providers. We encourage policymakers and stakeholders apply these findings to improve awareness, access to information, and better screening services in Nepal.
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Affiliation(s)
| | | | - Bishal Gyawali
- Department of Public Health, Global Health Section, University of Copenhagen, Denmark
| | - Dinesh Neupane
- Department of Epidemiology, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Binka C, Doku DT, Nyarko SH, Awusabo-Asare K. Male support for cervical cancer screening and treatment in rural Ghana. PLoS One 2019; 14:e0224692. [PMID: 31738796 PMCID: PMC6860429 DOI: 10.1371/journal.pone.0224692] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/18/2019] [Indexed: 11/18/2022] Open
Abstract
Men have a critical role to play in reducing cervical cancer burden. Yet, there is little information on male involvement in the cervical cancer screening and treatment process in Ghana. In this study, we explore male knowledge and support during cervical cancer screening and treatment in a rural setting in Ghana. In-depth interviews and focus group discussions were conducted among a total of 41 respondents to collect qualitative data from cervical cancer patients, their male partners and other married men in the North Tongu District, Ghana. A thematic approach was used for data analysis and presentation of the results. The results show that male partners have little or no knowledge about cervical cancer. Some men provide various forms of support–financial, social, material and emotional–to their partners during the screening and treatment stages of the disease. Some men, however, abandoned their partners during the screening and treatment process of the disease. Men whose partners did not have cervical cancer said they were willing to provide financial, social, emotional and material support to their partners if they should contract the disease. Some men said they were willing to support their female partners but lacked education on the disease. This study underscores the need for cervical cancer education programmes to target Ghanaian men. The education should focus on the causes of the disease, screening and treatment methods of the disease, and, ultimately, promote spousal support during the screening and treatment processes.
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Affiliation(s)
- Charity Binka
- School of Public Service and Governance, Ghana Institute of Management and Public Administration, Achimota, Accra, Ghana
- * E-mail:
| | - David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Samuel H. Nyarko
- Institute for Demographic and Socioeconomic Research, University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Kofi Awusabo-Asare
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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Adegboyega A, Aleshire M, Dignan M, Hatcher J. Spousal support and knowledge related to cervical cancer screening: Are Sub-Saharan African immigrant men interested? Health Care Women Int 2019; 40:665-681. [PMID: 31084466 DOI: 10.1080/07399332.2019.1615914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Sub-Saharan African immigrant (SSAI) men have significant influence on the health-seeking behavior including cervical cancer screening uptake by their female partners/wives. We conducted a qualitative descriptive study with 21 SSAI men to explore knowledge, perceptions, and support related to cervical screening. Participants were aged 36 ± 9 years, college educated (88%), and 53% have lived in the U.S. > 5 years. Three themes emerged; inadequate cervical cancer knowledge, willingness and strategies for support, and shared versus autonomous decision making for screening. Social structure with emphasis on male leadership could be leveraged in cervical cancer screening promotion for SSAI women.
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Affiliation(s)
- Adebola Adegboyega
- a College of Nursing , University of Kentucky , Lexington , Kentucky , USA
| | - Mollie Aleshire
- a College of Nursing , University of Kentucky , Lexington , Kentucky , USA
| | - Mark Dignan
- b Prevention Research Center , University of Kentucky , Lexington , Kentucky , USA
| | - Jennifer Hatcher
- a College of Nursing , University of Kentucky , Lexington , Kentucky , USA
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Klippert H, Schaper A. Using Facebook to communicate mammography messages to rural audiences. Public Health Nurs 2018; 36:164-171. [PMID: 30370687 DOI: 10.1111/phn.12556] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/19/2018] [Accepted: 09/22/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this scholarly project was to answer the following question: What is the highest level of engagement achieved with a mammography campaign on Facebook? DESIGN AND SAMPLE An Idaho public health department implemented a tailored message mammography campaign on Facebook during Breast Cancer Awareness Month. Target sample for the Facebook campaign were women and men over the age of 40 in rural Idaho. MEASURES Data collected from Facebook were used to measure and stratify engagement into a hierarchy of six levels, with intent to get a mammogram representing the highest level of engagement. A survey measuring women's intent to a get a mammogram was distributed via an online link. RESULTS The posts reached 48,503 Facebook users-11,147 of the total reach were unique users. Intent to get a mammogram, the highest level of engagement, was stated both in Facebook comments and on the online survey. Forty-nine women completed the survey, and 82% of women expressed intent to get a mammogram in the next year. CONCLUSION This project conducted as a program evaluation demonstrates how public health nurses can develop, implement, and evaluate Facebook mammography campaigns in the future.
