1
|
Alatrash M, Alkrisat S. Knowledge, Age, and Perceived Social Barriers Regarding Mammography Screening Among Immigrant Arab Women in the United States: A Predictive and Associative Analysis. J Womens Health (Larchmt) 2024. [PMID: 38979628 DOI: 10.1089/jwh.2023.1167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
Background: Ethnic minority women in the United States continue to experience racial disparities. Immigrant Arab women (IAW) underutilize mammography screening (MS) even compared with other ethnic minorities. This population still has gaps in knowledge regarding breast cancer (BC) and screening methods and encounters social barriers, highlighting the imperative role of the male figure and the family, which hinders screening. Materials and Methods: A cross-sectional design with an exploratory and predictive approach was employed to examine knowledge gaps and perceived social barriers associated with MS and to identify predictive factors of MS among IAW in California. The analysis included 316 women that met the eligibility criteria. Results: Familiarity with MS and awareness of screening recommendations were the specific areas of knowledge significantly associated with mammography uptake (odds ratio [OR] 15.4, 95% confidence interval [CI]: 5.6-40.8, p < 0.001) and (OR 12.07, 95% CI: 7-21, p < 0.001), respectively. Logistic regression revealed three MS predictors, the two knowledge areas and age. Perceived social barriers were significantly associated with age [F (3,312) = 4.684, p = 0.003]. There was a significant difference in social barriers between women in their 40s and those in their 60s (p = 0.002) and between women in their 50s and those in their 60s (p = 0.003), suggesting lower barriers among women in their 60s (M = 14.3). Living status was significantly associated with perceived social barriers [F (1,314) = 8.83, p = 0.003]. Conclusions: This study offered valuable insights for health care professionals, policymakers, and community organizations working to improve BC early detection in immigrant and ethnic women to reduce social disparities and reinforce social justice. Knowledge-deficit areas and social barriers must be analyzed and incorporated in awareness programs to improve screening practices of IAW.
Collapse
Affiliation(s)
| | - Sarah Alkrisat
- Alliant International University, Alhambra, California, USA
| |
Collapse
|
2
|
Alkhaifi S. "I Trust That Only God Can Protect Me, But …": The Religious Meaning Behind Mammogram Attitudes and Behaviors Among Immigrant Muslim Women. J Immigr Minor Health 2024; 26:546-553. [PMID: 37980314 DOI: 10.1007/s10903-023-01567-1] [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: 10/18/2023] [Indexed: 11/20/2023]
Abstract
Although breast cancer is the second leading cause of death among women in the United States, women from ethnic minorities still underutilize mammogram screenings. Immigrant Muslim women (IMW) demonstrated low mammogram screening rates compared to the national target of 77.1% determined by Healthy People 2030. Although IMW comprise an understudied population in the health field, a limited number of studies have proposed that Islamic religious beliefs have an impact on their behaviors and practices in regard to mammogram use. This study aimed to understand the meanings IMW ascribe to their religious beliefs in relation to mammogram utilization. A qualitative thematic analysis study was conducted on a purposive sample. A total of 28 IMW were recruited for one-on-one interviews in either Arabic or English, and inductive thematic analysis as per Braun and Clarke (2008) informed data analysis, guided by symbolic interactionism. A total of 28 interviews (10 in English and 18 in Arabic) were conducted with IMW whose mean age was 54.7. During these interviews, three major themes emerged regarding the participants' experience with mammograms, within the context of their religious beliefs: (a) 'Your body is a trust,' (b) the notions of al-tawakkul and al-tawaakoul, and (c) religious methods for coping with mammogram use. Results from this study suggests some religious means that can be integrated into an educational program designed for IMW to enhance their mammogram screening rates.
Collapse
Affiliation(s)
- Sarah Alkhaifi
- Department of Maternity and Childhood Nursing, School of Nursing, King Abdulaziz University, P.O. Box 80200, 21589, Jeddah, Kingdom of Saudi Arabia.
