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Kalantzis MA, Braden AL, Haidar A. Disordered eating and emotional eating in Arab, middle eastern, and north African American women. Eat Behav 2024; 53:101868. [PMID: 38582007 DOI: 10.1016/j.eatbeh.2024.101868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 04/08/2024]
Abstract
Arab, Middle Eastern, and North African (A-MENA) American women are often subject to intersectional discrimination, and they have also not been traditionally recognized as a distinct racial group in disordered eating literature. No study to date has provided descriptive information on disordered and emotional eating A-MENA American women, nor has examined perceptions of widely used measurements of eating pathology in this population. The current study generated descriptive information among A-MENA women on two widely used measures of eating pathology, the Eating Disorder Examination Questionnaire (EDE-Q) and the Emotional Eating Scale (EES). Participants (N = 244) were A-MENA adult women were recruited via social media and snowball sampling. Qualitative findings provide potential sociocultural predictors of disordered eating that should be further explored, such as bicultural identity and family pressures/comments toward appearance. Secondly, themes from the EES-R indicate adding emotion of shame and considering identity-related stress. The current study provides prevalence data and future directions of research on widely used eating pathology and appearance attitude measurements for A-MENA American women.
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Affiliation(s)
- Maria A Kalantzis
- Department of Psychology, Bowling Green State University, United States of America.
| | - Abby L Braden
- Department of Psychology, Bowling Green State University, United States of America.
| | - Andrea Haidar
- Department of Psychology, Bowling Green State University, United States of America.
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2
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Mansuri S, Daniel MN, Westrick JC, Buchholz SW. Physical Activity Behavior and Measurement in Arab American Women: An Integrative Review. JOURNAL OF PREVENTION (2022) 2023; 44:749-776. [PMID: 37728719 DOI: 10.1007/s10935-023-00746-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/20/2023] [Indexed: 09/21/2023]
Abstract
Physical activity (PA) is associated with cardiovascular health; however, in the U.S., only 20% of women are physically active, compared to 28% of men. Arab American women (AAW) experience unique barriers to engaging in the recommended PA. This review examines quantitative PA studies conducted with AAW with a specific focus on how PA outcomes were assessed. Studies were analyzed to explore: (a) types of PA behavior, (b) components of PA interventions/interest (if conducted), (c) PA measurement, and (d) translation of PA tools. After screening titles, abstracts, and a full-text review of articles from five different databases, 12 studies met the inclusion criteria. Leisure-time PA was the most readily used PA measure. Only two out of the 12 studies included women-only participants. There was a total of 10 cross-sectional studies and two quasi-experimental studies. All the studies used a self-report PA questionnaire; one study used a pedometer to measure PA. Six PA questionnaires were translated into Arabic. Future studies must explore the use of reliable and valid translated instruments, objective PA measures, and randomized controlled trial designs.
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Affiliation(s)
- Sudaba Mansuri
- College of Nursing, Rush University, 600 S. Paulina St., Suite 1080, Chicago, IL, 60612, United States.
| | - Manju N Daniel
- College of Nursing, Rush University, 600 S. Paulina St., Suite 1080, Chicago, IL, 60612, United States
| | | | - Susan W Buchholz
- College of Nursing, Michigan State University, East Lansing, United States
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3
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AlAbdulKader AM, AlAsfour A, Golembiewski M, Gullett H. Disparities in cervical cancer screening among Arabic-speaking women refugees. ETHNICITY & HEALTH 2023; 28:1115-1127. [PMID: 37337316 DOI: 10.1080/13557858.2023.2224953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Cervical cancer remains one of the most common cancers among females and one of the top causes of cancer-related deaths worldwide. Minority women are disproportionately more vulnerable. This study addressed disparities in cervical cancer screening among Arabic-speaking women refugees. DESIGN We conducted a cross-sectional study using qualitative and quantitative research methods at a Federally Qualified Health Center (FQHC) in Cleveland, Ohio, in the United States of America (USA). A structured phone-based survey was developed and administered in Arabic. The study was conducted from 2018 to 2019 and involved 20 participants. RESULTS Inequity in cervical cancer screening exists among Arab women refugees (41% being up to date with their screening) compared to their English- and Spanish-speaking counterparts (51%). These women perceived that the top three barriers to cervical cancer screening were fear of cancer, language, and lack of knowledge. The top three perceived facilitators were the doctor's recommendation, reminders from the provider's office, and awareness of cervical cancer screening. CONCLUSION Our work brings unique insights into improving preventive care services for Arabic-speaking women. These findings add unique insight focused on improving preventive care in this group and can inform interventions to increase cancer screening amongst Arabic-speaking women.
