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Abraham O, Agoke A, Sanuth K, Fapohunda A, Ogunsanya M, Piper M, Trentham-Dietz A. Need for Culturally Competent and Responsive Cancer Education for African Immigrant Families and Youth Living in the United States. JMIR Cancer 2024; 10:e53956. [PMID: 38447129 PMCID: PMC10955401 DOI: 10.2196/53956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/23/2024] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
Cancer prevalence data for Black Americans is monolithic and fails to consider the diverse cultures and backgrounds within that community. For instance, African immigrants constitute a meaningful proportion of the foreign-born Black immigrants in the United States (42%), but the prevalence of cancer in the African immigrant community itself is unknown. Therefore, without accurate cancer prevalence data, it is impossible to identify trends and other key factors that are needed to support the health of African immigrants and their children. Moreover, it is impossible to understand how the culture and language of subgroups influence their cancer-related health behavior. While research in this area is limited, the existing literature articulates the need for culturally responsive and culturally tailored cancer education for African immigrants and their adolescent children, which is what we advocate for in this viewpoint paper. Existing projects demonstrate the feasibility of culturally responsive programming for adults; however, few projects include or focus on adolescents or children born to African immigrants. To best meet the needs of this understudied community, researchers must use culturally competent interventions alongside familiar, usable media. For adolescents, technology is ubiquitous thus, the creation of a culturally tailored digital intervention has immense potential to improve cancer awareness and prevention for youth and their community. More research is needed to address many of the existing research gaps and develop a rich understanding of the unique experience of cancer among African immigrant families that can be used to inform intervention development. Through this viewpoint, we review the current state of cancer-related research among African immigrant families in the United States. In this paper, we acknowledge the current knowledge gaps and issues surrounding measurement and then discuss the factors relevant to designing an educational intervention targeted at African immigrants and the role of African immigrant youth.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Adeola Agoke
- African Cultural Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Kazeem Sanuth
- National African Language Resource Center, Indiana University Bloomington, Bloomington, IN, United States
| | - Abimbola Fapohunda
- Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Motolani Ogunsanya
- College of Pharmacy, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
| | - Megan Piper
- Department of Medicine and Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Amy Trentham-Dietz
- Population Health Sciences and Carbone Cancer Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Chebli P, Strayhorn SM, Hanneke R, Muramatsu N, Watson K, Fitzgibbon M, Abboud S, Molina Y. A Scoping Review of Cancer Interventions with Arab Americans. J Immigr Minor Health 2024; 26:200-226. [PMID: 37266829 DOI: 10.1007/s10903-023-01497-y] [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] [Accepted: 05/10/2023] [Indexed: 06/03/2023]
Abstract
This scoping review provides an overview of cancer interventions implemented with Arab Americans across the cancer control continuum, including an examination of outcomes and implementation processes. The search strategy included database searching and reviewing reference lists and forward citations to identify articles describing interventions with Arab adults living in the US, with no restrictions on date of publication or research methodology. The review included 23 papers describing 12 unique cancer interventions. Most interventions focused on individual-level determinants of breast and cervical cancer screening; used non-quasi-experimental research designs to evaluate intervention effectiveness; and demonstrated improvements in short-term cancer screening knowledge. Implementation processes were less commonly described. Most interventions were culturally and linguistically tailored to communities of focus; were delivered in educational sessions in community settings; engaged with the community mostly for recruitment and implementation; and were funded by foundation grants. Suggestions for research and intervention development are discussed.
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Affiliation(s)
- Perla Chebli
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
- NYU Department of Population Health, NYU Grossman School of Medicine, New York, NY, 10016, USA.