- Initiative On Islam and Medicine, Brookfield, WI, USA.
| |
Collapse
|
3
|
Alkhaifi S, Padela AI. "I'm not Alone; He will be There for Me": A Mixed-Method Approach Exploring the Impact of Spousal Support on Mammogram Utilization and Health Beliefs. J Immigr Minor Health 2024; 26:257-267. [PMID: 37902903 DOI: 10.1007/s10903-023-01557-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 11/01/2023]
Abstract
Regular mammogram screenings are effective for early breast cancer (BC) detection and decreased mortality rate. However, immigrant Muslim Arab women (IMAW) are less likely to adhere to these screenings although the rate of BC among IMAW is high. Recent studies have explored low mammogram screening rates among immigrant Muslim and/or Arab women from a limited perspective, overlooking the fact that husbands have an influence in IMAW's health behaviors toward cancer screenings. Thus, this mixed-method approaches were employed to (a) explore the association between spousal support and IMAW's health beliefs toward mammograms and their utilization, (b) to understand IMAW's experiences of spousal influence related to their mammogram use and health beliefs. The quantitative portion of the study, recruitment and data collection were conducted via online surveys in Arabic and English. Logistic regressions were used to explore relationships between perceived spousal support and IMAW's mammogram utilization and health beliefs. The qualitative portion of the study was conducted on a purposive sample of IMAW. A semi-structured interview guide in Arabic and English was used during one-on-one interviews. Arabic interviews were translated into English and transcribed by professionals. Interviews were analyzed by thematic analysis according to Braun and Clarke (2008). A total of 184 IMAW completed the survey with mean age of 50.4 (SD = 5.58, range = 45-60). Results revealed low mammogram screening rate among IMAW. Only 32.6% adhered to mammograms. Spousal support was positively associated with ever having obtained a mammogram and IMAW's adherence to mammogram. The 20 qualitative interviews, 16 in Arabic and four in English, produced rich description supporting results from the survey which includes, (a) types of spousal support, (b) impact of spousal support on participants' mammogram utilization and experience, and (3) impact of spousal support on participants' health beliefs toward mammograms. Findings from surveys and interviews show that a husband's support is positively associated with IMAW's mammogram utilization and health beliefs. Suggesting a new approach to integrate husbands in culturally appropriate interventions to increase mammogram screening rates among IMAW.
Collapse
Affiliation(s)
- Sarah Alkhaifi
- School of Nursing, Department of Maternity and Childhood Nursing, King Abdulaziz University, Jeddah, Saudi Arabia.
- Initiative on Islam and Medicine, Brookfield, WI, USA.
| | - Aasim I Padela
- School of Nursing, University of California Los Angeles, Los Angeles, US
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| |
Collapse
|
4
|
Fleischer NJ, Sadek K. Arab, Middle Eastern, and North African Health Disparities Research: A Scoping Review. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01972-8. [PMID: 38466512 DOI: 10.1007/s40615-024-01972-8] [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: 12/22/2023] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Research in health disparities and how they affect underserved populations continues to grow and expand. However, the experiences of Arab/Middle Eastern and North African (MENA) Americans often go unnoticed, and yet, preliminary data suggests there are significant disparities between this population and other groups. The purpose of this scoping review is to examine and synthesize the extent of available literature on health disparities and outcomes for this group. METHODS A scoping review was conducted to investigate the current state of research on health disparities and outcomes among Arab/MENA individuals within the USA. The PRISMA protocol for scoping reviews was utilized. RESULTS Through the use of PubMed and PsychInfo databases, the search identified 43 articles that were eligible for inclusion in the final review. Five themes emerged: prevalence and health outcomes, factors impacting health, comparison studies, barriers, and health literacy and beliefs. Extant data was equivocal, suggesting the need for further research. CONCLUSIONS Research on Arab/MENA health disparities and outcomes is in the detection phase, indicating that more research is needed to elucidate the state of Arab/MENA health in the USA. These findings can help healthcare professionals and researchers understand the emerging literature on health disparities within the Arab/MENA community and inform further research and clinical practice within this population.
Collapse
Affiliation(s)
- Nicole J Fleischer
- Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, PA, USA.
