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Alam Z, Dean JA, Janda M. What do South Asian immigrant women know about HPV, cervical cancer and its early detection: A cross-sectional Australian study. J Migr Health 2022; 5:100102. [PMID: 35480875 PMCID: PMC9036138 DOI: 10.1016/j.jmh.2022.100102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/30/2021] [Accepted: 04/03/2022] [Indexed: 12/01/2022] Open
Abstract
Low HPV and cervical cancer knowledge levels among South Asian immigrant women. One third participants aware of the renewed cervical screening program changes. Screening uptake significantly associated with HPV and cervical cancer awareness. GP discussion on the topic found to have important role in increasing knowledge.
Cervical cancer commonly caused by Human Papillomavirus (HPV) imposes a significant burden in Asia. This study examined the awareness and knowledge of HPV, cervical cancer, and its early detection methods among South Asian immigrant women in Australia to determine factors associated with knowledge deficits. A cross-sectional internet-based survey was completed by a convenience sample of women (n=148), with South-Asian background, residing in Queensland during May-October 2019. Main outcome variables were awareness of HPV, cervical cancer, cervical screening test (Pap test and HPV test) and HPV test self-sampling availability (Yes/No). HPV and cervical cancer knowledge were assessed via 16-item and 20 item aggregated scales respectively, (higher scores indicating better knowledge). Five individual items queried knowledge of the Pap and HPV test, and one item actual cervical screening uptake. One-way ANOVA was used to study differences in HPV and cervical cancer knowledge among sociodemographic groups. Of 148 participating women, 55% (n=86) had heard of HPV, 77% (n=114) of cervical cancer and 81.8% (n=121) of Pap tests. Only one third of participants (n=49) were aware that now an HPV test is used for cervical screening and 10% (n=15) of its self-sampling availability, whereas 55.4% (n=82) reported participation in screening previously. The mean HPV knowledge score was 5.3 (S.D: 5.7) and mean cervical cancer knowledge score 9.8 (S.D: 6.5) with zero being the most common score on both scales. Higher knowledge scores were significantly associated with higher educational level, English language proficiency, discussion with a GP on the topic and previous participation in screening. The majority of participants lacked detailed knowledge about the available screening tests. This study identified key target groups for future interventions.
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Affiliation(s)
- Zufishan Alam
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba Queensland 4102, Australia
- Corresponding author.
| | - Judith Ann Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston Queensland 4006
| | - Monika Janda
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba Queensland 4102, Australia
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Musonda JS, Sodo PP, Ayo-Yusuf O, Reji E, Musonda J, Mabuza LH, Ndimande JV, Akii J, Omole OB. Cervical cancer screening in a population of black South African women with high HIV prevalence: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001249. [PMID: 36962618 PMCID: PMC10021232 DOI: 10.1371/journal.pgph.0001249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022]
Abstract
Cervical cancer is largely preventable through early detection, but screening uptake remains low among black women in South Africa. The purpose of this study was to determine the prevalence and factors associated with cervical cancer screening in the past 10 years among black African women in primary health care (PHC) clinics, in Gauteng Province, South Africa. This was a cross-sectional study involving 672 consecutively recruited black women at cervical cancer screening programs in PHC clinics between 2017 and 2020. An interviewer-administered questionnaire covered socio-demographics, HIV status, sexual history, cervical cancer risk factors knowledge, and screening behaviours in the past 10 years. The mean age of participants was 38 years. More than half (63%) were aged 30-49 years. Most completed high school education (75%), were unemployed (61%), single (60%), and HIV positive (48%). Only 285 (42.4%) of participants reported screening for cervical cancer in the past 10 years. Of participants that reported receiving information on screening, 27.6% (n = 176) and 13.97% (n = 89) did so from healthcare facilities and community platforms respectively. Participants aged 30 years or more were more likely to report for cervical cancer screening as compared to other categories in the past 10 years. The study found low cervical cancer screening prevalence. This calls for health education campaigns and prevention strategies that would target individual patients' contexts and stages of behavioral change. Such strategies must also consider socio-demographic and clinical correlates of cervical cancer screening and promote better integration into PHC services in South Africa.
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Affiliation(s)
- Joyce Sikwese Musonda
- Department of Family Medicine & Primary Care, University of Pretoria, Pretoria, South Africa
| | - Pumla Pamella Sodo
- Division of Family Medicine, Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Olalekan Ayo-Yusuf
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Elizabeth Reji
- Department of Family Medicine, University of Free State, Bloemfontein, South Africa
| | - John Musonda
- Division of Family Medicine, Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Langalibalele Honey Mabuza
- Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - John Velaphi Ndimande
- Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Jimmy Akii
- Division of Family Medicine, Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Olufemi Babatunde Omole
- Division of Family Medicine, Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
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Elshami M, Thalji M, Abukmail H, Al-Slaibi I, Alser M, Radaydeh A, Alfuqaha A, Khader S, Khatib L, Fannoun N, Ahmad B, Kassab L, Khrishi H, Elhussaini D, Abed N, Nammari A, Abdallah T, Alqudwa Z, Idais S, Tanbouz G, Hajajreh M, Selmiyh HA, Abo-Hajouj Z, Hebi H, Zamel M, Skaik RN, Hammoud L, Rjoub S, Ayesh H, Rjoub T, Zakout R, Alser A, Abu-El-Noor N, Bottcher B. Knowledge of cervical cancer risk factors among Palestinian women: a national cross-sectional study. BMC WOMENS HEALTH 2021; 21:385. [PMID: 34727914 PMCID: PMC8561913 DOI: 10.1186/s12905-021-01510-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/12/2021] [Indexed: 12/24/2022]
Abstract
Background High awareness of cervical cancer (CC) risk factors is important to decrease the morbidity and mortality associated with CC. This study aimed to assess the knowledge level of Palestinian women about CC risk factors and to determine the factors associated with good knowledge. Methods This was a national cross-sectional study. Adult women from hospitals, primary healthcare centers, and public spaces of 11 governorates in Palestine were recruited using a stratified convenience sampling. A translated-into-Arabic version of the validated CC awareness measure (CeCAM) was used to assess the knowledge about the 11 CC risk factors. For each correctly identified risk factor, the participant was given one point. The total score was calculated and was categorized into three categories: poor knowledge (0–3), fair knowledge (4–7), and good knowledge (8–11). Results A total of 7223 participants completed the Arabic CeCAM (response rate = 89.3%) and 7058 questionnaires were included in the final analysis: 2655 from the Gaza Strip and 4403 from the West Bank and Jerusalem. Participants recruited from the Gaza Strip were younger, getting lower monthly incomes, and with less chronic diseases than participants recruited from the West Bank and Jerusalem. The most frequently identified risk factor was ‘having a weakened immune system’ (n = 5458, 77.3%) followed by ‘infection with a sexually transmitted infection’ (n = 5388, 76.3%). The least identified risk factor was ‘having many children’ (n = 1597, 22.6%). Only 1670 women (23.7%) had good knowledge of CC risk factors. Women living in the Gaza Strip were more likely than women living in the West Bank and Jerusalem to have good knowledge (25.2% vs 22.7%). Completing a secondary or diploma degree, being employed, and having a monthly income of ≥ 1450 NIS (around $450) were all associated with lower likelihood of having good knowledge of CC risk factors. Conversely, knowing someone with cancer was associated with higher likelihood of having good knowledge. Conclusion The overall awareness of CC risk factors was low. There is a substantial need to establish educational programs to promote Palestinian women’s awareness of CC. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01510-2.