| | - Shaila M Strayhorn
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Rosie Hanneke
- Information Services & Research Department at the Library of the Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Naoko Muramatsu
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Karriem Watson
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Marian Fitzgibbon
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Sarah Abboud
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Yamilé Molina
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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Schnaubelt S, Schnaubelt B, Pilz A, Oppenauer J, Yildiz E, Schriefl C, Ettl F, Krammel M, Garg R, Niessner A, Greif R, Domanovits H, Sulzgruber P. BLS courses for refugees are feasible and induce commitment towards lay rescuer resuscitation. Eur J Clin Invest 2022; 52:e13644. [PMID: 34185325 PMCID: PMC9285446 DOI: 10.1111/eci.13644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/29/2021] [Accepted: 06/26/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND High-quality Basic Life Support (BLS), the first step in the Utstein formula for survival, needs effective education for all kinds of population groups. The feasibility of BLS courses for refugees is not well investigated yet. METHODS We conducted BLS courses including automated external defibrillator (AED) training for refugees in Austria from 2016 to 2019. Pre-course and after course attitudes and knowledge towards cardiopulmonary resuscitation (CPR) were assessed via questionnaires in the individuals' native languages, validated by native speaker interpreters. RESULTS We included 147 participants (66% male; 22 [17-34] years; 28% <18 years) from 19 countries (74% from the Middle East). While the availability of BLS courses in the participants' home countries was low (37%), we noted increased awareness towards CPR and AED use after our courses. Willingness to perform CPR increased from 25% to 99%. A positive impact on the participants' perception of integration into their new environment was noted after CPR training. Higher level of education, male gender, age <18 years and past traumatizing experiences positively affected willingness or performance of CPR. CONCLUSION BLS education for refugees is feasible and increases their willingness to perform CPR in emergency situations, with the potential to improve survival after cardiac arrest. Individuals with either past traumatizing experiences, higher education or those <18 years might be eligible for advanced life support education. Interestingly, these BLS courses bear the potential to foster resilience and integration. Therefore, CPR education for refuge should be generally offered and further evaluated.
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Affiliation(s)
- Sebastian Schnaubelt
- Department of Emergency MedicineMedical University of ViennaViennaAustria
- Zurück ins LebenAssociation for First Aid Courses for MigrantsViennaAustria
- Austrian Cardiac Arrest Awareness Association–PULSViennaAustria
| | | | - Arnold Pilz
- Zurück ins LebenAssociation for First Aid Courses for MigrantsViennaAustria
- Department of PulmonologyClinic PenzingVienna Healthcare GroupViennaAustria
| | - Julia Oppenauer
- Department of Emergency MedicineMedical University of ViennaViennaAustria
| | - Erdem Yildiz
- Zurück ins LebenAssociation for First Aid Courses for MigrantsViennaAustria
- Department of OtorhinolaryngologyMedical University of ViennaViennaAustria
| | - Christoph Schriefl
- Department of Emergency MedicineMedical University of ViennaViennaAustria
- Austrian Cardiac Arrest Awareness Association–PULSViennaAustria
| | - Florian Ettl
- Department of Emergency MedicineMedical University of ViennaViennaAustria
- Austrian Cardiac Arrest Awareness Association–PULSViennaAustria
| | - Mario Krammel
- Austrian Cardiac Arrest Awareness Association–PULSViennaAustria
- Emergency Medical Service ViennaViennaAustria
| | - Rakesh Garg
- All India Institute of Medical SciencesNew DelhiIndia
| | - Alexander Niessner
- Division of CardiologyDepartment of Internal Medicine IIMedical University of ViennaViennaAustria
| | - Robert Greif
- Department of Anaesthesiology and Pain MedicineBern University HospitalUniversity of BernBernSwitzerland
- School of MedicineSigmund Freud University ViennaViennaAustria
| | - Hans Domanovits
- Department of Emergency MedicineMedical University of ViennaViennaAustria
- Austrian Cardiac Arrest Awareness Association–PULSViennaAustria
| | - Patrick Sulzgruber
- Austrian Cardiac Arrest Awareness Association–PULSViennaAustria
- Division of CardiologyDepartment of Internal Medicine IIMedical University of ViennaViennaAustria
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Noman S, Shahar HK, Rahman HA, Ismail S, Aljaberi MA, Abdulrahman MN. Factor structure and internal reliability of breast cancer screening Champion's Health Belief Model Scale in Yemeni women in Malaysia: a cross-sectional study. BMC Womens Health 2021; 21:437. [PMID: 34965865 PMCID: PMC8715606 DOI: 10.1186/s12905-021-01543-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/16/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The reliability and validity of the Champion's Health Belief Model Scale (CHBMS) used in assessing the belief of women regarding breast cancer (BC) and breast cancer screening (BCS) have been examined on various populations. However, the use of this tool has not been adequately assessed for its validity in ethnic minorities. This study assessed the validity and reliability of CHBMS by analyzing the factor structure and internal reliability of the factors among Yemeni women in Malaysia. METHODS A survey was conducted among 103 female teachers from 10 schools. SPSS version 22.0 was utilized in analyzing the data. Descriptive statistics were computed for the socio-demographic characteristics. The Cronbach's alpha coefficients were used in assessing the internal reliability. The Exploratory Factor Analysis (EFA) was used to analyze the factor structure of the translated items. Parallel analysis was performed to determine the number of factors accurately. RESULTS The alpha coefficients of the factors had acceptable values ranging between 0.76 and 0.87. The factor analysis yielded six and five factors for breast self-examination (BSE) and mammography (MMG), with a total explained variance of 47.69% and 52.63%, respectively. The Kaiser-Meyer-Olkin (KMO) index values of 0.64 and 0.72, and the Bartlett's Test of Sphericity (P = 0.0001) for BSE and MMG, respectively, verified the normality distribution and the adequacy of the sample size for EFA. All the items on each factor were from the same construct that were consistent with the number of factors obtained in the scale development study. The items achieved adequate factor loadings that ranged between 0.47 and 0.88. CONCLUSIONS The translated version of the CHBMS is a validated scale used in assessing the beliefs related to BC and BCS among Yemeni women living in Malaysia. Healthcare workers could use the scales to assess women's beliefs on BC and BCS. This instrument could be used to test the effectiveness of the intervention programs.