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Affiliation(s)
- Assim M AlAbdulKader
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alaa AlAsfour
- Department of English Language, College of Arts, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Heidi Gullett
- Center for Community Health Integration, Case Western Reserve University, Cleveland, OH, USA
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Osei EA, Ali Bakkari M, Boateng SA, Acquah A, Menlah A, Adusei A, Kumah J, Sekyi EKN. Perceptions and attitudes toward partners support for cervical cancer screening among married men in Ghana. Public Health 2023; 223:139-144. [PMID: 37651950 DOI: 10.1016/j.puhe.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVES The majority of literature on cervical cancer (CC) and cervical cancer screening (CCS) focused on women all over the world. However, research has indicated that men's involvement in CCS can lead to improved health outcomes for women. Despite this, there is limited information available in the literature regarding men's attitudes toward CCS. This highlights the need for further study on the subject to increase understanding and improve outcomes. The purpose of this study was therefore to explore the perceptions and attitudes toward partners' support for CCS among married men from the Adentan Municipality. STUDY DESIGN An exploratory descriptive qualitative approach was used in the study to explore the perceptions of married men about male involvement in CCS. METHODS Thirty-four married men were purposively selected to be part of the interviews. A semistructured interview guide was used to collect data, which were recorded. The tape-recorded data were reproduced verbatim, and content analysis was carried out to generate the themes and subthemes. RESULTS Three themes and nine subthemes were constructed from the data analysis. The study revealed that the perceptions of males about cervical cancer had a positive or a negative influence on women's behaviors toward CCS. It was interesting that some men constantly reminded their wives to participate in CCS. However, some barriers to men's support included fear of trauma to the wife's vagina during screening and concerns about exposure to the wife's nakedness. CONCLUSION It was therefore recommended that healthcare facilities should roll out sustainable programs and policies to involve men in CC prevention. In addition, health workers should devise innovative ways to make male involvement in CCS more attractive to men.
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Affiliation(s)
| | - M Ali Bakkari
- Department of Pharmaceutics, College of Pharmacy Jazan University, Jazan, Saudi Arabia.
| | - S A Boateng
- Nursing Department, School of Nursing and Midwifery, Valley View University, Ghana.
| | - A Acquah
- Department of Nursing, School of Nursing and Midwifery, Valley View University, Ghana.
| | - A Menlah
- Department of Nursing, School of Nursing and Midwifery, Valley View University, Ghana.
| | - A Adusei
- Department of Psychology and Information Studies, University of Ghana, Ghana.
| | - J Kumah
- Ghana Christian University College, Ghana.
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Namoos A, Sheppard V, Abdelkarim M, Abosamak N, Ramadan R, Albayati A, Gal T. Exploring Factors Influencing Cervical Cancer Prevention Behaviors: Unveiling Perspectives of Conservative Muslim American Women in Virginia. JOURNAL OF RELIGION AND HEALTH 2023; 62:3453-3465. [PMID: 37578624 DOI: 10.1007/s10943-023-01886-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/15/2023]
Abstract
Understanding the complexities surrounding cervical cancer prevention methods and hesitancy among conservative Muslim American women is crucial in addressing health disparities. This qualitative study aimed to delve into the religious, behavioral, and socio-cultural factors influencing Muslim women's decisions regarding cervical cancer screening (CC-S) and HPV vaccination (HPV-V) in Virginia, USA. Through interviews with 10 Muslim women residing in Virginia, qualitative data were collected as part of a mixed-method cross-sectional study conducted between August and September 2021. Findings revealed that participants had limited knowledge about cervical cancer, CC-S, and HPV-V, with notable themes emerging, such as cultural influences, misconceptions, language barriers, and challenges posed by the intricate US healthcare system. Future research should focus on exploring these barriers to mitigate the impact of cervical cancer within the Muslim population.
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Affiliation(s)
- Asmaa Namoos
- Department of Health Behavior Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23219, USA.
| | - Vanessa Sheppard
- Department of Health Behavior Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, 23219, USA
| | - Maryam Abdelkarim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - NourEldin Abosamak
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rana Ramadan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ayaat Albayati
- Department of Biology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Tamas Gal
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
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Ayash C, Raad N, Finik J, Attia N, Nourredine S, Aragones A, Gany F. Arab American Mothers’ HPV Vaccination Knowledge and Beliefs. J Community Health 2022; 47:716-725. [PMID: 35672534 PMCID: PMC9172982 DOI: 10.1007/s10900-022-01103-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2022] [Indexed: 10/25/2022]
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Comparative predictors for cervical cancer screening in Southeast Michigan for Middle Eastern-North African (MENA), White and African American/black women. Prev Med 2022; 159:107054. [PMID: 35460718 DOI: 10.1016/j.ypmed.2022.107054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 03/28/2022] [Accepted: 04/15/2022] [Indexed: 11/22/2022]
Abstract
The cervical cancer screening behaviors of Arab American women are not adequately understood, in part because Middle Eastern North African (MENA) descent is not a US Census category. Others have shown decreased cervical cancer screening in this race of women. Our primary aim is to evaluate the predictors of cervical cancer screening among MENA, White and Black women of southeast Michigan. A community-wide health survey reached MENA, White and Black populations asking self-report questions about health behaviors, attitudes, and medical history. Cervical cancer screening was considered up-to-date if it was reported to have occurred within the past three years. Survey responses were limited to women 30-65 years old and were analyzed with inferential and logistic regression models to determine risk factors for cervical cancer screening. Overall, 78% reported cervical cancer screening within the past three years. MENA women screened less often if time in the US was less than ten years (aOR 0.24 (0.05, 0.76)) compared to more than ten years and if single (aOR 0.27 (0.07, 0.97)) compared to married. Religion was not associated with screening in any study population. Those of all races without insurance screened significantly less often than those with insurance. The barriers to cervical cancer screening among MENA women are not associated with religion but instead with lack of insurance and length of time residing in the US.