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Affiliation(s)
- Mohamedraed Elshami
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Ministry of Health, Gaza, Palestine.
| | - Mariam Thalji
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Hanan Abukmail
- Ministry of Health, Gaza, Palestine.,Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | | | - Afnan Radaydeh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Alaa Alfuqaha
- Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine
| | - Salma Khader
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Lana Khatib
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Nour Fannoun
- Faculty of Pharmacy, Alazhar University of Gaza, Gaza, Palestine
| | - Bisan Ahmad
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Hiba Khrishi
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | - Deniz Elhussaini
- Faculty of Medicine, Alazhar University of Gaza, Gaza, Palestine
| | - Nour Abed
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | - Aya Nammari
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Zaina Alqudwa
- Faculty of Medicine, Alazhar University of Gaza, Gaza, Palestine
| | - Shahd Idais
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Ghaid Tanbouz
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | | | - Hala Abu Selmiyh
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | - Haya Hebi
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Manar Zamel
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Lama Hammoud
- Faculty of Dentistry and Dental Surgery, Al-Quds University, Jerusalem, Palestine
| | - Saba Rjoub
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Hadeel Ayesh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Toqa Rjoub
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Rawan Zakout
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
| | | | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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Abdi HI, Hoover E, Fagan SE, Adsul P. Cervical Cancer Screening Among Immigrant and Refugee Women: Scoping-Review and Directions for Future Research. J Immigr Minor Health 2021; 22:1304-1319. [PMID: 32350683 DOI: 10.1007/s10903-020-01014-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study is to explore existing research on determinants of cervical cancer screening among immigrants and refugees in the U.S. A scoping review was conducted on 77 studies targeting immigrant and/or refugee women in the U.S., investigating factors related to cervical cancer screening. Sixty-three percent of studies were conducted in the past ten years, and included 122,345 women. Studies predominately explored knowledge, beliefs and barriers related to cervical cancer and screening. Common beliefs included fear of cancer, treatment and death. Participants perceived pap smears to be associated with embarrassment, pain and fear. Barriers to screening were reported in three categories: psychosocial (shame and embarrassment), communication (inability to speak in English), and barriers related to access (lack of insurance or primary care provider). Study findings indicate research focused at the individual-level and future research should focus on exploring multilevel influences on cancer screening uptake.
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Affiliation(s)
- Hamdi I Abdi
- Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware St. S.E., Minneapolis, MN, 55455, USA
| | | | | | - Prajakta Adsul
- Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Comprehensive Cancer Center, 1 University of New Mexico, 2325 Camino de Salud, Albuquerque, NM, 87131, USA.
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Lu L, Liu J, Yuan YC. Health Information Seeking Behaviors and Source Preferences between Chinese and U.S. Populations. JOURNAL OF HEALTH COMMUNICATION 2020; 25:490-500. [PMID: 33150861 DOI: 10.1080/10810730.2020.1806414] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study examined similarities and differences in health information-seeking behaviors between American and Chinese people using data from the 2017 U.S. Health Information National Trends Survey (HINTS) and the 2017 China HINTS. It is one of the first studies that use comparable samples and survey instruments to make direct comparisons of the two populations' health information-seeking behaviors. Results showed that Americans (including different racial/ethnic groups in the U.S.) were more likely to actively seek health information than Chinese people. Americans were also more likely to use mediated communication as their primary sources of health information while Chinese people favored interpersonal sources. Chinese people reported lower quality of doctor-patient communication than their American counterparts. These differences between the two countries highlight the importance of using different information sources to reach specific populations, and the need to develop tailored public health intervention programs in different cultures.
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Affiliation(s)
- Linqi Lu
- College of Media and International Culture, Zhejiang University , Hangzhou, Zhejiang, China
- Department of Communication, Cornell University , Ithaca, New York, USA
| | - Jiawei Liu
- Department of Communication, Cornell University , Ithaca, New York, USA
| | - Y Connie Yuan
- Department of Communication, Cornell University , Ithaca, New York, USA
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Seo JY, Li J, Li K. Cervical Cancer Screening Experiences Among Chinese American Immigrant Women in the United States. J Obstet Gynecol Neonatal Nurs 2018; 47:52-63. [PMID: 29144960 PMCID: PMC6260927 DOI: 10.1016/j.jogn.2017.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To understand the experiences and perceptions of having cervical cancer screening tests and to explore the extant barriers to having the tests among first-generation Chinese American women in the United States. DESIGN Qualitative, descriptive, phenomenological research. SETTING Los Angeles, California. PARTICIPANTS Snowball and purposive sampling of 12 Chinese American immigrant women ages 20 to 65 years. METHODS Individual face-to-face, in-depth, semistructured interviews in which participants were asked about their experiences and perceptions about cervical cancer screening. Interviews were audiotaped, transcribed, and translated into English. Data analysis included comparing and distinguishing, collecting and counting, and presupposing and inferring. RESULTS Through the analysis process, we identified four major themes that reflected the experiences, perceptions, and barriers to having cervical cancer screening among Chinese American women: Belief in a Healthy Lifestyle, Maintaining Privacy for Female Health Problems, Fear of Losing Control, and Feeling Vulnerable in an Unfamiliar Health Care System. These themes indicated that Chinese immigrant women in the United States face challenges to their cultural health beliefs and practices with regard to decision-making and health-seeking behaviors related to cervical cancer screening. They felt more vulnerable as immigrants because of systematic barriers to navigation of the unfamiliar health care system and limited resources. CONCLUSION Women's health care providers should be aware of and give consideration to cultural differences through the provision of more educational information and comfort to Chinese immigrant women who seek cervical cancer screening. Ultimately, the development of culturally appropriate and affordable cancer prevention programs with effective strategies is important to ease Chinese American women's senses of vulnerability.