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Widiasih R, Nelson K. Muslim Husbands’ Roles in Women’s Health and Cancer: The Perspectives of Muslim Women in Indonesia. Asian Pac J Cancer Prev 2018; 19:1703-1709. [PMID: 29938469 PMCID: PMC6103578 DOI: 10.22034/apjcp.2018.19.6.1703] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Breast and cervical cancers are the most common cause of cancer death among women in the world. These cancers are detectable early, however only a few women participate in cancer screening especially in developing countries, including Indonesia. Family, culture and religion can influence why women have screening. Husbands, in Muslim families have a significant role in the family’s health including their wife’s reproductive health. However, information about Muslim husbands’ roles in wife’s health especially cancer is limited. Objective: The purpose of this study was to determine Muslim husband’s roles in women’s health and cancer from the perspectives of Muslim women. Methods: This study was a qualitative study using a descriptive exploratory approach. Purposive sampling was used to recruit 20 Muslim women, 10 from urban areas and 10 from rural areas of West Java Province, Indonesia. Women were interviewed using a semi-structured interview schedule. Data from the interviews were analyzed using the Comparative Analysis for Interview technique. Results: The study found two main themes emerged from the analysis: Muslim husbands’ extensive roles in promoting women’s health and Husbands’ have limited actions with regard to cancer screening. This study also found similarities between rural and urban women’s opinions that in general husbands actively supported promoting women’s health. Conclusion: Muslim husbands focused on encouraging women to have healthy lifestyles, however, a lack of support from husbands related to cancer screening. This behaviour could be a hindrance to Muslim women’s participation in prevention and the early detection of cancer. There is a need to improve Muslim husbands’ awareness in women’s cancer.
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Affiliation(s)
- Restuning Widiasih
- Department of Maternity Nursing, Faculty of Nursing, Padjadjaran University, Bandung, Indonesia. Restuning.widiasih@ unpad.ac.id
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Knowledge and Beliefs Regarding Breast and Cervical Cancer Screening Among Mexican-Heritage Latinas. Cancer Nurs 2017; 40:420-427. [PMID: 27472190 DOI: 10.1097/ncc.0000000000000423] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lower participation rates in mammography and Papanicolaou test are common among Latinas compared with other ethnic groups. Suboptimal screening rates are attributed to lack of knowledge, access to services, and cultural influences. OBJECTIVE The purpose of this study is to qualitatively examine an alternative framework for examining cultural influences on Mexican-heritage Latinas' understandings of breast and cervical cancer screening and how to leverage their beliefs to positively influence screening practices. METHODS The study is based on the analysis of 4 focus groups with 47 Latinas residing in greater Phoenix, Arizona. RESULTS Iterative qualitative analyses identified 5 major themes: (1) knowledge and beliefs about cancer cause and risk in general, (2) knowledge and beliefs specific to breast and cervical cancer screening, (3) experiences with breast and cervical cancer screening, (4) facilitators and barriers to breast and cervical screening, and (5) desired information about cancer and screening. CONCLUSIONS Rather than focusing on Latinas' knowledge and/or misconceptions of breast and cervical cancer in screening-related education, researchers must examine what Latinas believe and leverage those convictions to expand their perceptions and behaviors related to breast and cervical cancer prevention practices. IMPLICATIONS FOR PRACTICE Practitioners should recognize that Latinas may differ in beliefs from other minorities, and that even within-group, there may be cultural differences that influence cancer screening behaviors.