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Harper DM, Sen A, Tariq M, Khoury CE, Haro EK, Alman E, Patel MR, Resnicow K. Concordant physician-patient characteristics lose importance for Arab American women and their healthcare- cross-sectional study. LANCET REGIONAL HEALTH. AMERICAS 2022; 10:100225. [PMID: 35765541 PMCID: PMC9236211 DOI: 10.1016/j.lana.2022.100225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Arab American women have preferred women physicians of their own culture in the past. The primary aim of this study is to determine the current influence of religion/culture among MENA women and their preferences for physicians of same sex, culture, and religion on the avoidance and uncomfortableness of routine and women's health exams. Methods A cross sectional community survey including religiosity and the importance of physician matched sex, culture, and religion was completed. Outcome measures were avoidance of a routine physical exam, or a women's health exam because of religious/cultural issues; and the uncomfortableness of the women's health exam. Linear regression modeling was used to evaluate the association between outcomes and potential predictors, with significance assessed using a bootstrap method. Findings The responses of 97 MENA women 30-65 years old showed that MENA women agreed that they would avoid routine health exams because of religious/cultural issues if their physician was of the same religion or culture as they were (p < 0.001, p < 0.05, respectively) or they had less education (p < 0.05). MENA women also avoided women's health exams due to religious/cultural issues if her physician was of the same religion as she (p < 0.01). Interpretation MENA women 30-65 years old may no longer be bound to a female physician of their same religion/culture for their health exams.
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Affiliation(s)
- Diane M Harper
- Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, 1018 Fuller Street, MI 48104, USA,Department of Obstetrics & Gynecology, University of Michigan School of Medicine, Ann Arbor, MI, USA,Department of Women’s Studies, College of Literature, Science and the Arts, University of Michigan, Ann Arbor, MI, USA,Corresponding author at: Department of Family Medicine, University of Michigan School of Medicine, 1018 Fuller Street, Ann Arbor MI 48105, USA. (D.M. Harper)
| | - Ananda Sen
- Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, 1018 Fuller Street, MI 48104, USA,School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Madiha Tariq
- Arab Community Center for Economic and Social Services (ACCESS), Dearborn, MI, USA
| | - Christelle El Khoury
- Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, 1018 Fuller Street, MI 48104, USA
| | - Elizabeth K. Haro
- Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, 1018 Fuller Street, MI 48104, USA
| | - Emma Alman
- Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, 1018 Fuller Street, MI 48104, USA
| | - Minal R. Patel
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Ken Resnicow
- Outreach and Health Disparities Research, University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA,Center for Health Communications Research, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Dalla V, Panagiotopoulou EK, Deltsidou A, Kalogeropoulou M, Kostagiolas P, Niakas D, Labiris G. Level of Awareness Regarding Cervical Cancer Among Female Syrian Refugees in Greece. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:717-727. [PMID: 32959214 DOI: 10.1007/s13187-020-01873-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 06/11/2023]
Abstract
Nowadays, prevention, control and treatment of cervical cancer are a worldwide public health priority. Primary objective of this study was to evaluate the level of awareness of female Syrian refugees who have recently settled in Greece regarding the warning signs and the risk factors of cervical cancer. This is a descriptive, cross-sectional study that was conducted in two facilities of the Hellenic Red Cross. The Cervical Cancer Awareness Measure questionnaire was addressed to 176 female Syrian refugees, aged between 18 and 50. Syrian women presented low awareness both for risk factors and warning signs. The most frequently identified warning signs were vaginal bleeding after menopause (44.3%), vaginal bleeding between menstruation (34.1%) and unexplained weight loss (32.4%). Regarding the risk factors' recognition rates, 74.5% considered the existence of many sexual partners as a risk factor and 61.3% the existence of a sexual partner with many previous sexual partners. Older age, a higher level of education and confidence that any potential symptom would be identified were associated with increased awareness. Our findings confirm former published reports that indicate poor awareness regarding cervical cancer among refugee populations. Full compliance with the guidelines of the World Health Organization for a national cervical cancer screening programme is highly advised in Greece and should address the needs of both native and refugee populations. This research is the first one that underlines the need for raising awareness of cervical cancer among female Syrian refugees in Greece by developing health promotion strategies adjusted to their unique cultural needs.
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Affiliation(s)
- Vasiliki Dalla
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece.
| | | | - Anna Deltsidou
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
- Department of Midwifery, University of West Attica, Athens, Greece
| | | | - Petros Kostagiolas
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
- Department of Archives, Library Science and Museology, School of Information Science and Informatics, Ionian University, Corfu, Greece
| | - Dimitris Niakas
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Labiris
- Faculty of Social Sciences, Hellenic Open University, Patras, Greece
- Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Namoos A, Abosamak NE, Abdelkarim M, Ramadan R, Philips B, Ramadan D, Abdou M, Gal TS. Muslim Women and Disparities in Cancer Diagnosis: A Retrospective Study. JOURNAL OF MUSLIM MINORITY AFFAIRS 2021; 41:541-547. [PMID: 35210932 PMCID: PMC8865392 DOI: 10.1080/13602004.2021.2008868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Muslim women often find their religious customs at odds with their healthcare needs, such as regular gynecological check-ups and cervical cancer screenings, especially before marriage. Religious beliefs may also affect beliefs about gender roles, illness, and death, affecting seeking healthcare services. This retrospective study explored the differences in care-seeking related to cancer between Muslim women and the general female population at the Virginia Commonwealth University in the United States between 2010 and 2019. There were major differences in insurance status between the two cohorts. Muslim women were less likely to have government-sponsored health insurance and were much more likely to be uninsured than non-Muslim women. We also found that preventable female cancers were more prevalent among Muslim women than among non-Muslim women and was also diagnosed at more advanced stages.