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Seng LM, Rosman AN, Khan A, Haris NM, Mustapha NAS, Husaini NSM, Zahari NF. Awareness of cervical cancer among women in Malaysia. Int J Health Sci (Qassim) 2018; 12:42-48. [PMID: 30022903 PMCID: PMC6040851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The purpose of this study is to evaluate and ascertain the current knowledge, perception, level of awareness, and attitudes toward cervical cancer (CC) among women in Malaysia. METHODS A cross-sectional study was conducted which involved 210 women aged between 21 and 60 years old at the public in Malaysia, a subsequent statistical analysis was performed by SPSS version 22. RESULTS In comparison with other studies, there is still lacking of awareness on CC and these induced informal cluelessness and poor attitudes toward it. In terms of risk factors, there are two factors with some degree of awareness among women in Malaysia, i.e., multiple sexual partners and sexually transmitted diseases. Women in Malaysia have less awareness on the causes and clinical manifestations of the disease (P < 0.05). They are aware that regular papanicolaou (Pap) smear would screen CC and surgery could be a treatment of choice. In addition, women in Malaysia also have moderate awareness about Pap smear as prevention to detect and prevent CC at the early stage. CONCLUSIONS Women in Malaysia only has a good awareness about multiple sex partner and sexually transmitted disease as a risk factor for CC, they also have good knowledge on regular Pap smear as a tool to diagnose and surgery as a treatment. Future, further effort is required to promote awareness of women's perception and attitudes toward CC.
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Affiliation(s)
- Lee Mun Seng
- Department of Clinical, Faculty of Medicine, Quest International University Perak, No. 122A, Jalan Hj. Eusoff, Housing Trust, 30250 Ipoh, Perak Darul Ridzuan, Malaysia,Address for correspondence: Dr. Lee Mun Seng, Faculty of Medicine, Quest International University Perak, No. 122A, Jalan Hj. Eusoff, Housing Trust, 30250 Ipoh, Perak Darul Ridzuan, Malaysia. E-mail:
| | - Aina Najwa Rosman
- Department of Clinical, Faculty of Medicine, Quest International University Perak, No. 122A, Jalan Hj. Eusoff, Housing Trust, 30250 Ipoh, Perak Darul Ridzuan, Malaysia
| | - Almas Khan
- Department of Clinical, Faculty of Medicine, Quest International University Perak, No. 122A, Jalan Hj. Eusoff, Housing Trust, 30250 Ipoh, Perak Darul Ridzuan, Malaysia
| | - Najwa Md Haris
- Department of Clinical, Faculty of Medicine, Quest International University Perak, No. 122A, Jalan Hj. Eusoff, Housing Trust, 30250 Ipoh, Perak Darul Ridzuan, Malaysia
| | - Nur Alyan Syahmi Mustapha
- Department of Clinical, Faculty of Medicine, Quest International University Perak, No. 122A, Jalan Hj. Eusoff, Housing Trust, 30250 Ipoh, Perak Darul Ridzuan, Malaysia
| | - Nur Sakina Muhammad Husaini
- Department of Clinical, Faculty of Medicine, Quest International University Perak, No. 122A, Jalan Hj. Eusoff, Housing Trust, 30250 Ipoh, Perak Darul Ridzuan, Malaysia
| | - Nurul Fadhilah Zahari
- Department of Clinical, Faculty of Medicine, Quest International University Perak, No. 122A, Jalan Hj. Eusoff, Housing Trust, 30250 Ipoh, Perak Darul Ridzuan, Malaysia
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Uysal Toraman A, Yildirim N. Knowledge About Cervical Cancer Risk Factors and Practices of Pap Testing Among Turkish Immigrant Women in the United States. J Immigr Minor Health 2017; 20:1222-1229. [PMID: 28929252 DOI: 10.1007/s10903-017-0653-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective of this study was to examine knowledge about cervical cancer risk factors and practices of Pap testing among female Turkish immigrants in the state of Florida in the United States of America (USA). This descriptive study was conducted between April and September 2012. The study sampling was consist of 156 Turkish women living in the state of Florida. A questionnaire-based survey was conducted among the population of Turkish immigrant women. On the survey form comprised of a total of 37 questions and three sections there are questions pertaining to the socio-demographic characteristics of the individuals, their knowledge on the cervical cancer risk factors and their approach to getting Pap smear tests. Statistical Package for Social Sciences (version 16.0) was used to compute frequency and descriptive statistics related to demographic data. The average age of the women is 35.67 ± 10.0. More than half of women (66%) women reported cervical cancer screening at least one. Over two-thirds knew that having abnormal vaginal bleeding (85.8%) and vaginal infections (78.2%), having sexual activity with a man who has had multiple sexual partners (61.5%), and having multiple sexual partners (61.5%) increase the risk of cervical cancer. The result of the multivariate regression analysis have determined that the age of immigrant women (OR 11.3, 95 % CI 5.1-25.2, p:0.000) and the number of children ( OR 3.4, 95 % CI 1.7-6.9, p:0.000) are factors that impact pap smear testing behavior. Our study findings confirm low levels of Pap testing and show important knowledge deficits about cervical cancer risk factors and the importance of Pap testing among Turkish immigrant women. It is recommended that the immigrant women be educated about cervical cancer by means of organizing conferences in their own language and preparing informative materials.
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Affiliation(s)
- Aynur Uysal Toraman
- Department of Public Health Nursing, Faculty of Nursing, Ege University, 35100, Bornova, Izmir, Turkey.