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Tung WC, Smith-Gagen J, Lu M, Warfield M. Application of the Transtheoretical Model to Cervical Cancer Screening in Latina Women. J Immigr Minor Health 2016; 18:1168-1174. [DOI: 10.1007/s10903-015-0183-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nonzee NJ, Ragas DM, Ha Luu T, Phisuthikul AM, Tom L, Dong X, Simon MA. Delays in Cancer Care Among Low-Income Minorities Despite Access. J Womens Health (Larchmt) 2015; 24:506-14. [PMID: 26070037 DOI: 10.1089/jwh.2014.4998] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Narrowing the racial/ethnic and socioeconomic disparities in breast and cervical cancer requires an in-depth understanding of motivation for adherence to cancer screening and follow-up care. To inform patient-centered interventions, this study aimed to identify reasons why low-income women adhered to or delayed breast or cervical cancer screening, follow-up and treatment despite access to cancer care-related services. METHODS Semistructured qualitative interviews were conducted among women with access to cancer care-related services receiving care at an academic cancer center, federally qualified health centers, or free clinics in the Chicago metropolitan area. Transcripts were coded and analyzed for themes related to rationales for adherence. RESULTS Among 138 participants, most were African American (46%) or Hispanic (36%), English speaking (70%), and between ages 41 and 65 years (64%). Primary drivers of nonadherence included lack of knowledge of resources, denial or fear, competing obligations, and embarrassment. Facilitators included abnormality identification, patient activation, provider-initiated actions, and motivation from family or friends. CONCLUSIONS Interventions targeting increased adherence to care among low-income and ethnic minority women should direct efforts to proactive, culturally and patient-informed education that enables patients to access resources and use the health care system, address misconceptions about cancer, ensure health care providers' communication of screening guidelines, and leverage the patient's social support network.
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Affiliation(s)
- Narissa J Nonzee
- 1 Institute for Public Health and Medicine, Northwestern University , Chicago, Illinois.,2 Robert H. Lurie Comprehensive Cancer Center, Northwestern University , Chicago, Illinois
| | - Daiva M Ragas
- 3 Department of Obstetrics and Gynecology, Northwestern University , Chicago, Illinois
| | - Thanh Ha Luu
- 3 Department of Obstetrics and Gynecology, Northwestern University , Chicago, Illinois
| | - Ava M Phisuthikul
- 3 Department of Obstetrics and Gynecology, Northwestern University , Chicago, Illinois
| | - Laura Tom
- 1 Institute for Public Health and Medicine, Northwestern University , Chicago, Illinois
| | - XinQi Dong
- 4 Rush Institute for Healthy Aging, Rush University Medical Center , Chicago, Illinois
| | - Melissa A Simon
- 1 Institute for Public Health and Medicine, Northwestern University , Chicago, Illinois.,2 Robert H. Lurie Comprehensive Cancer Center, Northwestern University , Chicago, Illinois.,3 Department of Obstetrics and Gynecology, Northwestern University , Chicago, Illinois.,5 Department of Preventive Medicine, Northwestern University , Chicago, Illinois
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Witharana C, Wijesiriwardhana P, Jayasekara K, Kumari P, Rodrigo C. Awareness of female malignancies among women and their partners in Southern Sri Lanka and implications for screening: a cross sectional study. BMC Public Health 2015; 15:1179. [PMID: 26608133 PMCID: PMC4660802 DOI: 10.1186/s12889-015-2531-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 11/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidences of breast, cervical and uterine malignancies continue to increase in Sri Lanka. It is important to explore the awareness of both women and their male partners regarding these malignancies and available screening services as it would determine the health seeking behaviours of females. METHODS This was a cross sectional survey of couples residing in the Galle District of the Southern province of Sri Lanka. The sample was selected from all 17 health administrative divisions of the district. An interviewer administered questionnaire was used to collect data on demography and level of awareness (risk factors, symptoms, signs, screening services) of breast, cervical and uterine cancers. Same questionnaire was used for both sexes except for gender specific questions. RESULTS A total of 282 (n-282, 564 individuals) couples were interviewed. The level of awareness regarding all malignancies was low. More than 50% of participants in both sexes scored less than half the points on a questionnaire testing awareness. Better family income, better education and permanent employment showed a significant association with better awareness in both sexes (univariate analysis). Encouragement by male partner was associated with better participation in some instances. CONCLUSIONS Community based health education on female malignancies needs to target both sexes. Educating males is important as, i) male partners can encourage females to utilize screening services and ii) some screening and preventive measures are relevant to males also. Better awareness of males may increase the uptake of screening services by females in societies with male dominant gender roles.