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Affiliation(s)
| | | | | | | | | | | | | | - Tamas S Gal
- Virginia Commonwealth University, Virginia, US
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11
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Allen CG, Todem D, Williams KP. Adherence to Mammography and Pap Screening Guidelines Among Medically Underserved Women: the Role of Family Structures and Network-Level Behaviors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1155-1162. [PMID: 33107009 PMCID: PMC8076331 DOI: 10.1007/s13187-020-01879-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Poor adherence to screening recommendations is an important contributing factor to disparities in breast and cervical cancer outcomes among women in the USA. Screening behaviors are multifactorial, but there has been limited focus on how family network beliefs and behaviors influence individual's likelihood to complete screening. This research aims to fill this gap by evaluating the role of family network composition and screening behaviors on women's likelihood to adhere to mammogram and pap screening recommendations. We used an ego network approach to analyze data from 137 families and their networks. Primary outcomes were whether an individual had received a mammogram in the past year and whether she had received a pap screening in the past 3 years. Network-level predictors included network composition (size of network, average age of network members, satisfaction with family communication) and network screening behaviors. We conducted multivariable logistic regressions to assess the influence of network-level variables on both mammogram and pap smears, adjusting for potential individual-level confounders. Each network had an average age of 47.9 years, and an average size of 3.05 women, with the majority of members being sisters (57.7%). We found differences in network screening behaviors by race, with Arab networks being less likely to have completed self-breast exams (OR = 0.21, 95%CI = 0.05-0.76, p = 0.02), ever a gotten pap screen (OR = 0.11, 95%CI = 0.01-0.85, p = 0.04), and gotten pap screening in the last 3 years (OR = 0.31, 95%CI = 0.10-0.99, p = 0.04) compared with African American networks. Network screening behaviors also strongly influenced the likelihood of an individual completing a similar screening behavior. This analysis sheds light on family network characteristics that influence screening behaviors among medically underserved women. These findings support the development and dissemination of screening interventions among female's family networks.
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Affiliation(s)
- Caitlin G Allen
- Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - David Todem
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
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Desta M, Getaneh T, Yeserah B, Worku Y, Eshete T, Birhanu MY, Kassa GM, Adane F, Yeshitila YG. Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis. PLoS One 2021; 16:e0259339. [PMID: 34735507 PMCID: PMC8568159 DOI: 10.1371/journal.pone.0259339] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/18/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia. METHODS AND FINDINGS Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%). CONCLUSIONS This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.
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Affiliation(s)
- Melaku Desta
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Temesgen Getaneh
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Bewuket Yeserah
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Yichalem Worku
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Tewodros Eshete
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | | | - Getachew Mullu Kassa
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Fentahun Adane
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
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Shallal A, Abada E, Musallam R, Fehmi O, Kaljee L, Fehmi Z, Alzouhayli S, Ujayli D, Dankerlui D, Kim S, Cote ML, Kumar VA, Zervos M, Ali-Fehmi R. Evaluation of COVID-19 Vaccine Attitudes among Arab American Healthcare Professionals Living in the United States. Vaccines (Basel) 2021; 9:942. [PMID: 34579179 PMCID: PMC8471462 DOI: 10.3390/vaccines9090942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/09/2021] [Accepted: 08/18/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is the next great barrier for public health. Arab Americans are a rapidly growing demographic in the United States with limited information on the prevalence of vaccine hesitancy. We therefore sought to study the attitudes towards the coronavirus disease 2019 (COVID-19) vaccine amongst Arab American health professionals living in the United States. METHODS This was a cross sectional study utilizing an anonymous online survey. The survey was distributed via e-mail to National Arab American Medical Association members and Arab-American Center for Economic and Social Services healthcare employees. Respondents were considered vaccine hesitant if they selected responses other than a willingness to receive the COVID-19 vaccine. RESULTS A total of 4000 surveys were sent via e-mail from 28 December 2020 to 31 January 2021, and 513 responses were received. The highest group of respondents were between the ages of 18-29 years and physicians constituted 48% of the respondents. On multivariable analysis, we found that respondents who had declined an influenza vaccine in the preceding 5 years (p < 0.001) and allied health professionals (medical assistants, hospital administrators, case managers, researchers, scribes, pharmacists, dieticians and social workers) were more likely to be vaccine hesitant (p = 0.025). In addition, respondents earning over $150,000 US dollars annually were less likely to be vaccine hesitant and this finding was significant on multivariable analysis (p = 0.011). CONCLUSIONS Vaccine hesitancy among health care providers could have substantial impact on vaccine attitudes of the general population, and such data may help inform vaccine advocacy efforts.