| | - Nilufer Yildirim
- Department of Public Health Nursing, Faculty of Nursing, Ege University, 35100, Bornova, Izmir, Turkey
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Oba S, Toyoshima M, Ogata H. Association of Cervical Cancer Screening with Knowledge of Risk Factors, Access to Health Related Information, Health Profiles, and Health Competence Beliefs among Community-Dwelling Women in Japan. Asian Pac J Cancer Prev 2017; 18:2115-2121. [PMID: 28843231 PMCID: PMC5697469 DOI: 10.22034/apjcp.2017.18.8.2115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: The aim of this study was to evaluate the past attendance for cervical cancer screening with knowledge
of risk factors, access to health-related information, health profiles and health competence beliefs among Japanese
women. Methods: Women ages 25, 30, 35, 40, 45, 50, 55, and 60 were contacted cross-sectionally as part of a project
for the Japanese Ministry of Health, Labour and Welfare in Nikaho, Akita prefecture Japan between June 2010 and
March 2011, and 249 women were analyzed for the current study. The questionnaire asked about past cervical cancer
screening. Knowledge of each cervical cancer risk factor was determined on a four-point scale. A barriers to information
access scale was utilized to assess the degree of difficulty in accessing health-related information. Health profiles were
measured using the EuroQOL EQ-5D. Perceived health competence was measured using a scale (PHCS). The association
was evaluated with odds ratios with 95% confidence interval were calculated from a logistic regression analysis after
adjustment for age and potential confounders. The trend across the level was also assessed. Results: Women who knew
that sexual intercourse at young age was a risk factor were significantly more likely to have participated in cervical
cancer screening sometime in their lives (p for trend =0.02). Women who had pain/discomfort and those who had
anxiety/depression were significantly more likely to have participated in cervical screening within the past two years
(odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.04–3.94; OR: 2.32, 95% CI: 1.05–5.16, respectively). Women
with higher PHCS were significantly more likely to have attended for cervical screened at some point in their lives
(p=0.04). Conclusion: This study observed that specific knowledge of cervical cancer risk factors, health profiles and
PHCS were associated with the past attendance for cervical cancer screening among women in a community. Further
researches are warranted.
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Affiliation(s)
- Shino Oba
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, Japan.
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Hulme J, Moravac C, Ahmad F, Cleverly S, Lofters A, Ginsburg O, Dunn S. "I want to save my life": Conceptions of cervical and breast cancer screening among urban immigrant women of South Asian and Chinese origin. BMC Public Health 2016; 16:1077. [PMID: 27733161 PMCID: PMC5062908 DOI: 10.1186/s12889-016-3709-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 09/23/2016] [Indexed: 11/13/2022] Open
Abstract
Background Breast and cervical cancer screening rates remain low among immigrant women and those of low socioeconomic status. The Cancer Awareness: Ready for Education and Screening (CARES) project ran a peer-led multi-lingual educational program between 2012 and 2014 to reach under and never-screened women in Central Toronto, where breast and cervical cancer screening rates remain low. The objective of this qualitative study was to better understand how Chinese and South Asian immigrants – the largest and most under-screened immigrant groups according to national and provincial statistics - conceive of breast and cervical cancer screening. We explored their experiences with screening to date. We explicitly inquired about their perceptions of the health care system, their screening experiences with family physicians and strategies that would support screening in their communities. Methods We conducted 22 individual interviews and two focus groups in Bengali and Mandarin with participants who had attended CARES educational sessions. Transcripts were coded through an iterative constant comparative and interpretative approach. Results Themes fell into five major, overlapping domains: risk perception and concepts of preventative health and screening; health system engagement and the embedded experience with screening; fear of cancer and procedural pain; self-efficacy, obligation, and willingness to be screened; newcomer barriers and competing priorities. These domains all overlap, and contribute to screening behaviours. Immigrant women experienced a number of barriers to screening related to ‘navigating newness’, including transportation, language barriers, arrangements for time off work and childcare. Fear of screening and fear of cancer took many forms; painful or traumatic encounters with screening were described. Female gender of the provider was paramount for both groups. Newly screened South Asian women were reassured by their first encounter with screening. Some Chinese women preferred the anonymous screening options available in China. Women generally endorsed a willingness to be screened, and even offered to organize women in their community hubs to access screening. Conclusions The experience of South Asian and Chinese immigrant women suggests that under and never-screened newcomers may be effectively integrated into screening programs through existing primary care networks, cultural-group specific outreach, and expanding access to convenient community -based screening.
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Affiliation(s)
- Jennifer Hulme
- Emergency Department, University Health Network, University of Toronto, Toronto, Canada. .,Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
| | - Catherine Moravac
- Postgraduate Medical Education, University of Toronto, Toronto, Canada
| | - Farah Ahmad
- Faculty of Health, School of Health Policy and Management, York University, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shelley Cleverly
- Postgraduate Medical Education, University of Toronto, Toronto, Canada.,Centre for Health Promotion, Department of Public Health Sciences, University of Toronto, Toronto, Canada
| | - Aisha Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada.,Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Department of Family and Community Medicine, St. Michael Hospital, Toronto, Canada
| | - Ophira Ginsburg
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Women's College Research Institute, Toronto, Canada.,Department of Medicine, University of Toronto, Toronto, Canada
| | - Sheila Dunn
- Women's College Research Institute, Toronto, Canada.,Women's College Hospital, Toronto, Canada
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Hussain S, Nasare V, Kumari M, Sharma S, Khan MA, Das BC, Bharadwaj M. Perception of human papillomavirus infection, cervical cancer and HPV vaccination in North Indian population. PLoS One 2014; 9:e112861. [PMID: 25386964 PMCID: PMC4227878 DOI: 10.1371/journal.pone.0112861] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 10/20/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) -associated cervical cancer is the second-most common cancer in women worldwide but it is the most frequent gynaecological cancer and cancer associated death in India women. The objective of this study was to assess knowledge about cervical cancer, HPV, HPV vaccine, HPV vaccine acceptance among school and undergraduates students and their parent's perception about acceptance of HPV vaccine in Northern part of India (Delhi and NCR regions). MATERIALS AND METHODS A qualitative questionnaire based survey among 2500 urban/rural students aged 12-22 years was conducted. RESULTS Overall, a low frequency (15%) of HPV and cervical cancer awareness was observed in students and their parents. However, the awareness was much higher in females belonging to urban setup compared to boys with a perception that HPV causes cervical cancer in women only. Additionally, only (13%) participants who were aware of cervical cancer and HPV) were willing to accept HPV vaccination. Apparently, parents of female students were two times more willing to accept HPV vaccination for their ward than male students (p<0.001; OR 95%CI = 2.09 (1.58-2.76). CONCLUSION Cervical cancer and HPV awareness among school, undergraduate students and also to their parents was found to be very low in this part of India. The level of awareness and education appears to be insignificant determinants in rural compared to urban setup. Better health education will be needed to maximize public awareness for cervical cancer prevention.