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Affiliation(s)
- Chamindri Witharana
- Allied Health Sciences, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
| | | | - Kalani Jayasekara
- Allied Health Sciences, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
| | - Priyanka Kumari
- Allied Health Sciences, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
| | - Chaturaka Rodrigo
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25, Kynsey Road, Colombo 08, Sri Lanka.
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Abstract
Purpose
– The purpose of this paper is to present a three-part framework of information engagement for situated gynecological cancers. These particular cancers intertwine with medicalization of sexuality and gender power dynamics, situating information behaviors and interactions in women’s socio-health perceptions. Using Kavanagh and Broom’s feminist risk framework, the framework establishes functional and temporal parameters for sense-making and information engagement.
Design/methodology/approach
– This paper employs a structured, reiterative literature review with emergent thematic analysis. Nine indices from medicine, information studies, and sociology were searched using combinations of five terms on cervical cancer (CC) and 14 terms on information engagement in the title, abstract, and subject fields. Results were examined on a reiterative basis to identify emergent themes pertaining to knowledge development and information interactions.
Findings
– Environmentally, social stigma and gender roles inhibit information seeking; normalizing CC helps integrate medical, moral, and sexual information. Internally, living with the dichotomy between “having” a body and “being” a body requires high-trust information resources that are presented gradually. Actively, choosing to make or cede medical decision-making requires personally relevant information delivered in the form of concrete facts and explanations.
Research limitations/implications
– The study covers only one country.
Originality/value
– This study’s information framework and suggestions for future research encourage consideration of gender power dynamics, medicalization of sexuality, and autonomy in women’s health information interactions.
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Calderón-Garcidueñas AL, Flores-Peña Y, De León-Leal S, Vázquez-Martínez CA, Farías-Calderón AG, Melo-Santiesteban G, Elizondo-Zapién RM, Hernandez-Hernandez DM, Garza-Moya R, Cerda-Flores RM. An educational strategy for improving knowledge about breast and cervical cancer prevention among Mexican middle school students. Prev Med Rep 2015; 2:250-4. [PMID: 26844079 PMCID: PMC4721448 DOI: 10.1016/j.pmedr.2015.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Prevention programs have not achieved the expected results in preventing mortality from breast and cervical cancer in Mexico. Therefore, we propose a complementary strategy. METHODOLOGY An educational strategy for high school students in Mexico (2011-2013) was designed (longitudinal design, two measurements and a single intervention). The postintervention assessment included: 1) knowledge acquired by students about cancer prevention and 2) The performance of the student as a health promoter in their household. The strategy was based on analysis of cases and developed in three sessions. An assessment tool was designed and validated (Test-Retest). The levels of knowledge according to the qualifications expected by chance were determined. Wilcoxon test compared results before and after intervention. RESULTS An assessment instrument with 0.80 reliability was obtained. 831 high school students were analyzed. Wilcoxon rank-sum test showed a significant learning after the intervention (Z = - 2.64, p = 0.008) with improvement of levels of knowledge in a 154.5%. 49% of students had a good performance as health promoters. CONCLUSIONS The learning in preventive measures is important to sensitize individuals to prevention campaigns against cancer. This strategy proved to improve the level of knowledge of students in an easy and affordable way.