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Affiliation(s)
- Sarah Noman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.
- Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen.
| | - Hayati Kadir Shahar
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
- Malaysian Research Institute of Ageing (MyAgeing), 43400, Serdang, Malaysia
| | - Hejar Abdul Rahman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Suriani Ismail
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Musheer A Aljaberi
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
- Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
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P Iqbal M, Walpola R, Harris-Roxas B, Li J, Mears S, Hall J, Harrison R. Improving primary health care quality for refugees and asylum seekers: A systematic review of interventional approaches. Health Expect 2021; 25:2065-2094. [PMID: 34651378 PMCID: PMC9615090 DOI: 10.1111/hex.13365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 09/07/2021] [Accepted: 09/19/2021] [Indexed: 12/30/2022] Open
Abstract
Background It has been widely acknowledged that refugees are at risk of poorer health outcomes, spanning mental health and general well‐being. A common point of access to health care for the migrant population is via the primary health care network in the country of resettlement. This review aims to synthesize the evidence of primary health care interventions to improve the quality of health care provided to refugees and asylum seekers. Methods A systematic review was undertaken, and 55 articles were included in the final review. The Preferred Reporting Items for Systematic Reviews was used to guide the reporting of the review, and articles were managed using a reference‐management software (Covidence). The findings were analysed using a narrative empirical synthesis. A quality assessment was conducted for all the studies included. Results The interventions within the broad primary care setting could be organized into four categories, that is, those that focused on developing the skills of individual refugees/asylum seekers and their families; skills of primary health care workers; system and/or service integration models and structures; and lastly, interventions enhancing communication services. Promoting effective health care delivery for refugees, asylum seekers and their families is a complex challenge faced by primary care professionals, the patients themselves and the communication between them. Conclusion This review highlights the innovative interventions in primary care promoting refugee health. Primary care interventions mostly focused on upskilling doctors, with a paucity of research exploring the involvement of other health care members. Further research can explore the involvement of interprofessional team members in providing effective refugee/migrant health. Patient or Public Contribution Patient and public involvement was explored in terms of interventions designed to improve health care delivery for the humanitarian migrant population, that is, specifically refugees and asylum seekers.