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Affiliation(s)
- Showket Hussain
- Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Vilas Nasare
- Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Malasha Kumari
- Division of Clinical Oncology, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Shashi Sharma
- Division of Biostatistics & Epidemiology, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Mohammad Aijaz Khan
- Division of Behaviour Oncology, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
- * E-mail: (MB); (MAK)
| | - Bhudev C. Das
- Division of Molecular Oncology, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Mausumi Bharadwaj
- Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
- * E-mail: (MB); (MAK)
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12
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Ma GX, Wang MQ, Ma XS, Shive SE, Tan Y, Toubbeh JI. Pathways of cervical cancer screening among Chinese women. Int J Womens Health 2013; 5:351-9. [PMID: 23843708 PMCID: PMC3702238 DOI: 10.2147/ijwh.s45405] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background The purpose of this community-based study was to develop a structural equation model for factors contributing to cervical cancer screening among Chinese American women. Methods A cross-sectional design included a sample of 573 Chinese American women aged 18 years and older. The initial step involved use of confirmatory factor analysis, that included the following variables: access to and satisfaction with health care, and enabling and predisposing cultural and health beliefs. Structural equation model analyses were conducted on factors related to cervical cancer screening. Results Age, marital status, employment, household income, and having health insurance, but not educational level, were significantly related to cervical screening status. Predisposing and enabling factors were positively associated with cervical cancer screening. The cultural factor was significantly related to the enabling factor or the satisfaction with health care factor. Conclusion This model highlights the significance of sociocultural factors in relation to cervical cancer screening. These factors were significant, with cultural, predisposing, enabling, and health belief factors and access to and satisfaction with health care reinforcing the need to assist Chinese American women with poor English fluency in translation and awareness of the importance of cervical cancer screening. Community organizations may play a role in assisting Chinese American women, which could enhance cervical cancer screening rates.
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Affiliation(s)
- Grace X Ma
- Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA
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Chinese-Australian Women’s Knowledge, Facilitators and Barriers Related to Cervical Cancer Screening: A Qualitative Study. J Immigr Minor Health 2011; 13:1076-83. [DOI: 10.1007/s10903-011-9491-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Muliira JK, Kisaakye E, Kizza IB, Suubi RR. Perceived cervical cancer risk, knowledge and preventive practices. ACTA ACUST UNITED AC 2011. [DOI: 10.12968/ajmw.2011.5.2.87] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Irene Betty Kizza
- Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rhoda Racheal Suubi
- of Maternal and Child Health Nursing, Sultan Qaboos University, College of Nursing, Muscat, Oman
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15
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Cooper CP, Polonec L, Gelb CA. Women's Knowledge and Awareness of Gynecologic Cancer: A Multisite Qualitative Study in the United States. J Womens Health (Larchmt) 2011; 20:517-24. [DOI: 10.1089/jwh.2011.2765] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Lindsey Polonec
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cynthia A. Gelb
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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16
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Chen CJ, Kendall J, Shyu YIL. Grabbing the rice straw: health information seeking in Chinese immigrants in the United States. Clin Nurs Res 2011; 19:335-53. [PMID: 20601638 DOI: 10.1177/1054773810372542] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chinese immigrants in the United States experience a higher incidence of cancers of the oral cavity, pharynx, stomach, and liver and higher rates of tuberculosis and hepatitis B virus than other U.S. immigrant groups. Because of language and cultural barriers, many do not seek the health information they need, resulting in delayed diagnosis and inability to effectively manage health problems. The purpose of this study was to identify the cultural beliefs and meanings influencing the utilization behaviors and perceptions of how this group finds and uses the health information they need. Using an explorative qualitative descriptive design, 24 Chinese immigrants in two urban centers in the northwestern part of the United States were interviewed about their beliefs and perceptions of health information. Results revealed many challenges that served as barriers to health promotion, indicating that health care providers need to respond to the needs of this population with increased thoughtfulness and culturally relevant practices.
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Affiliation(s)
- Chih-Ju Chen
- School of Nursing, National Taichung Nursing College, Taichung, Taiwan
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17
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Fang CY, Ma GX, Tan Y. Overcoming Barriers to Cervical Cancer Screening Among Asian American Women. ACTA ACUST UNITED AC 2011; 4:77-83. [PMID: 21687826 DOI: 10.7156/v4i2p077] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Significant disparities in cervical cancer incidence and mortality exist among ethnic minority women, and in particular, among Asian American women. These disparities have been attributed primarily to differences in screening rates across ethnic/racial groups. Asian American women have one of the lowest rates of screening compared to other ethnic/racial groups. Yet Asian Americans, who comprise one of the fastest growing populations in the United States, have received the least attention in cancer control research. Studies suggest that various factors, including lack of knowledge, psychosocial and cultural beliefs, and access barriers, are associated with cervical cancer screening behaviors among Asian American women. Indeed, the few interventions that have been developed for Asian American women demonstrate that targeting these factors can yield significant increases in screening rates. It is important to note, however, that the effectiveness of educational interventions is often attenuated if access barriers are not adequately addressed. Hence, interventions that include key essential components, such as the use of community individuals as lay health workers, culturally-tailored and linguistically-appropriate educational materials, and navigation assistance to overcome access barriers, are more likely to be successful in enhancing screening rates. As the benefits of community-based cervical cancer prevention programs become more apparent, it will be essential to identify effective approaches for disseminating such programs more broadly. In conclusion, community-based cervical cancer screening programs have demonstrated promise in addressing existing cervical cancer disparities by increasing awareness and knowledge and promoting recommended screening behaviors. These findings will be instrumental in guiding future community-based programs to reduce cervical cancer health disparities among Asian American women.
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Affiliation(s)
- Carolyn Y Fang
- Fox Chase Cancer Center, Cancer Prevention and Control Program, Robert C. Young Pavilion, 4 Floor, 333 Cottman Avenue, Philadelphia, Pennsylvania 19111, Tel: 215-728-4062, ,
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18
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Howlett RI, Larsh S, Dobi L, Mai V. Promoting cancer screening among Ontario Chinese women. Canadian Journal of Public Health 2010. [PMID: 19722348 DOI: 10.1007/bf03403954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Cancer screening participation is typically low among newcomers to Canada. Consequently, mortality and morbidity rates are higher in ethno/cultural populations. There are inherent challenges in reaching these population groups to increase awareness and participation in cancer screening. Many reports have cited the need for culturally appropriate materials and multi-pronged strategies for effective outreach in the Chinese community. This paper outlines the consultation/development process and evaluation strategy for promoting cancer screening among Chinese women with limited English language skills. PARTICIPANTS As Chinese is the third most commonly spoken language in Canada, this community education project focused on health promoters providing services to Chinese women 50 years and older. SETTING Ontario communities. INTERVENTION Partners and stakeholders were consulted and engaged to define the best approach to develop and distribute culturally sensitive public education resources to assist communities in realizing greater awareness of and participation in cancer screening. OUTCOMES Customized resource kits were developed and distributed to the target population over the course of two phases of this project. An evaluation strategy was designed and implemented to assess the impact of the project. CONCLUSION The process to develop culturally sensitive and evidence-based materials for Chinese is detailed in this article. This multi-year project designed and distributed customized resource kits, through consultation with partners and stakeholders. Project outcomes will be further assessed one year after distribution of the kits. This project template may be useful for adaptation and use in other ethnocultural groups within and outside Ontario.