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Affiliation(s)
- Ana Laura Calderón-Garcidueñas
- Instituto Mexicano del Seguro Social, Hospital de Especialidades No. 25, UMAE, Av. Gonzalitos y Lincoln, Col. Nueva Morelos, Monterrey, NL 64300, Mexico; Universidad Veracruzana, Instituto de Medicina Forense, Boca del Río, Ver, Mexico
| | - Yolanda Flores-Peña
- Autonomous University of Nuevo Leon (UANL). Nursing Graduate School. Av. Gonzalitos 1500 Nte, Col. Mitras Centro, 64460, Monterrey, Mexico
| | | | | | - Ana Gabriela Farías-Calderón
- Instituto Tecnológico y de Estudios Superiores de Monterrey, Graduate School of Public Administration and Public Policy, Eugenio Garza Lagüera y Rufino Tamayo, Col. Valle Oriente, San Pedro, NL 66269, Mexico
| | | | | | | | - Rubén Garza-Moya
- Instituto Mexicano del Seguro Social, Hospital de Especialidades No. 25, UMAE, Av. Gonzalitos y Lincoln, Col. Nueva Morelos, Monterrey, NL 64300, Mexico
| | - Ricardo Martín Cerda-Flores
- Autonomous University of Nuevo Leon (UANL). Nursing Graduate School. Av. Gonzalitos 1500 Nte, Col. Mitras Centro, 64460, Monterrey, Mexico
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De Jesus M, Carrete C, Maine C, Nalls P. "Getting tested is almost like going to the Salem witch trials": discordant discourses between Western public health messages and sociocultural expectations surrounding HIV testing among East African immigrant women. AIDS Care 2015; 27:604-11. [PMID: 25616443 PMCID: PMC4607024 DOI: 10.1080/09540121.2014.1002827] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Washington, DC, has the highest AIDS diagnosis rate in the USA, and Black women are disproportionately affected. Although HIV testing is the first entryway into vital treatment services, evidence reveals that foreign-born blacks have a lower rate of recent HIV testing than US-born blacks. To date, however, there are no studies that examine the culture-specific perceptions of HIV testing among East African immigrant women (who comprise a large share of Black Africans in DC) to better understand their potential barriers to testing. Adopting the PEN-3 cultural model as our theoretical framework, the main objective of this study was to examine East African women's HIV testing perceptions and partner communication norms. Between October 2012 and March 2013, trained interviewers conducted a total of 25 interviews with East African women in the Washington, DC, metropolitan area. For triangulation purposes, data collection consisted of both in-depth, semi-structured interviews and cognitive interviews, in which participants were administered a quantitative survey and assessed on how they interpreted items. Qualitative thematic analysis revealed a systematic pattern of discordant responses across participants. While they were aware of messages related to Western public health discourse surrounding HIV testing (e.g., Everyone should get tested for HIV; One should talk to one's spouse about HIV testing), divergent sociocultural expectations rooted in cultural and religious beliefs prevailed (e.g., Getting an HIV test brings shame to the person who got tested and to one's family; it implies one is engaging in immoral behavior; One should not talk with one's spouse about HIV testing; doing so breaks cultural norms). Implications of using a culture-centered model to examine the role of sociocultural expectations in HIV prevention research and to develop culturally responsive prevention strategies are discussed.
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Affiliation(s)
- Maria De Jesus
- a School of International Service , American University , Washington , DC , USA
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18
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Rosser JI, Zakaras JM, Hamisi S, Huchko MJ. Men's knowledge and attitudes about cervical cancer screening in Kenya. BMC WOMENS HEALTH 2014; 14:138. [PMID: 25416335 PMCID: PMC4254217 DOI: 10.1186/s12905-014-0138-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 10/20/2014] [Indexed: 01/23/2023]
Abstract
Background A number of studies have identified male involvement as an important factor affecting reproductive health outcomes, particularly in the areas of family planning, antenatal care, and HIV care. As access to cervical cancer screening programs improves in resource-poor settings, particularly through the integration of HIV and cervical cancer services, it is important to understand the role of male partner support in women’s utilization of screening and treatment. Methods We administered an oral survey to 110 men in Western Kenya about their knowledge and attitudes regarding cervical cancer and cervical cancer screening. Men who had female partners eligible for cervical cancer screening were recruited from government health facilities where screening was offered free of charge. Results Specific knowledge about cervical cancer risk factors, prevention, and treatment was low. Only half of the men perceived their partners to be at risk for cervical cancer, and many reported that a positive screen would be emotionally upsetting. Nevertheless, all participants said they would encourage their partners to get screened. Conclusions Future interventions should tailor cervical cancer educational opportunities towards men. Further research is needed among both men and couples to better understand barriers to male support for screening and treatment and to determine how to best involve men in cervical cancer prevention efforts.