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Affiliation(s)
- Maha P Iqbal
- School of Population Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Ramesh Walpola
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ben Harris-Roxas
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,South Eastern Sydney Research Collaboration Hub (SEaRCH), Population and Community Health, South Eastern Sydney Local Health District, Darlinghurst, New South Wales, Australia
| | - Jiadai Li
- School of Population Health, UNSW Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen Mears
- Hunter New England Medical Library, New Lambton, New South Wales, Australia
| | - John Hall
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation; Level 6, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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Ji M, Liu Y, Hao T. Predicting Health Material Accessibility: Development of Machine Learning Algorithms. JMIR Med Inform 2021; 9:e29175. [PMID: 34468321 PMCID: PMC8444043 DOI: 10.2196/29175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/26/2021] [Accepted: 07/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background Current health information understandability research uses medical readability formulas to assess the cognitive difficulty of health education resources. This is based on an implicit assumption that medical domain knowledge represented by uncommon words or jargon form the sole barriers to health information access among the public. Our study challenged this by showing that, for readers from non-English speaking backgrounds with higher education attainment, semantic features of English health texts that underpin the knowledge structure of English health texts, rather than medical jargon, can explain the cognitive accessibility of health materials among readers with better understanding of English health terms yet limited exposure to English-based health education environments and traditions. Objective Our study explores multidimensional semantic features for developing machine learning algorithms to predict the perceived level of cognitive accessibility of English health materials on health risks and diseases for young adults enrolled in Australian tertiary institutes. We compared algorithms to evaluate the cognitive accessibility of health information for nonnative English speakers with advanced education levels yet limited exposure to English health education environments. Methods We used 113 semantic features to measure the content complexity and accessibility of original English resources. Using 1000 English health texts collected from Australian and international health organization websites rated by overseas tertiary students, we compared machine learning (decision tree, support vector machine [SVM], ensemble tree, and logistic regression) after hyperparameter optimization (grid search for the best hyperparameter combination of minimal classification errors). We applied 5-fold cross-validation on the whole data set for the model training and testing, and calculated the area under the operating characteristic curve (AUC), sensitivity, specificity, and accuracy as the measurement of the model performance. Results We developed and compared 4 machine learning algorithms using multidimensional semantic features as predictors. The results showed that ensemble classifier (LogitBoost) outperformed in terms of AUC (0.858), sensitivity (0.787), specificity (0.813), and accuracy (0.802). Support vector machine (AUC 0.848, sensitivity 0.783, specificity 0.791, and accuracy 0.786) and decision tree (AUC 0.754, sensitivity 0.7174, specificity 0.7424, and accuracy 0.732) followed. Ensemble classifier (LogitBoost), support vector machine, and decision tree achieved statistically significant improvement over logistic regression in AUC, sensitivity, specificity, and accuracy. Support vector machine reached statistically significant improvement over decision tree in AUC and accuracy. As the best performing algorithm, ensemble classifier (LogitBoost) reached statistically significant improvement over decision tree in AUC, sensitivity, specificity, and accuracy. Conclusions Our study shows that cognitive accessibility of English health texts is not limited to word length and sentence length as had been conventionally measured by medical readability formulas. We compared machine learning algorithms based on semantic features to explore the cognitive accessibility of health information for nonnative English speakers. The results showed the new models reached statistically increased AUC, sensitivity, and accuracy to predict health resource accessibility for the target readership. Our study illustrated that semantic features such as cognitive ability–related semantic features, communicative actions and processes, power relationships in health care settings, and lexical familiarity and diversity of health texts are large contributors to the comprehension of health information; for readers such as international students, semantic features of health texts outweigh syntax and domain knowledge.
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Affiliation(s)
- Meng Ji
- School of Languages and Cultures, The University of Sydney, Sydney, Australia
| | - Yanmeng Liu
- School of Languages and Cultures, The University of Sydney, Sydney, Australia
| | - Tianyong Hao
- School of Computer Science, South China Normal University, Guangdong, China
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Siddiq H, Alemi Q, Mentes J, Pavlish C, Lee E. Preventive Cancer Screening Among Resettled Refugee Women from Muslim-Majority Countries: A Systematic Review. J Immigr Minor Health 2021; 22:1067-1093. [PMID: 31900753 DOI: 10.1007/s10903-019-00967-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As refugee populations continue to age in the United States, there is a need to prioritize screening for chronic illnesses, including cancer, and to characterize how social and cultural contexts influence beliefs about cancer and screening behaviors. This study examines screening rates and socio-cultural factors influencing screening among resettled refugee women from Muslim-majority countries of origin. A systematic and integrative review approach was used to examine articles published from 1980 to 2019, using PubMed, CINAHL, and PsycINFO. A total of 20 articles met the inclusion criteria. Cancer screening rates among refugee women are lower when compared to US-born counterparts. Social and cultural factors include religious beliefs about cancer, stigma, modesty and gender roles within the family context. The findings of this review, suggest that resettled refugee women underutilize preventive services, specifically mammography, Pap test and colonoscopy screening, and whose perceptions and behaviors about cancer and screening are influenced by social and cultural factors.