| | - Katherine Sadek
- Department of Educational Psychology, University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Alkhaifi S, Padela AI, Hodge F, Brecht ML. Breast cancer screening among immigrant Muslim arab women in the United States: Analyzing relationships between beliefs, knowledge, spousal support and mammogram utilization. J Natl Med Assoc 2023; 115:302-313. [PMID: 36967269 DOI: 10.1016/j.jnma.2023.03.001] [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: 07/04/2022] [Revised: 10/14/2022] [Accepted: 03/06/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Regular mammogram screenings contribute to a decreased breast cancer (BC) mortality rate. Women from ethnic minorities in the United States, however, often underutilize mammogram screenings; in particular, immigrant Muslim Arab (IMAW) women have low mammogram screening rates. OBJECTIVE To explore the associations between mammogram utilization and (a) health and religious beliefs, (b) level of knowledge about mammograms, (c) health care provider (HCP) recommendations, and (d) spousal support. METHODS A cross-sectional study employed online data collection. An Arabic or English survey was completed by women who were 45 or older and married, had immigrated from Arab countries, and had no history of breast cancer. Logistic regression was conducted for data analyses. RESULTS Of the 184 Immigrant Muslim Arab survey participants, 86.6% reported having had at least one mammogram in their lifetime, and 32.6% adhered to mammograms. Ever having obtained a mammogram and adherence to mammograms were negatively associated with perceived mammogram barriers and positively associated with (a) spousal support, (b) level of mammogram knowledge, and (c) perceived self-confidence. Receiving (HCP) recommendation increased the likelihood of ever having obtained a mammogram. Finally, participants who reported higher levels of perceived mammogram benefits were more likely to have obtained a mammogram within the last 2 years compared to their counterparts. CONCLUSIONS IMAW have demonstrated low mammogram adherence rate. IMPLICATIONS Nursing clinicians and scholars must play a role in designing and implementing interventions to promote women adherence to mammograms. Involving husbands in these interventions may improve immigrant Muslim Arab women's mammogram adherence rates.
Collapse
Affiliation(s)
- Sarah Alkhaifi
- King Abdulaziz University, School of Nursing, Department of Maternity and Childhood, Nursing, Jeddah, Saudi Arabia; University of California Los Angeles, Schools of Nursing.
| | - Aasim I Padela
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee WI, USA; Initiative on Islam and Medicine, Brookfield, Wisconsin, USA
| | - Felicia Hodge
- University of California Los Angeles, Schools of Public Health
| | | |
Collapse
|
7
|
Kaur K, Jajoo R, Naman S, Kandwal T, Brar GS, Garg P, Bhullar PS, Baldi A. Identifying barriers to early diagnosis of breast cancer and perception of women in Malwa region of Punjab, India. GLOBAL HEALTH JOURNAL 2023. [DOI: 10.1016/j.glohj.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
8
|
Racine L, D'Souza MS, Tinampay C. Effectiveness of breast cancer screening interventions in improving screening rates and preventive activities in Muslim refugee and immigrant women: A systematic review and meta-analysis. J Nurs Scholarsh 2023; 55:329-344. [PMID: 36199240 DOI: 10.1111/jnu.12818] [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: 06/01/2022] [Revised: 08/22/2022] [Accepted: 09/09/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE To systematically assess the effectiveness of breast cancer (BC) interventions in improving breast self-examination (BSE), clinical breast examination (CBE), mammogram screening rates, and preventive activities in Muslim refugee and immigrant women. DESIGN Guided by the Health Belief Model, a mixed method systematic review and meta-analysis was performed using a sequential design. METHODS This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA), the Critical Appraisal Skill Program Checklists, and the Joanna Briggs Institute (JBI) methodology for systematic review and meta-analysis. A systematic search of English-language peer-reviewed articles was undertaken in multiple health and social sciences databases from January 1, 2015, to March 31, 2022. Randomized clinical trials and quasi-experimental studies focused on the uptake of BSE, CBE, and mammograms were selected. RESULTS Fourteen articles were included in the review. Most of the studies relied on quasi-experimental designs and were carried out in the United States of America. The qualitative analysis of BC screening interventions generated three themes: (1) education, (2) access-focused, and (3) cultural and faith-based. The meta-analysis included three randomized control trials and two quasi-experimental studies. The meta-analysis demonstrates the effectiveness of community-led cultural and faith-based interventions in facilitating the completion of CBE and mammography screening. Education on BC and patient navigator interventions are more effectively used in conjunction than standalone interventions, yet community-based cultural and faith-based interventions are the most effective. CONCLUSION This systematic and meta-analysis review provides evidence on the effectiveness of access-focused and cultural and faith-based interventions in improving BC screening in Muslim refugee and immigrant women. Future research should focus on designing and measuring the effectiveness of cultural and faith-based interventions to increase Muslim refugee and immigrant women's BC screening knowledge and practices. CLINICAL RELEVANCE This systematic and meta-analysis review demonstrates the need to explore Muslim refugee and immigrant women's cultural contexts for developing culturally sensitive BC screening interventions. Knowledge and practice of BC and religiosity intersect with financial, geographic, and linguistic barriers to decrease participation in screening and preventive activities in Muslim refugee and immigrant women.