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Affiliation(s)
- Joelle I Rosser
- Department of Internal Medicine, University of Washington, 1959 NE Pacific Street, Box 356421, Seattle, WA, 98195-6421, USA.
| | - Jennifer M Zakaras
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Ward 6D-14, San Francisco, CA, 94110, USA.
| | - Sabina Hamisi
- Family AIDS Care and Education Services, Kenya Medical Research Institute, PO BOX 54840-00200, Mbagathi Way, Nairobi City, Kenya.
| | - Megan J Huchko
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Ward 6D-14, San Francisco, CA, 94110, USA.
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19
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Olsson E, Lau M, Lifvergren S, Chakhunashvili A. Community collaboration to increase foreign-born women's participation in a cervical cancer screening program in Sweden: a quality improvement project. Int J Equity Health 2014; 13:62. [PMID: 25106490 PMCID: PMC4422324 DOI: 10.1186/s12939-014-0062-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 06/27/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The prevailing inequities in healthcare have been well addressed in previous research, especially screening program participation, but less attention has been paid to how to overcome these inequities. This paper explores a key factor of a successful improvement project: collaboration with local doulas to raise cervical cancer screening participation by more than 40 percent in an area with a large number of foreign-born residents. METHODS Data was collected through two focus group discussions with the doulas in order to design interventions and debrief after interventions had been carried out in the community. Various tools were used to analyze the verbal data and monitor the progress of the project. RESULTS Three major themes emerged from the focus group discussions: barriers that prevent women from participating in the cervical cancer screening program, interventions to increase participation, and the role of the doulas in the interventions. CONCLUSIONS This paper suggests that several barriers make participation in cervical cancer screening program more difficult for foreign-born women in Sweden. Specifically, these barriers include lack of knowledge concerning cancer and the importance of preventive healthcare services and practical obstacles such as unavailable child care and language skills. The overarching approach to surmount these barriers was to engage persons with a shared cultural background and mother tongue as the target audience to verbally communicate information. The doulas who helped to identify barriers and plan and execute interventions gained increased confidence and a sense of pride in assisting to bridge the gap between healthcare providers and users.
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Affiliation(s)
- Erik Olsson
- Centre for Equity in Health/Kunskapscentrum för Jämlik Vård, Western Region of Sweden/Västra Götalandsregionen, Regionens Hus, SE-405 44, Göteborg, Sweden. .,Centre for Healthcare Improvement and Division of Quality Sciences, Chalmers University of Technology, SE-412 96, Göteborg, Sweden.
| | - Malena Lau
- Angered Local Hospital/Angereds Närsjukhus, Box 63, SE-424 22, Angered, Sweden.
| | - Svante Lifvergren
- Centre for Healthcare Improvement and Division of Quality Sciences, Chalmers University of Technology, SE-412 96, Göteborg, Sweden.
| | - Alexander Chakhunashvili
- Centre for Healthcare Improvement and Division of Quality Sciences, Chalmers University of Technology, SE-412 96, Göteborg, Sweden.