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Affiliation(s)
- Anita Shallal
- Division of Infectious Disease, Henry Ford Hospital, 2799 W. Grand Blvd, CFP 303, Detroit, MI 48202, USA; (A.S.); (M.Z.)
| | - Evi Abada
- Department of Pathology, Wayne State University School of Medicine/Detroit Medical Center, 3990 John R. Rd, Detroit, MI 48201, USA;
| | - Rami Musallam
- Wayne State University School of Medicine, 4201 St Antoine, Detroit, MI 48201, USA; (R.M.); (S.A.)
| | - Omar Fehmi
- The University of Michigan College of Literature, Science, and the Arts, 101 N Main St, Ann Arbor, MI 48104, USA; (O.F.); (Z.F.)
| | - Linda Kaljee
- Global Health Initiative, Henry Ford Health System, One Ford Place, 1E, Detroit, MI 48202, USA; (L.K.); (D.D.)
| | - Ziad Fehmi
- The University of Michigan College of Literature, Science, and the Arts, 101 N Main St, Ann Arbor, MI 48104, USA; (O.F.); (Z.F.)
| | - Suma Alzouhayli
- Wayne State University School of Medicine, 4201 St Antoine, Detroit, MI 48201, USA; (R.M.); (S.A.)
| | - Deema Ujayli
- Michigan State University College of Human Medicine, 965 Fee Rd A110, East Lansing, MI 48824, USA;
| | - Doreen Dankerlui
- Global Health Initiative, Henry Ford Health System, One Ford Place, 1E, Detroit, MI 48202, USA; (L.K.); (D.D.)
| | - Seongho Kim
- Biostatistics Core, Karmanos Cancer Institute, Department of Oncology, Wayne State University School of Medicine, 4100 John R. St, Detroit, MI 48201, USA;
| | - Michele L. Cote
- Population Sciences and Disparities Research, Karmanos Cancer Institute, Department of Oncology, Wayne State University School of Medicine, 4100 John R. Rd, Detroit, MI 48201, USA;
| | - Vijaya Arun Kumar
- Department of Emergency Medicine, Wayne State University School of Medicine/Detroit Medical Center, 3990 John R. Rd, Detroit, MI 48201, USA;
| | - Marcus Zervos
- Division of Infectious Disease, Henry Ford Hospital, 2799 W. Grand Blvd, CFP 303, Detroit, MI 48202, USA; (A.S.); (M.Z.)
| | - Rouba Ali-Fehmi
- Department of Pathology, Wayne State University School of Medicine/Detroit Medical Center, 3990 John R. Rd, Detroit, MI 48201, USA;
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14
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Díaz de León-Martínez L, Flores-Ramírez R, López-Mendoza CM, Rodríguez-Aguilar M, Metha G, Zúñiga-Martínez L, Ornelas-Rebolledo O, Alcántara-Quintana LE. Identification of volatile organic compounds in the urine of patients with cervical cancer. Test concept for timely screening. Clin Chim Acta 2021; 522:132-140. [PMID: 34418363 DOI: 10.1016/j.cca.2021.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/19/2021] [Accepted: 08/13/2021] [Indexed: 01/15/2023]
Abstract
The objective of this research was to identify a global chemical pattern of volatile organic compounds (VOCs) in urine capable of discriminating between women with cervical cancer (CC) and control women using an electronic nose and to elucidate potential biomarkers by gas chromatography-mass spectrometry (GC-MS). A cross-sectional study was performed, with 12 control women, 5 women with CIN (Cervical Intraepithelial Neoplasia) and 12 women with CC. Global VOCs in urine were assessed using an electronic nose and specific by GC-MS. Multivariate analysis was performed: Principal Component Analysis (PCA), Canonical Principal Coordinate Analysis (CAP) and Partial Least Squares Discriminant Analysis (PLS-DA) and the test's diagnostic power was evaluated through ROC (Receiver Operating Characteristic) curves. Results from the PCA between the control group compared to the CC present variability of 98.4% (PC1 = 93.9%, PC2 = 2.3% and PC3 = 2.1%). CAP model shows a separation between the overall VOCs profile of the control and CC group with a correct classification of 94.7%. PLS-DA indicated that 8 sensors have a higher contribution in the CC group. The sensitivity, specificity, value reached 91.6% (61.5%-99.7%) and 100% (73.5%-100%) respectively, according to the ROC curve. GC-MS analysis indicated that 33 compounds occur only in the CC group and some of them have been found in other types of cancer. In all, this study provides the basis for the development of an accessible, non-invasive, sensitive and specific screening platform for cervical cancer through the application of electronic nose and chemometric analysis.
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Affiliation(s)
- Lorena Díaz de León-Martínez
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, CP 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, México
| | - Rogelio Flores-Ramírez
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, CP 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, México.
| | - Carlos Miguel López-Mendoza
- Unidad de Innovación en Diagnóstico Celular y Molecular. Coordinación para la Innovación y la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Av. Sierra Leona 550, Lomas 2a sección, 78120 San Luis Potosí, México
| | | | - Garima Metha
- CEO of Altus Lifescience, San José, CA, United States
| | - Lourdes Zúñiga-Martínez
- Unidad de Innovación en Diagnóstico Celular y Molecular. Coordinación para la Innovación y la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Av. Sierra Leona 550, Lomas 2a sección, 78120 San Luis Potosí, México
| | - Omar Ornelas-Rebolledo
- Labinnova Center of Research in Breath for early diseases detection, Guadalajara, Mexico
| | - Luz Eugenia Alcántara-Quintana
- Unidad de Innovación en Diagnóstico Celular y Molecular. Coordinación para la Innovación y la Aplicación de la Ciencia y Tecnología, Universidad Autónoma de San Luis Potosí, Av. Sierra Leona 550, Lomas 2a sección, 78120 San Luis Potosí, México.