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Ma GX, Toubbeh JI, Wang MQ, Shive SE, Cooper L, Pham A. Factors associated with cervical cancer screening compliance and noncompliance among Chinese, Korean, Vietnamese, and Cambodian women. J Natl Med Assoc 2010; 101:541-51. [PMID: 19585922 DOI: 10.1016/s0027-9684(15)30939-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to determine factors associated with cervical cancer screening compliance and noncompliance among Chinese, Korean, Vietnamese, and Cambodian women aged 18 years and older. METHODS A cross-sectional design was used. The sample consisted of 1049 women aged 18 or older, of whom 37.94% reported never having been screened for cervical cancer, 23.55% reported noncompliance, and 38.51% were in compliance with screening guidelines. The sample was comprised of Chinese, 50.58%; Koreans, 17.50%; Vietnamese, 16.15%; and Cambodians, 15.77%. RESULTS Education was significantly associated with never having been screened for cervical cancer for Cambodians. Low income (<$10000) was significantly associated with never having been screened for Cambodian and Chinese women. Not having health insurance was significantly correlated with not getting screened for all ethnic groups. Age and living in the United States less than 15 years were significantly correlated with never having been screened for Vietnamese, Korean, and Chinese women. Marital status was significantly correlated with not getting screened for Korean and Chinese women. English fluency was significantly associated with screening for Cambodians, Koreans, and Chinese. Barriers associated with women who were never screened compared to those barriers for women who were screened and were compliant included lack of knowledge, psychosocial, no insurance, language, transportation, and lack of time, but these barriers were different among the 4 ethnic groups. CONCLUSION Compliance with cervical cancer screening guidelines among Asian American women can be enhanced significantly by providing culturally and linguistically appropriate educational and early intervention programs.
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Affiliation(s)
- Grace X Ma
- Department of Public Health, College of Health Professions, Temple University, Philadelphia, Pennsylvania 19122-0843, USA.
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20
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Wang X, Fang C, Tan Y, Liu A, Ma GX. Evidence-based intervention to reduce access barriers to cervical cancer screening among underserved Chinese American women. J Womens Health (Larchmt) 2010; 19:463-9. [PMID: 20156089 PMCID: PMC2867551 DOI: 10.1089/jwh.2009.1422] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The primary objective of the present study was to evaluate the effects of a community-based pilot intervention that combined cervical cancer education with patient navigation on cervical cancer screening behaviors among Chinese American women residing in New York City. METHODS Chinese women (n = 134) who had not had a Pap test within the previous 12 months were recruited from four Asian community-based organizations (CBOs). Women from two of the CBOs received the intervention (n = 80) consisting of education, interaction with a Chinese physician, and navigation assistance, including help in identifying and accessing free or low-cost screening services. The control group (n = 54) received education delivered by Chinese community health educators and written materials on general health and cancer screening, including cervical cancer, the Pap test, and information about sites that provided free screening. Study assessments were obtained in-person at baseline and postintervention. Screening behavior was self-reported at 12-month postintervention and verified by medical staff. RESULTS In the 12-month interval following the program, screening rates were significantly higher in the intervention group (70%) compared to the control group (11.1%). Hierarchical logistic regression analyses indicated that screening behavior was associated with older age (OR = 1.08, 95% CI = 1.01-1.15, p < .05). In addition, women with poorer English language fluency (OR = 0.30, 95% CI = 0.10-0.89, p < .05) and who did not have health insurance were less likely to obtain screening (OR = 0.15, 95% CI = 0.02-0.96, p < .05). Among health beliefs, greater perceived severity of disease was positively associated with screening behavior (OR = 4.26, 95% CI = 1.01-18.04, p < .05). CONCLUSIONS Community-based programs that provide combined education and patient navigation may be effective in overcoming the extensive linguistic and access barriers to screening faced by Chinese American women.
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Affiliation(s)
- Xingjie Wang
- Center for Asian Health, Department of Public Health, College of Health Professions, Temple University, Philadelphia, Pennsylvania
- Chinese Community Clinic, Flushing, New York
| | - Carolyn Fang
- Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Yin Tan
- Center for Asian Health, Department of Public Health, College of Health Professions, Temple University, Philadelphia, Pennsylvania
| | - Andy Liu
- Chinese American Community Business Network, New York, New York
| | - Grace X. Ma
- Center for Asian Health, Department of Public Health, College of Health Professions, Temple University, Philadelphia, Pennsylvania
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21
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Stein K, Zhao L, Crammer C, Gansler T. Prevalence and sociodemographic correlates of beliefs regarding cancer risks. Cancer 2007; 110:1139-48. [PMID: 17657733 DOI: 10.1002/cncr.22880] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Inaccurate beliefs about cancer risk may contribute to unhealthy lifestyle behaviors and poor adherence to recommended screening and prevention guidelines. To address this issue the current study assessed the prevalence and sociodemographic correlates of scientifically unsubstantiated beliefs about cancer risk in a representative sample of the US population. METHODS Nine hundred fifty-seven US adults with no history of cancer were surveyed by telephone. The survey included 12 statements about cancer risk, risk factors, and prevention that were framed to be contrary to the consensus of current scientific evidence. RESULTS Participants were inconsistent in their ability to identify the statements as false, and appraisal accuracy was associated with several sociodemographic characteristics. Five of the 12 misconceptions were endorsed as true by at least a quarter of the respondents, and uncertainty was higher than 15% for 7 statements. At the same time, more than two-thirds of the participants were able to identify 7 statements as false and, on average, respondents endorsed fewer than 3 statements as true. Respondents who were male, older, non-White, less educated, and of lower income were most likely to hold inaccurate beliefs. CONCLUSIONS A notable percentage of the participants in this study hold beliefs about cancer risk at odds with the prevailing scientific evidence. Because the population segments with the least accurate knowledge also bear the greatest burden of cancer, areas for public education and intervention efforts are identified.
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Affiliation(s)
- Kevin Stein
- Behavioral Research Center, American Cancer Society, Atlanta, GA 30303, USA.