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20
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Gonzalez P, Lim JW, Wang-Letzkus M, Flores KF, Allen KM, Castañeda SF, Talavera GA. Breast Cancer Cause Beliefs: Chinese, Korean, and Mexican American Breast Cancer Survivors. West J Nurs Res 2014; 37:1081-99. [PMID: 25001237 DOI: 10.1177/0193945914541518] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined causal attribution beliefs about breast cancer and the influence that these beliefs exert on health behavior change among breast cancer survivors (BCS). Focus groups with Chinese (n = 21), Korean (n = 11), and Mexican American (n = 9) BCS recruited through community- and hospital-based support groups were conducted. Interviews were audio-recorded, transcribed verbatim, and translated into English for thematic content analysis. Three themes concerning beliefs about breast cancer cause common to all three groups included (a) stress, (b) diet, and (c) fatalism. Causal beliefs corresponded to behavioral changes with women describing efforts to improve their diet and manage their stress. Ethnic minority BCS adhere to beliefs about what caused their cancer that influence their health behaviors. Providing quality health care to ethnically diverse cancer survivors requires cultural sensitivity to patients' beliefs about the causes of their cancer and awareness of how beliefs influence patients' health behaviors post diagnosis.
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Affiliation(s)
| | - Jung-Won Lim
- Kangnam University, Yongin-Si, Gyeonggi-do, Korea
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21
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Allen JD, Leyva B, Torres AI, Ospino H, Tom L, Rustan S, Bartholomew A. Religious beliefs and cancer screening behaviors among Catholic Latinos: implications for faith-based interventions. J Health Care Poor Underserved 2014; 25:503-26. [PMID: 24858865 PMCID: PMC4162660 DOI: 10.1353/hpu.2014.0080] [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] [Indexed: 02/07/2023]
Abstract
Although most U.S. Latinos identify as Catholic, few studies have focused on the influence of this religious tradition on health beliefs among this population. This study explores the role of Catholic religious teachings, practices, and ministry on cancer screening knowledge, attitudes, and behaviors among Latinos. Eight focus groups were conducted with 67 Catholic Latino parishioners in Massachusetts. Qualitative analysis provided evidence of strong reliance on faith, God, and parish leaders for health concerns. Parishes were described as vital sources of health and social support, playing a central role in the community's health. Participants emphasized that their religious beliefs promote positive health behaviors and health care utilization, including the use of cancer screening services. In addition, they expressed willingness to participate in cancer education programs located at their parishes and provided practical recommendations for implementing health programs in parishes. Implications for culturally appropriate health communication and faith-based interventions are discussed.
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Marván ML, Ehrenzweig Y, Catillo-López RL. Knowledge about cervical cancer prevention and psychosocial barriers to screening among Mexican women. J Psychosom Obstet Gynaecol 2013; 34:163-9. [PMID: 24156635 DOI: 10.3109/0167482x.2013.846904] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The objectives of this study were to evaluate: Mexican women's knowledge about cervical cancer prevention; psychosocial barriers to screening; and the relation of both to cervical cancer screening behavior. Three hundred and eighty-four rural and urban women who had achieved a basic or higher educational level were surveyed. Almost 80% of the women had a Pap test but rural women were less likely to have done so. Although most women had received their most recent Pap within the last three years, only 29% had had their first Pap in accordance with the official Mexican norm. Participants showed inadequate knowledge about the risk factors for cervical cancer, especially women with only a basic educational level, irrespective of residence in an urban or rural area. Factors associated with non-screening were poor knowledge about Pap testing and about the risk factors for cervical cancer, as well as the following barriers: believing that Pap testing is too embarrassing; believing that men do not want them to have a Pap test; and believing that the test is painful. In light of these socio-cultural influences, our findings could be helpful in designing effective programs to increase Pap screening.