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15
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Shallal A, Abada E, Fehmi Z, Kamatham S, Trak J, Fehmi O, Toma A, Farooqi S, Jang H, Kim S, Bandyopadhyay S, Zervos M, Ali-Fehmi R. Human Papillomavirus Infection and Cervical Dysplasia in a Subset of Arab American Women. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:273-278. [PMID: 34318297 PMCID: PMC8310747 DOI: 10.1089/whr.2020.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 06/13/2023]
Abstract
Background: With limited health data on Arab Americans (AAs), we sought to describe the health-seeking behaviors, prevalence of abnormal cervical cytology and high-risk human papillomavirus (HPV) serotypes, and the relationship with socioeconomic factors among a subset of AA women. Methods: Retrospective observational cohort study of women undergoing routine cancer screening at the Arab-American Center for Economic and Social Services clinic. Data collected included demographics, tobacco use, gross monthly income, prior Papanicolaou (Pap) smear history, and results of cervical cytology and high-risk HPV testing. Results: Of 430 women, 74 (17%) reported that they had never had a Pap smear. Three hundred eighty-eight (90%) women had cervical cytology interpreted as "negative for intraepithelial lesion," the remaining 42 (10%) women had abnormal results. Thirteen (3%) women reported prior abnormal Pap smear, which was significantly associated with additional abnormal Pap smear on multivariable analyses (odds ratio 65.46; 95% confidence interval [CI] 17.01-338.62; p < 0.001). One hundred twenty-five (29%) women were tested for high-risk HPV serotypes; 106 (91%) had negative results, 4 (3%) were positive for HPV-16, 7 (6%) were positive for other high-risk serotypes, and 8 results were not recorded. A negative HPV screen was significantly associated with a negative Pap smear (Fisher's exact test p = 0.006). There was no significant association between abnormal cervical cytology and evaluated socioeconomic factors. Conclusions: Additional population based-studies to determine cervical dysplasia/cancer and HPV prevalence in women of Middle Eastern descent are needed.
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Affiliation(s)
- Anita Shallal
- Division of Infectious Disease, Henry Ford Hospital, Detroit, Michigan, USA
| | - Evi Abada
- Department of Pathology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan, USA
| | - Ziad Fehmi
- University of Michigan, Ann Arbor, Michigan, USA
| | | | - Joseph Trak
- Detroit Medical Center/Wayne State University, Detroit, Michigan, USA
| | - Omar Fehmi
- University of Michigan, Ann Arbor, Michigan, USA
| | - Andrew Toma
- Oakland University, Rochester, Michigan, USA
| | - Sarah Farooqi
- Detroit Medical Center/Wayne State University, Detroit, Michigan, USA
| | - Hyejeong Jang
- Department of Oncology, Biostatistics Core, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Seongho Kim
- Department of Oncology, Biostatistics Core, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Sudeshna Bandyopadhyay
- Department of Pathology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan, USA
| | - Marcus Zervos
- Division of Infectious Disease, Henry Ford Hospital, Detroit, Michigan, USA
| | - Rouba Ali-Fehmi
- Department of Pathology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan, USA
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16
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Taghizadeh Asl R, Van Osch L, De Vries N, Zendehdel K, Shams M, Zarei F, De Vries H. The role of knowledge, risk perceptions, and cues to action among Iranian women concerning cervical cancer and screening: a qualitative exploration. BMC Public Health 2020; 20:1688. [PMID: 33176743 PMCID: PMC7656771 DOI: 10.1186/s12889-020-09701-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/14/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Iran has a low incidence but higher rate of death from cervical cancer (CC). The country is in the process of implementing an organized screening program including HPV testing and cytology. Studies show high dropout in continued testing among eligible women. This qualitative study aimed to explore women's awareness regarding CC and CC testing and the role of knowledge, perceived risk, and cues to action in this process. METHOD Through a qualitative study based on the Framework Method, we recruited 81 women aged 25-65 who participated in 15 focus group discussions (FGDs) and two in-depth interviews in Tehran. The interviewees were selected purposefully during January to May 2015 from households belonging to different socioeconomic classes until data saturation. The data were acquired through 11 open-ended questions and 32 related probe questions. All interviews were transcribed and independently analyzed by two researchers (Kappa and agreement testing respectively: 0.77, 97.11%). RESULTS The coded texts were categorized under three themes and 13 subthemes. The three thematic areas referred to knowledge, cues to action, and perceived risks regarding CC and screening. The results showed that women had limited and unspecified knowledge about CC and screening, compounded by misconceptions regarding infection and cancer prevention measures. Social and cultural barriers hindered proper communication between health system/providers and clients and within communities on subjects related to CC and screening. The perceived risk of getting CC was low because of overestimating the role of hereditary factors for CC, difficulty in differentiating between cancer and sexually transmitted infections (STI), and the absence of visible symptoms. CONCLUSION The results indicate a strong need to invest more efforts to improve health education and communication in the current national health program to promote awareness of the need to screen for CC through, for example, establishing correct knowledge and risk perceptions among women. In addition, this intervention should address women's social environment in order to prevent misconceptions being communicated to women.