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22
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Merchant RC, Gee EM, Bock BC, Becker BM, Clark MA. Correlates of women's cancer screening and contraceptive knowledge among female emergency department patients. BMC WOMENS HEALTH 2007; 7:7. [PMID: 17519020 PMCID: PMC1890545 DOI: 10.1186/1472-6874-7-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2006] [Accepted: 05/22/2007] [Indexed: 11/17/2022]
Abstract
Background Lack of knowledge regarding preventive health services for women might impede campaigns to expand these services in the emergency department setting. For 18–55-year-old English-speaking women visiting an urban emergency department, we aimed to: (1) Ascertain their knowledge regarding the applicability, purpose, and recommended intervals of three women's cancer screening and three contraceptive methods; and (2) Determine if patient age, race/ethnicity, medical insurance status, and current or recent usage of these methods are associated with greater or lesser knowledge about them. Methods Emergency department-based survey on recent or current usage and knowledge about Pap smears, breast self-examinations, mammograms, condoms, birth control, and emergency contraception. Analyses included calculation of summary statistics and creation of multivariable logistic regression models. Results Of 1,100 patients eligible for the study, 69.9% agreed to participate. Most of the participants were < age 35, white, single (never married and no partner), Catholic, and had private medical insurance. Participant's recent or current usage of a particular cancer screening or contraceptive method varied by type of method: Pap smear within the past year (69.1%), breast self-exam within the past month (45.5%), mammogram within the past year (65.7% for women age 45–55), condom usage during every episode of sexual intercourse (15.4%), current usage of birth control pills (17.8%), and ever use of emergency contraception (9.3%). The participants correctly answered 87.9% of all survey questions about condoms, 82.5% about birth control pills, 78.5% about breast self-exams, 52.9% about Pap smears, 35.4% about mammograms, and 25.0% about emergency contraception. In multivariable logistic regression models, survey participants who had private medical insurance and those who recently or currently used a given screening or contraceptive method had a greater odds of correctly answering all questions about each cancer screening or contraceptive method. Conclusion Although these female ED patients demonstrated strong knowledge on some women's cancer screening and contraceptive methods, there were several areas of knowledge deficit. Women without private medical insurance and those who have not used a particular cancer screening or contraceptive method demonstrated less knowledge. Reduced knowledge about women's cancer screening and contraceptive methods should be considered during clinical encounters and when instituting or evaluating emergency department-based initiatives that assess the need for these methods.
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Affiliation(s)
- Roland C Merchant
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Erin M Gee
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Beth C Bock
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, USA
| | - Bruce M Becker
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Melissa A Clark
- Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Do HH, Taylor VM, Burke N, Yasui Y, Schwartz SM, Jackson JC. Knowledge about cervical cancer risk factors, traditional health beliefs, and Pap testing among Vietnamese American women. J Immigr Minor Health 2007; 9:109-14. [PMID: 17165138 DOI: 10.1007/s10903-006-9025-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The objective of this paper was to examine knowledge about cervical cancer risk factors and traditional health beliefs in relation to Papanicolaou (Pap) testing among Vietnamese women. METHODS A population-based survey was conducted in Seattle (n<352, response rate=82%) during 2002. RESULTS The proportions of women who knew that older age, not getting regular Pap tests, and Vietnamese ethnicity are associated with an elevated cervical cancer risk were only 53%, 62%, and 23%, respectively. The majority (87%) incorrectly believed poor women's hygiene is a risk factor for cervical cancer. Approximately two-thirds (68%) of the women had received a Pap test during the preceding three years. Knowing that lack of Pap testing increases the risk of cervical cancer was strongly associated (p<0.001) with recent Pap smear receipt. CONCLUSION Our results confirm that Vietnamese women have lower levels of cervical cancer screening than non-Latina white women. Intervention programs addressing Pap testing in Vietnamese communities should recognize women's traditional beliefs while encouraging them to adopt biomedical preventive measures into their daily lives.
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Affiliation(s)
- H Hoai Do
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, PO Box 19024, M3-B232, Seattle, WA 98109-1024, USA.
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Donovan RJ, Carter OBJ, Byrne MJ. People's perceptions of cancer survivability: implications for oncologists. Lancet Oncol 2006; 7:668-75. [PMID: 16887484 DOI: 10.1016/s1470-2045(06)70794-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Individuals typically overestimate survival for lung cancer and underestimate it for melanoma. However, reporting of results generally masks the extent of disagreement between people on survival rates. Most methods used to question individuals are of little use and are not comparable across studies. The topic of people's perceptions of survival for various cancers is under-researched. A clearer definition is needed of survivability, as is a standard way to measure it and then present the information. We have undertaken a review of studies reporting public perceptions of cancer survival rates and compared the results, where possible, with actual survival rates. We also investigate some potential implications of people's underestimation or overestimation of survival for screening and prevention behaviours and delineate implications for oncologists.
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Affiliation(s)
- Robert J Donovan
- Centre for Behavioural Research in Cancer Control, Curtin University, Bentley, WA 6102, Australia.
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Gany FM, Herrera AP, Avallone M, Changrani J. Attitudes, knowledge, and health-seeking behaviors of five immigrant minority communities in the prevention and screening of cancer: a focus group approach. ETHNICITY & HEALTH 2006; 11:19-39. [PMID: 16338753 DOI: 10.1080/13557850500391394] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Despite an observed decrease in overall cancer death rates in the USA, immigrant minorities continue to experience disproportionately higher cancer incidence and mortality rates. Thirteen focus groups were conducted in the Haitian, English-Speaking Caribbean, Latino, Korean, and Chinese communities of New York City to better understand their health-seeking behaviors with respect to cancer prevention, screening, and treatment. Focus groups addressed the degree to which cultural, linguistic, and systematic barriers impact these behaviors and explored methods to support salutary behaviors. Findings underscored that, while there are many similarities across immigrant groups, there are significant variations between the immigrant groups to necessitate a tailored community-based approach. The prevalent misinformation observed among all groups warrants the prompt development of culturally competent programs for cancer control with immigrant minorities.
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Affiliation(s)
- Francesca M Gany
- Center for Immigrant Health, NYU School of Medicine, Primary Care Division, New York, NY 10016, USA.