Collapse
Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Melba Sheila D'Souza
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Cindy Tinampay
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
9
|
Association between Breast Cancer Knowledge and Mammogram Utilization among Immigrant Muslim Arab Women in California: Cross-Sectional Design. Healthcare (Basel) 2022; 10:healthcare10122526. [PMID: 36554050 PMCID: PMC9778312 DOI: 10.3390/healthcare10122526] [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: 10/27/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Regular mammogram screenings have contributed to early breast cancer (BC) diagnoses and lowered the mortality rate by 40% in the United States of America (USA). Nonetheless, ethnic women living in developed countries, such as immigrant Muslim Arab women (IMAW), are less likely to get mammograms. AIM OF THE STUDY In our study, we aimed to understand health behaviors among IMAWs as understudied populations in the USA. METHODS We conducted a cross-sectional study on a convenience sample of IMAW living in southern California. We used logistic regression and multivariate logistic regressions to analyze the data. RESULTS The total number of participants who completed the survey was 184 IMAW. Participants who had a higher level of knowledge about BC signs and symptoms and mammogram knowledge were more likely to have obtained a mammogram at some point compared with their counterparts (OR = 1.23, p = 0.03, CI: 1.07-1.42; OR = 2.23, p = 0.23, CI: 1.11-4.46, respectively). CONCLUSIONS Our results provide more evidence emphasizing the important influence of BC and mammogram knowledge on immigrant women's behavior regarding mammogram utilization. The average level of knowledge in all three domains (BC risk factors, BC signs and symptoms, and mammogram use) reported in this study is considered low.
Collapse
|
10
|
Racine L, Andsoy I, Maposa S, Vatanparast H, Fowler-Kerry S. Examination of Breast Cancer Screening Knowledge, Attitudes, and Beliefs among Syrian Refugee Women in a Western Canadian Province. Can J Nurs Res 2021; 54:177-189. [PMID: 34038264 PMCID: PMC9109584 DOI: 10.1177/08445621211013200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Women living in the Arab world present low breast cancer screening rates,
delayed diagnosis, and higher mortality rates. Purpose To further explore the Muslim Syrian refugee women’s breast self-examination
(BSE), utilization of clinical breast examination (CBE) and mammography. Methods A cross-sectional descriptive exploratory study design was used. The sample
consisted of 75 refugee women. Data were collected using Champion’s Health
Belief Model Scale, the Cancer Stigma Scale, and the Arab Culture-Specific
Barriers to Breast Cancer Questionnaire. Descriptive, Pearson correlation
and logistic regression analyses were used to analyze the data. Results A minority of women had BSE (32%), CBE (12%) and mammograms (6.7%) anytime
during their lifetime. Women’s breast cancer screening (BCS) knowledge
ranked at a medium level (M = 10.57, SD = 0.40). Low knowledge score, BSE
information, policy opposition, responsibility, barriers to BSE, and
seriousness were found to be statistically significant in women’s BSE
practice. BSE benefits and religious beliefs significantly predict CBE Age,
education, knowledge, responsibility, susceptibility, social barriers, and
religious beliefs were statistically significant in women’s mammography use
(p < .01). Conclusions Participants’ breast cancer screening practices were low. Health beliefs,
Arab culture and stigma about cancer affected women’s BCS practices.
Faith-based interventions may improve knowledge and practices.
Collapse
Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Isil Andsoy
- Department of Nursing, Karabuk University, Karabuk, Turkey
| | | | | | | |
Collapse
|
11
|
Predictors of Healthcare Access and Utilization by Syrian Americans in the United States. J Immigr Minor Health 2021; 24:136-144. [PMID: 33389394 DOI: 10.1007/s10903-020-01133-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2020] [Indexed: 10/22/2022]
Abstract
There are currently no studies examining healthcare access and utilization by Syrian Americans. A better understanding of the determinants of healthcare utilization among this group could help aid in the design of culturally competent programs. A self-administered survey was distributed at events across Southern California and Jacksonville, Florida from January 2018 to May 2019. Statistical analysis utilized multivariate regressions. Insurance coverage was associated with a preference for speaking Arabic (OR 0.433, p = 0.02) and increased length of residency (OR 1.04, p = 0.02). Routine checkup was associated with female sex (OR 1.97, p = 0.001), age (OR 1.05, p < 0.001), and insurance coverage (OR 6.96, p < 0.001). Colonoscopy compliance rate was 43.3% and positively associated with higher education (OR 2.70, p = 0.002), routine checkup (OR 7.61, p = 0.009) and increased length of residency (OR 1.06, p < 0.001). Syrian Americans may benefit from further health promotion campaigns with regard to insurance coverage, preventative care and cancer screenings.