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Affiliation(s)
- Hafifa Siddiq
- Division of General Internal Medicine and Health Services Research, School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
| | - Qais Alemi
- School of Behavioral Health, Loma Linda University, 1898 Business Center Dr., San Bernardino, CA, 92408, USA
| | - Janet Mentes
- School of Nursing, University of California, Los Angeles, Factor Bldg, 700 Tiverton Avenue, Los Angeles, CA, 90095, USA
| | - Carol Pavlish
- School of Nursing, University of California, Los Angeles, Factor Bldg, 700 Tiverton Avenue, Los Angeles, CA, 90095, USA
| | - Eunice Lee
- School of Nursing, University of California, Los Angeles, Factor Bldg, 700 Tiverton Avenue, Los Angeles, CA, 90095, USA
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Abdel-Rahman O. Patterns and Trends of Cancer Screening in Canada: Results From a Contemporary National Survey. J Natl Compr Canc Netw 2021; 19:68-76. [PMID: 33406489 DOI: 10.6004/jnccn.2020.7613] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/26/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to assess the patterns and trends of colorectal, breast, and cervical cancer screening within a contemporary cohort of Canadian adults. METHODS Canadian Community Health Survey datasets (2007-2016) were accessed and 3 cohorts were defined: (1) a colorectal cancer (CRC) screening cohort, defined as men and women aged 50 to 74 years with complete information about CRC screening tests and their timing; (2) a breast cancer screening cohort, defined as women aged 40 to 74 years with complete information about mammography and its timing; and (3) a cervical cancer screening cohort, defined as women aged 25 to 69 years with complete information about the Papanicolaou (Pap) test and its timing. Multivariable logistic regression analysis was then performed to evaluate factors associated with not having timely screening tests at the time of survey completion. RESULTS A total of 99,820 participants were considered eligible for the CRC screening cohort, 59,724 for the breast cancer screening cohort, and 46,767 for the cervical cancer screening cohort. Among eligible participants, 43% did not have timely recommended screening tests for CRC, 35% did not have timely mammography (this number decreased to 26% when limiting the eligible group to ages 50-74 years), and 25% did not have a timely Pap test. Lower income was associated with not having a timely recommended screening tests for all 3 cohorts (odds ratios [95% CI]: 1.86 [1.76-1.97], 1.89 [1.76-2.04], and 1.96 [1.79-2.14], respectively). Likewise, persons self-identifying as a visible minority were less likely to have timely recommended screening tests in all 3 cohorts (odds ratios for White race vs visible minority [95% CI]: 0.87 [0.83-0.92], 0.85 [0.80-0.91], and 0.66 [0.61-0.70], respectively). CONCLUSIONS More than one-third of eligible individuals are missing timely screening tests for CRC. Moreover, at least one-quarter of eligible women are missing their recommended breast and cervical cancer screening tests. More efforts from federal and provincial health authorities are needed to deal with socioeconomic disparities in access to cancer screening.
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Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Alberta, Canada
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Noman S, Shahar HK, Abdul Rahman H, Ismail S, Abdulwahid Al-Jaberi M, Azzani M. The Effectiveness of Educational Interventions on Breast Cancer Screening Uptake, Knowledge, and Beliefs among Women: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010263. [PMID: 33396424 PMCID: PMC7795851 DOI: 10.3390/ijerph18010263] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/22/2020] [Indexed: 12/31/2022]
Abstract
There have been various systematic reviews on the significance of educational interventions as necessary components to encourage breast cancer screening (BCS) and reduce the burden of breast cancer (BC). However, only a few studies have attempted to examine these educational interventions comprehensively. This review paper aimed to systematically evaluate the effectiveness of various educational interventions in improving BCS uptake, knowledge, and beliefs among women in different parts of the world. Following the PRISMA guidelines, a comprehensive literature search on four electronic databases, specifically PubMed, Scopus, Web of Science, and ScienceDirect, was performed in May 2019. A total of 22 interventional studies were reviewed. Theory- and language-based multiple intervention strategies, which were mainly performed in community and healthcare settings, were the commonly shared characteristics of the educational interventions. Most of these studies on the effectiveness of interventions showed favorable outcomes in terms of the BCS uptake, knowledge, and beliefs among women. Educational interventions potentially increase BCS among women. The interpretation of the reported findings should be treated with caution due to the heterogeneity of the studies in terms of the characteristics of the participants, research designs, intervention strategies, and outcome measures.