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Chen H, Tu SP, Teh CZ, Yip MP, Choe JH, Hislop TG, Taylor VM, Thompson B. LAY BELIEFS ABOUT HEPATITIS AMONG NORTH AMERICAN CHINESE: IMPLICATIONS FOR HEPATITIS PREVENTION. J Community Health 2006; 31:94-112. [PMID: 16737171 DOI: 10.1007/s10900-005-9000-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The objective was to learn about the hepatitis prevention behavior of relatively unacculturated North American Chinese adults, along with their knowledge, beliefs, and perceptions with regard to hepatitis, screening, and vaccination. Forty Chinese men and women, aged 18-64, were recruited from immigrant communities in Seattle, Washington, and Vancouver, British Columbia. Semi-structured interviews (Cantonese or Mandarin) were audiotaped, translated, transcribed verbatim, and coded. Open coding, axial coding, constant comparison methods, and QSR NUD*IST 5 software was used for analysis. Findings were validated using eight focus groups. Findings indicated that many interviewees lack accurate knowledge with regard to hepatitis, often confusing the different types. Perceived causes of hepatitis included potentially harmful food (e.g., fried foods or potentially contaminated foods), alcohol, contact with infected individuals, stress, and inadequate rest. Preventive strategies associated with Chinese health beliefs included the use of Chinese herbal medicine, maintaining a stress-free mind, strengthening the body's natural defenses, and getting enough sleep. Other preventive strategies were the practice of good hygiene, vaccination, and the avoidance of contact with infected persons. Vaccination was not seen as primary, as 65% of those who had heard of hepatitis vaccination did not cite it as a means for hepatitis prevention until asked. Also, participants lacked information about the types and purposes of hepatitis vaccination and were worried about side effects. In conclusion, any attempt to promote hepatitis testing and vaccination among the North American Chinese should take traditional beliefs and practices into consideration.
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Affiliation(s)
- Hueifang Chen
- Division of General Internal Medicine, University of Washington, Box 359780, 325 Ninth Avenue, Seattle, WA 98104-2420, USA.
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Philips Z, Avis M, Whynes DK. Knowledge of cervical cancer and screening among women in east-central England. Int J Gynecol Cancer 2005; 15:639-45. [PMID: 16014118 DOI: 10.1111/j.1525-1438.2005.00126.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
This study assesses the extent and accuracy of women's knowledge of cervical cancer, risk factors, and the efficacy of the national screening program. Data were obtained from a questionnaire survey of randomly selected women eligible for screening, drawn from a population in east-central England. The majority of women in the sample overestimated the current incidence of cervical cancer, both absolutely and relative to other cancers. Perceiving incidence to be high was associated with reporting worries about the disease. With respect to the screening process, 78.3% believe that the smear abnormality rate is higher than it actually is, and only 7.6% correctly appreciate that the abnormality rate is highest at younger ages. With respect to performance, 16.3% believed the smear test to be completely accurate, and more than half overestimated the likely number of cancer cases prevented by screening. While certain cervical cancer risk factors were correctly assigned by the majority of women, undue emphasis was placed on genetic influence, while the risks posed by human papillomavirus infection were unfamiliar to almost half of the sample. We conclude that women typically possess only a partial picture of risk factors and overestimate both the incidence of cervical cancer and the efficacy of screening.
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Affiliation(s)
- Z Philips
- School of Economics, University of Nottingham, Nottingham, United Kingdom
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McMullin JM, De Alba I, Chávez LR, Hubbell FA. Influence of beliefs about cervical cancer etiology on Pap smear use among Latina immigrants. ETHNICITY & HEALTH 2005; 10:3-18. [PMID: 15841584 DOI: 10.1080/1355785052000323001] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To assess Latina immigrants' beliefs about the role of sexual activities in cervical cancer etiology and the impact of the beliefs on Papanicolaou (Pap) smear use. Previous research has found that Latinas, particularly immigrants, believe that cervical cancer is related to 'unwise' sexual activities; however, their beliefs about the nature of the relationship are unclear. DESIGN We conducted semi-structured face-to-face interviews with a non-probability purposive sample of 20 Mexican immigrant women who resided in Orange County, California regarding their beliefs about risk factors for cervical cancer and Pap smear use. We used qualitative content analysis to identify major themes. Three investigators independently reviewed transcripts of the audio-taped interviews to identify themes and came to a consensus about them. RESULTS The women had a mean age of 39 years and had resided in the USA for an average of 16.3 years. We identified several themes. The majority of respondents had limited knowledge about cervical cancer and no knowledge about human papillomavirus (HPV); believed that infections caused by physical trauma, certain sexual activities, and poor hygiene caused cervical cancer; believed that they only needed a Pap smear if they developed symptoms of a pelvic infection; and felt that women who engaged in 'unwise' sexual behaviors, in particular, should receive regular Pap smear exams. CONCLUSION The results suggest that culturally related beliefs about the etiology of cervical cancer play a role in the decision to obtain Pap smears for Latina immigrants. The findings may help to explain why researchers have found Latino ethnicity to be an independent predictor of Pap smear use. They also suggest that programs designed to improve cervical cancer screening, particularly among Latina immigrants, should stress the nature of HPV transmission, its role in the etiology of cervical cancer, and the importance of Pap smear screening in the absence of symptoms.
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Affiliation(s)
- Juliet M McMullin
- Department of Medicine, University of California, Irvine, 101 City Drive, Bldg 200 #720, Orange, CA 92868-4076, USA
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Quan H, Ghali WA, Dean S, Norris C, Galbraith PD, Faris P, Graham MM, Knudtson ML. Validity of using surname to define Chinese ethnicity. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2004; 95:314. [PMID: 15362479 PMCID: PMC6976270 DOI: 10.1007/bf03542932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Hude Quan
- Department of Community Health Sciences, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1 Canada
- Centre for Health and Policy Studies, University of Calgary, Canada
| | - William A. Ghali
- Department of Community Health Sciences, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1 Canada
- Centre for Health and Policy Studies, University of Calgary, Canada
- Department of Medicine, University of Calgary, Canada
| | | | - Colleen Norris
- Department of Medicine, University of Alberta, Edmonton, AB Canada
| | - P. Diane Galbraith
- Department of Community Health Sciences, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1 Canada
- Centre for Health and Policy Studies, University of Calgary, Canada
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Quan H, Ghali WA, Dean S, Norris C, Galbraith PD, Faris P, Graham MM, Knudtson ML. Validity of using surname to define Chinese ethnicity. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2004; 95:314. [PMID: 15362479 PMCID: PMC6976270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Hude Quan
- Department of Community Health Sciences, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1 Canada
- Centre for Health and Policy Studies, University of Calgary, Canada
| | - William A. Ghali
- Department of Community Health Sciences, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1 Canada
- Centre for Health and Policy Studies, University of Calgary, Canada
- Department of Medicine, University of Calgary, Canada
| | | | - Colleen Norris
- Department of Medicine, University of Alberta, Edmonton, AB Canada
| | - P. Diane Galbraith
- Department of Community Health Sciences, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1 Canada
- Centre for Health and Policy Studies, University of Calgary, Canada
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