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Affiliation(s)
- Maria Luisa Marván
- Institute of Psychological Research, Universidad Veracruzana , Xalapa , México
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Sharkey JR, Johnson CM, Dean WR. Nativity is associated with sugar-sweetened beverage and fast-food meal consumption among Mexican-origin women in Texas border colonias. Nutr J 2011; 10:101. [PMID: 21962014 PMCID: PMC3196692 DOI: 10.1186/1475-2891-10-101] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Accepted: 09/30/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trends of increasing obesity are especially pronounced among Mexican-origin women. There is little understanding of dietary patterns among U.S.- and Mexico-born Mexican-origin individuals residing in new-destination immigrant communities in the United States, especially behaviors related to obesity, such as consumption of sugar-sweetened beverages (SSB) and fast-food meals (FFM). METHODS The study used survey data of 599 adult Mexican-origin women from the 610 women who completed the 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA), which was completed in person by trained promotora-researchers in 44 colonias near the Texas border towns of Progreso and La Feria. Data included demographic characteristics (age, education, nativity or country of birth, household income, household composition, and employment status), access to transportation, self-reported height and weight, food and nutrition assistance program participation, and consumption of SSB and FFM. Descriptive statistics were calculated by nativity (U.S.-born vs. Mexico-born); multivariable linear regression models were estimated for correlates of consumption of SSB and FFM. RESULTS There are three major findings related to nativity. First, U.S.-born women consumed more SSB and FFM than Mexican-born counterparts in the same areas of colonias. Second, in the combined sample and controlling for other population characteristics, being born in Mexico was independently associated with FFM (fewer FFM), but not with SSB. Third, in analyses stratified by nativity, FFM and SSB were associated with each other among both nativity groups. Among Mexico-born women only, age, presence of a child, or being a lone parent was significantly associated with SSB; full-time employment, being a lone parent, and SSB consumption were each independently associated with increased frequency of FFM. CONCLUSIONS Our analyses revealed differences in prevalence and correlates of SSB and FFM based on country of birth. Nativity, as a proxy for acculturation, may indicate the extent that immigrants have adopted behaviors from their new environment. However, nativity could also indicate limited accessibility to resources such as food/nutrition assistance programs, transportation, and proper documentation. Additionally, future research should focus on expanding our understanding of the meaning of nativity among individuals who share common contextual factors, but may have different life course experiences and resources needed to transition into a new place. Additional measures should be considered such as educational and occupational background, migration history, documentation status, and dietary acculturation, which may better explain heterogeneity within Hispanic subgroups.
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Affiliation(s)
- Joseph R Sharkey
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX (USA
| | - Cassandra M Johnson
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX (USA
- UNC Center for Health Promotion and Disease Prevention and Department of Nutrition, UNC Gillings School of Global Public Health, Chapel Hill, NC (USA
| | - Wesley R Dean
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX (USA
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Tung WC. Cervical Cancer Screening Among Hispanic and Asian American Women. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2011. [DOI: 10.1177/1084822311413555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Flores B“P, Volker DL. Cervical Cancer Screening and Older Mexican American Women: A Case Study. Res Gerontol Nurs 2011; 4:3-8. [DOI: 10.3928/19404921-20101201-04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 10/27/2010] [Indexed: 11/20/2022]
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Male partner involvement in reducing loss to follow-up after cervical cancer screening in Uganda. Int J Gynaecol Obstet 2009; 107:103-6. [PMID: 19716557 DOI: 10.1016/j.ijgo.2009.07.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 05/19/2009] [Accepted: 07/15/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the efficacy of male partner involvement in reducing loss to follow-up among women in Uganda referred for colposcopy after a positive cervical cancer-screening test. METHODS In 2 family-planning/postnatal clinics at Mulago Hospital, Kampala, Uganda, 5094 women were screened for cervical lesions. Those who screened positive were referred for colposcopy; half were allocated to the intervention group and half to the control group. In the intervention group, information about the screening findings and a request to assist their partner in attending the next examination were sent to male partners. In the control group, a standard service was provided, which did not include a letter to the male partner. Logistic regression models were applied to calculate the probability of women returning for colposcopy. RESULTS Of the 834 women referred, 209 (25%) did not return for colposcopy: 143/419 (34%) from the control group and 66/415 (16%) from the intervention group. Women in the intervention group were more likely to return (odds ratio 2.8; 95% confidence interval, 1.9-3.9). CONCLUSION Male partner involvement significantly reduced loss to follow-up among women referred for colposcopy.
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