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Affiliation(s)
- Sarah Noman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Hayati Kadir Shahar
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
- Malaysian Research Institute of Ageing (MyAgeing), Serdang 43400, Malaysia
- Correspondence:
| | - Hejar Abdul Rahman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Suriani Ismail
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Musheer Abdulwahid Al-Jaberi
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; (S.N.); (H.A.R.); (S.I.); (M.A.A.-J.)
| | - Meram Azzani
- Community Medicine Department, Faculty of Medicine, MAHSA University, Saujana Putra Campus, Jenjarom 42610, Malaysia;
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Effectiveness of Interventions for Hepatitis B and C: A Systematic Review of Vaccination, Screening, Health Promotion and Linkage to Care Within Higher Income Countries. J Community Health 2020; 45:201-218. [PMID: 31332639 DOI: 10.1007/s10900-019-00699-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Viral hepatitis is a significant global health concern, particularly within low-middle income countries. Diseases historically affecting low-middle income countries, such as viral hepatitis, have become increasingly prevalent within high-income countries due to globalisation and mass international migration. High prevalence of viral hepatitis in migrant populations is of particular concern due to the associated morbidity and mortality, as well as the increased risk of vertical and horizontal transmission in the community. This is compounded by the asymptomatic nature of hepatitis, meaning many of those affected are unaware of their infection status. Long-term effects of viral hepatitis can include liver cirrhosis, liver cancer and liver failure. Therefore, the health needs of vulnerable migrants within high-income countries due to issues associated with viral hepatitis require attention. This includes assessment of measures such as targeted health education, increased screening, linkage to appropriate treatment and follow-up care. Additionally, it is necessary to address migrant healthcare barriers, such as language, economic and social barriers. It is imperative that vulnerable migrant groups gain appropriate access to health services to prevent disease transmission and the widening of health-related disparities within high-income countries.
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Sacca L, Markham C, Fares J. Using Intervention Mapping to Develop Health Education and Health Policy Components to Increase Breast Cancer Screening and Chemotherapy Adherence Among Syrian and Iraqi Refugee Women in Beirut, Lebanon. Front Public Health 2020; 8:101. [PMID: 32351923 PMCID: PMC7174686 DOI: 10.3389/fpubh.2020.00101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 03/12/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Despite the continuous increase in the incidence of metastatic breast cancer among Syrian and Iraqi refugee women residing in camp settings in Lebanon, mammography and chemotherapy adherence rates remain low due to multiple social, economic, and environmental interfering factors. This in turn led to an alarming increase in breast cancer morbidity and mortality rates among the disadvantaged population. Methods: Intervention mapping, a systematic approach which guides researchers and public health experts in the development of comprehensive evidence-based interventions (EBIs) was used to plan a health education and health policy intervention to increase breast cancer screening and chemotherapy adherence among Iraqi and Syrian refugee women aged 30 and older who are residing in refugee camps within the Beirut district of Lebanon. Results: The generation of the logic model during the needs assessment phase was guided by an extensive review of the literature and reports published in peer-reviewed journals or by international/local organizations in the country to determine breast cancer incidence and mortality rates among refugee women of Syrian and Iraqi nationalities. The underlying behavioral and environmental determinants of the disease were identified from qualitative and quantitative studies carried out among the target population and also aided in assessing the sub-behaviors related to the determinants of breast cancer screening and chemotherapy completion as well as factors affecting policy execution to formulate performance objectives. We then developed matrices of change objectives and their respective methods and practical applications for behavior change at the intrapersonal, interpersonal, organizational, and societal levels. Both educational components (brochures, flyers) and technological methods (videos disseminated via Whats app and Facebook) will be adopted to apply the different methods selected (modeling, self-reevaluation, consciousness raising, persuasion, and tailoring). We also described the development of the educational and technological tools, in addition to providing future implementers with methods for pre-testing and pilot-testing of individual and environmental prototype components. Conclusion: The use of intervention mapping in the planning and implementation of holistic health promotion interventions based on information collected from published literature, case reports, and theory can integrate the multiple disciplines of public health to attain the desired behavioral change.