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Affiliation(s)
- Rahim Taghizadeh Asl
- Cancer Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital, Keshavarz Blvd, Tehran, Iran
| | - Liesbeth Van Osch
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Nanne De Vries
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Kazem Zendehdel
- Cancer Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital, Keshavarz Blvd, Tehran, Iran
| | - Mohsen Shams
- School of Health, Yasuj University of Medical Sciences, Pasdaran 15 Blvd., Yasuj, Iran
| | - Fatemeh Zarei
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University(TMU), P.O. Box: 14115-331, Tehran, Iran
| | - Hein De Vries
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
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17
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Luft H, Perzan M, Mitchell R, Schmidt A. An integrative literature review of barriers and facilitators to cervical cancer screening among refugee women in the United States. Health Care Women Int 2020; 42:992-1012. [PMID: 32814006 DOI: 10.1080/07399332.2020.1803872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Refugee women experience disproportionally high cervical cancer-related mortality. In this integrative review, we identify and discuss factors related to cervical cancer screening among refugee women in the US according to the Social Ecological Model. Two qualitative and three quantitative studies met inclusion criteria. Individual-level factors include English-language ability, availability, and individual knowledge, attitudes, and beliefs. Interpersonal-level factors include interactions with family/friends, provider, and community health worker. Community-, organization-, and policy-level factors include sociocultural values, transportation, ability to navigate the healthcare system, and health insurance. We discuss findings in the context of related reviews and applicability to other global settings.
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Affiliation(s)
- Heidi Luft
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Mireille Perzan
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Rita Mitchell
- Advocate Aurora Library Network, Advocate Aurora Health, Milwaukee, Wisconsin, USA
| | - Austin Schmidt
- Milwaukee Global Health Consortium, Milwaukee, Wisconsin, USA
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18
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Mandviwala T. Private Revolutions of Second-generation Muslim American Women. Curr Opin Psychol 2020; 35:26-30. [PMID: 32248044 DOI: 10.1016/j.copsyc.2020.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 12/01/2022]
Abstract
While certain research topics regarding second-generation Muslim American women are still relevant, (e.g., Islamophobia and the hijab), recent research unearths the nuances within these topics while also moving away from them for a more holistic, accurate picture of the population. The gendered and racialized aspects of Islamophobia are examined, but so, too, are the responses and the agency of the women who are subjected to these prejudices. The reactions of Muslim women are critical to recognize as they highlight their agency and their presence as intentional actors in their own lives. Navigating both Muslim and non-Muslim spheres, they activate different sources of cultural knowledge for both while also creating their own dynamic, experiential sources. These new sources include the marrying of "American" technologies to traditional Islamic reasoning to create a third body of knowledge that is uniquely second-generation, Muslim, and American. The cumulative result of a generation of women having private identity revolutions is a slow but sure sociocultural change for Islam in America.
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19
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Ross Perfetti A, Abboud S, Behme M, Barg FK. Understanding wellness and barriers to care among Iraqi refugee women in the United States. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1430-1437. [PMID: 31338949 DOI: 10.1111/hsc.12810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 06/10/2023]
Abstract
Iraqi refugees in the US experience a high prevalence of non-communicable diseases. In this article, we explore how cultural and structural realities intersect to influence utilisation of preventative healthcare and cancer screening with the aim of understanding health disparities in this population. We conducted three focus group discussions with a total of 14 Iraqi refugee women living in a northeastern US city in 2016 and analysed the qualitative data using a thematic analysis. Eight themes emerged from our data: (a) 'prevention is better than cure:' Iraqi refugee women maintain wellness; (b) physical and mental health are interrelated in causing and curing ill-health; (c) Iraqi refugee women embrace both biomedical and other healing practices; (d) God contributes to healing; (e) cancer is caused by dangerous environments. Three of the eight themes related to barriers to care; (f) multi-level problems within hospitals and clinics prevent the delivery of care; (g) financial barriers prevent access to care and good health; (h) competing priorities are a barrier to good health. We argue that understanding refugee health requires critical analysis of both culturally informed understandings of health and illness as well as the structural aspects of health disparities that result in limited access to life opportunities, racism and inequality for refugees and their communities.