Collapse
|
12
|
Resnicow K, Patel MR, Green M, Smith A, Bacon E, Goodell S, Tariq M, Alhawli A, Syed N, Van Horn ML, Stiffler M. Development of an Ethnic Identity Measure for Americans of Middle Eastern and North African Descent: Initial Psychometric Properties, Sociodemographic, and Health Correlates. J Racial Ethn Health Disparities 2020; 8:1067-1078. [PMID: 32974877 PMCID: PMC8285340 DOI: 10.1007/s40615-020-00863-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022]
Abstract
Background Southeast Michigan is home to the second largest Middle Eastern and North African (MENA) US population. There is increasing interest in understanding correlates of psychosocial outcomes and health behaviors in this growing population. One potentially important health correlate is ethnic identity (EI). This paper reports the development, validity, and initial correlates of a new measure of MENA identity named the MENA-IM. Methods We used convenience sampling at locations frequented by individuals of MENA descent in southeast Michigan. We also measured EI centrality, religiosity, cultural mistrust, substance use, and health status to assess convergent and divergent validity. Exloratory and Confirmatory Factor Analysis identified three subscales, which were valid for both Arab and Chaldean respondents and were named (1) MENA cultural affiliation, (2) MENA media use, and (3) multicultural affiliation. We also created and tested a 20-item, single-factor version. Results We obtained data from 378 adults, 73% of whom identified as Arab and 27% as Chaldean. MENA-IM scores were higher among older, lower-educated, lower-income, non-US born, and Arabic-speaking respondents. Arab respondents reported significantly higher scores than Chaldeans. MENA-IM scores were positively associated with EI centrality and religiosity. Higher MENA-IM scores were found among those not reporting use of marijuana, alcohol, and opiates. Higher MENA-IM scores were also found among those without a self-reported history of heart disease and among those with better mental health status. Discussion The MENA-IM has strong psychometric properties and demonstrated initial evidence of convergent and discriminant validity. In general, values on the measure were associated with better psychosocial and health status. How the measure performs with MENA populations outside of Michigan and how it may relate to other health outcomes merit investigation.
Collapse
Affiliation(s)
- Ken Resnicow
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI, 48109-2029, USA. .,University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA.
| | - Minal R Patel
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI, 48109-2029, USA.,University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA
| | - Molly Green
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI, 48109-2029, USA
| | - Alyssa Smith
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI, 48109-2029, USA
| | - Elizabeth Bacon
- University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA
| | | | - Madiha Tariq
- ACCESS, 6450 Maple St., Dearborn, MI, 48126, USA
| | | | - Nadia Syed
- ACCESS, 6450 Maple St., Dearborn, MI, 48126, USA
| | - M Lee Van Horn
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | | |
Collapse
|
13
|
Bourdeanu L, Alatrash M, Ketchedjian N, Pate B. Perceived Fears, Barriers, and Benefits Regarding Breast Cancer Screening: A Comparison of Lebanese and Lebanese-American Women. JCO Glob Oncol 2020; 6:1200-1210. [PMID: 32735490 PMCID: PMC7392747 DOI: 10.1200/go.20.00019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Breast cancer is the most prevalent malignancy among Lebanese women, and nearly half of these women are age < 50 years at diagnosis. Despite the current screening guidelines in Lebanon to start mammograms at 40 years of age, monthly self-breast examination, and yearly clinical breast examination, compliance with these recommendations remains low in both Lebanese and Lebanese-American women. This study aimed to examine different factors associated with breast cancer screening compliance in Lebanese and Lebanese-American women and determine and compare factors that predict breast cancer screening for these 2 groups. A cross-sectional study design was used to examine the factors associated with breast cancer screening compliance in Lebanese and Lebanese-American women. A total of 250 Lebanese women and 105 Lebanese-American women completed the questionnaires. Of these, 74.3% of Lebanese-American women and 72.5% of Lebanese women had ever had a mammogram, and 58.4% of Lebanese women had had a clinical breast examination, compared with 84.8% of Lebanese-American women. In both groups, health care provider recommendation was a predictor of having had a mammogram. Although the breast cancer screening practices of both groups are higher than previously reported, they continue to fall below the recommended rate of 81% according to the Healthy People Project. Given the susceptibility of Lebanese women age > 40 years to develop breast cancer, promotional breast cancer screening campaigns must emphasize the importance of adhering to screening guidelines for both Lebanese and Lebanese-American women.
Collapse
Affiliation(s)
| | | | | | - Barbara Pate
- Western Governors University, Salt Lake City, UT
| |
Collapse
|