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Affiliation(s)
- Lea Sacca
- The University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion and Behavioral Sciences, Houston, TX, United States
| | - Christine Markham
- The University of Texas Health Science Center at Houston School of Public Health, Department of Health Promotion and Behavioral Sciences, Houston, TX, United States
| | - Johny Fares
- The University of Texas MD Anderson Cancer Center, Department of Infectious Disease, Infection Control, and Employee Health, Houston, TX, United States
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Raines Milenkov A, Felini M, Baker E, Acharya R, Longanga Diese E, Onsa S, Fernando S, Chor H. Uptake of cancer screenings among a multiethnic refugee population in North Texas, 2014-2018. PLoS One 2020; 15:e0230675. [PMID: 32226017 PMCID: PMC7105132 DOI: 10.1371/journal.pone.0230675] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 03/05/2020] [Indexed: 01/04/2023] Open
Abstract
Background Refugees are less likely than US born populations to receive cancer screenings. Building Bridges is a community health worker prevention program designed to increase refugee’s cancer screening uptake. The purpose of this cross sectional analysis was to assess differences in uptake of cervical, breast, liver, and colorectal screens across six cultural groups. Methods Data was abstracted in 2018 for this analysis. Participants were categorized into six cultural groups (Myanmar, Central Africa, Bhutan, Somalia, Arabic Speaking Countries, and Other) to assess differences in sociodemographic measures and screening uptake. Uptake proportions were calculated for each cancer type (cervical, breast, liver, and colon) among eligible participants, by gender and cultural group. Differences in uptake across groups were assessed using stratified analysis and logistic regression. Prevalence odds ratios (POR) and 95% confidence intervals (CIs) were calculated for each group to assess the association between screening completion and cultural group. Findings 874 refugees were asked about cancer screening history. The majority of participants were either ‘never had been screened’ or ‘not up-to-date’ for every cancer screening. Among age eligible, 82% had no prior pap exam within the past 3 years, 81% had no prior mammogram within the past year, 69% didn’t know their Hepatitis B status and 87% never had a colon cancer screening. Overall, higher uptake of all types of cancer screenings was observed in Myanmar and Bhutanese groups, except colon cancer screening which was higher among Central African Region and Arabic Speaking participants. Conclusion Screening uptake varied by ethnic group and screening type. The program reached an under and never screened population, however, the proportion of refugees who received a cancer screening remained low compared to the US population. Diversity within refugee communities requires adaptation to specific cultural and linguistic needs to include new Americans in cancer elimination efforts.
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Affiliation(s)
- Amy Raines Milenkov
- Department of Pediatrics & Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
- * E-mail:
| | - Martha Felini
- Department of Pediatrics & Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Eva Baker
- Department of Pediatrics & Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Rushil Acharya
- Department of Pediatrics & Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Elvis Longanga Diese
- Department of Pediatrics & Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Sara Onsa
- Department of Pediatrics & Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Shane Fernando
- Department of Pediatrics & Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Holy Chor
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States of America
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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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Rodriguez-Torres SA, McCarthy AM, He W, Ashburner JM, Percac-Lima S. Long-Term Impact of a Culturally Tailored Patient Navigation Program on Disparities in Breast Cancer Screening in Refugee Women After the Program's End. Health Equity 2019; 3:205-210. [PMID: 31106287 PMCID: PMC6524343 DOI: 10.1089/heq.2018.0104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: To examine the long-term effects of a patient navigation (PN) program for mammography screening tailored to refugee women and to assess screening utilization among these women after PN ended. Methods: We assessed the proportion of patients completing mammography screening during the prior 2 years during 2012–2016 for refugee women who had previously received PN compared with that of English-speaking women cared for at the same health center during the same period, both overall and stratifying by age. We used logistic regression to compare screening completion between refugees and English speakers, adjusting for age, race, insurance status, number of clinic visits, and clustering by primary care physician and to test trends in screening over time. Results: In 2012, the year when the funding for PN ceased, among 126 refugee women eligible for breast cancer screening, mammography screening rates were significantly higher among refugees (90.5%, 95% confidence interval [CI]: 83.5–94.7%) than among English speakers (81.9%, 95% CI: 76.2–86.5%, p=0.006). By 2016, screening rates decreased among refugee women (76.5%, 95% CI: 61.6–86.9%, p=0.023) but were not statistically significantly different from those among English-speaking women (80.5%, 95% CI: 74.4–85.3%, p=0.460). Screening prevalence for refugee women remained above the pre-PN program screening levels, and considerably so in women <50 years. Conclusion: The culturally and language-tailored PN program for refugee women appeared to have persistent effects, with refugee women maintaining similar levels of mammography screening to English-speaking patients 5 years after the PN program's end.