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Affiliation(s)
| | - Sarah Abboud
- Department of Women Children & Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Matthew Behme
- Department of Internal Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Frances K Barg
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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20
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Campbell-Voytal KD, Schwartz KL, Hamade H, Dallo FJ, Neale AV. Attitudes towards health research participation: a qualitative study of US Arabs and Chaldeans. Fam Pract 2019; 36:325-331. [PMID: 30239688 PMCID: PMC6769398 DOI: 10.1093/fampra/cmy071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Arab Muslim and Chaldean Christian American community is unified by language but culturally diverse. Researchers are challenged to engage the Arab/Chaldean community to meet immigrant health needs. Arabs/Chaldeans are identified as white in clinical data sets making it difficult to identify health behaviours and patterns unique to the community. OBJECTIVES To explore the views of members of the Arab/Chaldean community, including researchers and the lay public, regarding health research participation and the role of clinicians, researchers and community leaders in the research process. METHODS A qualitative study of Arab and Chaldean adults and researchers conducted in a US community with a large Arab/Chaldean population. Five semi-structured focus group discussions were triangulated with five in-depth semi-structured interviews with Arab or Chaldean primary care researchers. Responses were audio-recorded and transcribed verbatim. Transcripts were coded and thematically analysed, and findings confirmed with community representatives. RESULTS Three themes were identified: (i) research expectations: risks and benefits; (ii) health care environment: clinicians as recruiters and (iii) research participations: risks and benefits. Themes captured concerns with social relationships, reputation or trust and the cost and benefit of research participation. In the Arab/Chaldean community, institutional and political fears and distrust are amplified. Respect for physicians, teachers and faith leaders connected with or recruiting for studies enhances likelihood of research participation. CONCLUSION Clinical researchers should address the cultural and immigration histories of Arab/Chaldean research participants. Studies that maximize trust will minimize participation bias and lay the groundwork for improved health. Institutional, sociocultural and personal factors require a pre-study phase to engage and educate participants.
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Affiliation(s)
- Kimberly D Campbell-Voytal
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Kendra L Schwartz
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Hiam Hamade
- Community Health and Research Center, Arab Community Center for Economic and Social Services, Dearborn, MI, USA
| | - Florence J Dallo
- Department of Public and Environmental Wellness, Oakland University School of Health Sciences, Rochester, MI, USA
| | - Anne Victoria Neale
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
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21
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McComb E, Ramsden V, Olatunbosun O, Williams-Roberts H. Knowledge, Attitudes and Barriers to Human Papillomavirus (HPV) Vaccine Uptake Among an Immigrant and Refugee Catch-Up Group in a Western Canadian Province. J Immigr Minor Health 2019; 20:1424-1428. [PMID: 29445898 DOI: 10.1007/s10903-018-0709-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Vaccination is a key strategy to prevent cervical cancer in developed countries. Lower uptake of human papillomavirus (HPV) vaccine among new immigrants and refugees has been documented, although exploration of underlying reasons remains an understudied area. Semi-structured interviews with eleven immigrant women (ages 18-26 years) were conducted to understand their knowledge, attitudes and barriers regarding HPV vaccination in a western Canadian province. Participants had limited knowledge about HPV and the vaccine. Most women perceived that their risk of HPV was low, however expressed willingness to receive the vaccine if it were recommended by their physician. Greater efforts are needed to increase knowledge about HPV among immigrant and refugee women and support for physicians to discuss and offer vaccination to this underserved population.
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Affiliation(s)
- Erin McComb
- Department of Obstetrics, Gynecology and Reproductive Sciences, College of Medicine, University of Saskatchewan, 107 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.
| | - Vivian Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Olufemi Olatunbosun
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Saskatchewan, Saskatoon, SK, Canada
| | - Hazel Williams-Roberts
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
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22
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Expression and clinical significance of high risk human papillomavirus and invasive gene in cervical carcinoma. ASIAN PAC J TROP MED 2017; 10:195-200. [PMID: 28237489 DOI: 10.1016/j.apjtm.2017.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/24/2016] [Accepted: 12/10/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To study the expression of E6 and E7 mRNA in high-risk human papillomavirus (HPV) HPV-18 and the relationship between the expression of invasive gene and cervical carcinoma. METHODS A total of 119 patients with cervical cancer, cervical erosion and cervical HPV infection who were diagnosed in our hospital were selected and randomly divided into two groups: cervical cancer group (n = 58) and non-cancerous group (n = 61). Another 60 patients with uterine leiomyoma were selected as normal control group. Detection of HPV18 E6, E7 mRNA expression and invasion, migration, proliferation inhibition genes, epithelial mesenchymal transition genes and proliferation related protein content. RESULTS The relative expression of E6 and E7 HPV-18 in cervical cancer group was significant higher than that in non-cancerous group and control group (mRNA) (P < 0.05). The content of TRAF6 and c-FLIP in invasive cervical cancer group was significantly higher than that in non-cancerous group and control group (P < 0.05). The mRNA content of CD44v6 and MMP-9 in cervical cancer group was significantly higher than that in non-cancerous group and control group (P < 0.05). The content of DEC-1, IKK16, MBP-1 in cervical cancer group was significant lower than that in non-cancerous group and control group (P < 0.05). The mRNA content of beta -catenin and Vimentin in cervical cancer group was significantly lower than that in non cancerous group and control group (P < 0.05). The proliferation related protein E2F1 of cervical cancer group was significantly lower than that of non-cancerous group and control group, Bmi-1 content was significantly higher than non-cancerous group and control group (P < 0.05). CONCLUSIONS The expression of the detection of cervical cancer in high-risk human papilloma virus HPV-18 E6 and E7 mRNA, and the invasion, migration, proliferation inhibition gene, epithelial mesenchymal transition and proliferation related gene protein content, HPV expression rate of mRNA increased with the development of cervical cancer, the expression is also enhanced. The expression has a certain correlation between the level and development of cervical cancer. Through the above indicators, the development of cervical cancer monitoring and treatment to provide important clinical guidance.
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