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Affiliation(s)
| | - Anne Marie McCarthy
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Wei He
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jeffrey M Ashburner
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Sanja Percac-Lima
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
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"They were just waiting to die": Somali Bantu and Karen Experiences with Cancer Screening Pre- and Post-Resettlement in Buffalo, NY. J Natl Med Assoc 2018; 111:234-245. [PMID: 30420078 DOI: 10.1016/j.jnma.2018.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/06/2018] [Accepted: 10/05/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Little is known about how pre-resettlement experiences affect refugees' uptake of cancer screenings. The objective of this study was to characterize Somali Bantu and Karen experiences with cancer and cancer screenings prior to and subsequent to resettlement in Buffalo, NY in order to inform engagement by health providers. METHODS The study was grounded in a community-based participatory research approach, with data collection and analysis guided by the Health Belief Model and life course framework. Interviews were transcribed, independently coded by two researchers, and analyzed using an immersion-crystallization approach. We conducted 15 semi-structured interviews and six interview-focus group hybrids with Somali Bantu (n = 15) and Karen (n = 15) individuals who were predominantly female (87%). RESULTS Cancer awareness was more prevalent among Karen compared to Somali Bantu participants. Prior to resettlement, preventative health care, including cancer screening, and treatment were unavailable or inaccessible to participants and a low priority compared with survival and acute health threats. There, Somali Bantu treated cancer-like diseases with traditional medicine (heated objects, poultices), and Karen reported traditional medicine and even late-stage biomedical treatments were ineffective due to extent of progressed, late-stage ulcerated tumors when care was sought. A fatalistic view of cancer was intertwined with faith (Somali Bantu) and associated with untreated, late-stage cancer (Karen). Karen but not Somali Bantu reported individuals living with cancer were stigmatized pre-resettlement due to the unpleasant manifestations of untreated, ulcerated tumors. Now resettled in the U.S., participants reported obtaining cancer screenings was challenged by transportation and communication barriers and facilitated by having insurance and interpretation services. While Somali Bantu women strongly preferred a female provider for screenings, Karen women felt cancer severity outweighed cultural modesty concerns in terms of provider gender. SIGNIFICANCE Our findings suggest the need for culturally-relevant cancer education that incorporates the life course experiences and addresses logistical barriers in linking individuals with screening, to be complemented by trauma-informed care approaches by healthcare providers.
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Griswold KS, Pottie K, Kim I, Kim W, Lin L. Strengthening effective preventive services for refugee populations: toward communities of solution. Public Health Rev 2018; 39:3. [PMID: 29450104 PMCID: PMC5809847 DOI: 10.1186/s40985-018-0082-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/16/2018] [Indexed: 11/23/2022] Open
Abstract
Refugee populations have unequal access to primary care and may not receive appropriate health screening or preventive service recommendations. They encounter numerous health care disadvantages as a consequence of low-income status, race and ethnicity, lower educational achievement, varying degrees of health literacy, and limited English proficiency. Refugees may not initially embrace the concept of preventive care, as these services may have been unavailable in their countries of origin, or may not be congruent with their beliefs on health care. Effective interventions in primary care include the appropriate use of culturally and linguistically trained interpreters for health care visits and use of evidence-based guidelines. Effective approaches for the delivery of preventive health and wellness services require community engagement and collaborations between public health and primary care. In order to provide optimal preventive and longitudinal screening services for refugees, policies and practice should be guided by unimpeded access to robust primary care systems. These systems should implement evidence-based guidelines, comprehensive health coverage, and evaluation of process and preventive care outcomes.
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Affiliation(s)
- Kim S. Griswold
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 77 Goodell St., Buffalo, NY 14203 USA
| | - Kevin Pottie
- Departments of Family Medicine and Epidemiology and Community Medicine, University of Ottawa, Stewart Street, Ottawa, ON K1N 6N5 Canada
- Bruyère Research Institute, 85 Primrose Ave, Annex E-208, Ottawa, ON K1R 6M1 Canada
- University of Ottawa, 75 Bruyère St, Ottawa, ON K1S 0P6 Canada
| | - Isok Kim
- School of Social Work, University at Buffalo, The State University of New York, Buffalo, USA
| | - Wooksoo Kim
- School of Social Work, University at Buffalo, The State University of New York, Buffalo, USA
| | - Li Lin
- Department of Industrial and Systems Engineering, University at Buffalo, The State University of New York, Buffalo, USA
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Mango VL, Ha R, Nguyen B, Mema E, Kobeski J, Singh T, Khandelwal N. RAD-AID Asha Jyoti Mammogram Quality Assessment in India: Optimizing Mobile Radiology. J Am Coll Radiol 2016; 13:831-4. [DOI: 10.1016/j.jacr.2016.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 03/10/2016] [Accepted: 03/11/2016] [Indexed: 11/16/2022]
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