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Chen WT, Sun W, Huang F, Shiu CS, Kim B, Candelario J, Toma L, Wu G, Ah-Yune J. Lost in Translation: Impact of Language Barriers and Facilitators on the Health Care of Asian Americans Living with HIV. J Racial Ethn Health Disparities 2024; 11:2064-2072. [PMID: 37306920 PMCID: PMC10713860 DOI: 10.1007/s40615-023-01674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023]
Abstract
Language barriers are major obstacles that Asian American immigrants face when accessing health care in the USA. This study was conducted to explore the impact of language barriers and facilitators on the health care of Asian Americans. Qualitative, in-depth interviews and quantitative surveys were conducted with 69 Asian Americans (Chinese, Filipino, Japanese, Malaysian, Indonesian, Vietnamese, and mixed Asian backgrounds) living with HIV (AALWH) in three urban areas (New York, San Francisco, and Los Angeles) in 2013 and from 2017 to 2020. The quantitative data indicate that language ability is negatively associated with stigma. Major themes emerged related to communication, including the impact of language barriers on HIV care and the positive impact of language facilitators-family members/friends, case managers, or interpreters-who can communicate with healthcare providers in the AALWH's native language. Language barriers negatively impact access to HIV-related services and thus result in decreased adherence to antiretroviral therapy, increased unmet healthcare needs, and increased HIV-related stigma. Language facilitators enhanced the connection between AALWH and the healthcare system by facilitating their engagement with health care providers. Language barriers experienced by AALWH not only impact their healthcare decisions and treatment choices but also increase levels of external stigma which may influence the process of acculturation to the host country. Language facilitators and barriers to health services for AALWH represent a target for future interventions in this population.
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Affiliation(s)
- Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Wenxiu Sun
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Cheng-Shi Shiu
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
- National Taiwan University, Department of Social Work, Taipei, Taiwan
| | - Boram Kim
- School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Jury Candelario
- APAIT- A division of Special Service for Groups, Inc., Los Angeles, CA, USA
| | - Lance Toma
- San Francisco Community Health Center, San Francisco, CA, USA
| | - Gilbert Wu
- Chinese-American Planning Council, Inc., New York, NY, USA
| | - Judy Ah-Yune
- Chinese-American Planning Council, Inc., New York, NY, USA
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Twersky SE, Jefferson R, Garcia-Ortiz L, Williams E, Pina C. The Impact of Limited English Proficiency on Healthcare Access and Outcomes in the U.S.: A Scoping Review. Healthcare (Basel) 2024; 12:364. [PMID: 38338249 PMCID: PMC10855368 DOI: 10.3390/healthcare12030364] [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: 12/29/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
A majority of individuals with limited English proficiency (LEP) in the U.S. are foreign-born, creating a complex intersection of language, socio-economic, and policy barriers to healthcare access and achieving good outcomes. Mapping the research literature is key to addressing how LEP intersects with healthcare. This scoping review followed PRISMA-ScR guidelines and included PubMed/MEDLINE, CINAHL, Sociological Abstracts, EconLit, and Academic Search Premier. Study selection included quantitative studies since 2000 with outcomes specified for adults with LEP residing in the U.S. related to healthcare service access or defined health outcomes, including healthcare costs. A total of 137 articles met the inclusion criteria. Major outcomes included ambulatory care, hospitalization, screening, specific conditions, and general health. Overall, the literature identified differential access to and utilization of healthcare across multiple modalities with poorer outcomes among LEP populations compared with English-proficient populations. Current research includes inconsistent definitions for LEP populations, primarily cross-sectional studies, small sample sizes, and homogeneous language and regional samples. Current regulations and practices are insufficient to address the barriers that LEP individuals face to healthcare access and outcomes. Changes to EMRs and other data collection to consistently include LEP status and more methodologically rigorous studies are needed to address healthcare disparities for LEP individuals.
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Affiliation(s)
- Sylvia E. Twersky
- Department of Public Health, The College of New Jersey, Ewing Township, NJ 08618, USA; (L.G.-O.)
| | - Rebeca Jefferson
- R. Barbara Gitenstein Library, The College of New Jersey, Ewing Township, NJ 08618, USA;
| | - Lisbet Garcia-Ortiz
- Department of Public Health, The College of New Jersey, Ewing Township, NJ 08618, USA; (L.G.-O.)
| | - Erin Williams
- Department of Public Health, The College of New Jersey, Ewing Township, NJ 08618, USA; (L.G.-O.)
| | - Carol Pina
- Department of Public Health, The College of New Jersey, Ewing Township, NJ 08618, USA; (L.G.-O.)
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Vang S, Margolies LR, Jandorf L. Screening Mammogram Adherence in Medically Underserved Women: Does Language Preference Matter? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1076-1082. [PMID: 33169336 PMCID: PMC8106692 DOI: 10.1007/s13187-020-01922-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 06/11/2023]
Abstract
This study examines the relationship between language preference and screening mammogram adherence in medically underserved women in New York City. A survey was conducted with 518 women age 40 and over attending breast health education programs in English, Spanish, Chinese (Mandarin/Cantonese), and French. Women who preferred Chinese were 53% less likely to have had a mammogram within the past year compared to women who preferred English (p < .01). Women age 75 and older (p < .0001) and those without insurance (p < .05) were also found to be significantly less likely to have had a screening mammogram compared to women ages 55-74 and those with private insurance, respectively. This research indicates medically underserved women who prefer a non-English language may benefit from linguistically appropriate interventions to improve screening mammogram adherence. Future research should examine appropriateness of breast cancer screening for women age 75 and older and explore ways to improve screening mammogram use in the uninsured population.
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Affiliation(s)
- Suzanne Vang
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1077, New York, NY, 10029, USA.
| | - Laurie R Margolies
- Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lina Jandorf
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Cancer Screening Program Delivered by Community Health Workers for Chinese Married Immigrant Women in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116655. [PMID: 35682239 PMCID: PMC9180934 DOI: 10.3390/ijerph19116655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/22/2022] [Accepted: 05/28/2022] [Indexed: 12/10/2022]
Abstract
This quasi-experimental study used a cancer prevention program delivered by community health workers (CHWs) as an intervention to improve health literacy and increase screening uptake. The intervention group was educated by trained CHWs and received information about the nearby hospitals. After education, participants received telephone counseling once a month for 6 months. In the intervention group, CHWs met the participants individually and delivered the CD-ROM containing conversation scenarios with voice during the cancer screening test. The control group was provided educational materials related to breast and cervical cancers and a booklet containing information on mammography and Pap test. This study assessed the difference in mammography and Pap tests between the intervention and control groups. The results showed that the participants’ knowledge improved, and the rate of cancer screening tests did not decrease in the intervention group. Therefore, it is necessary to develop and apply various programs that train CHWs and apply them to immigrant women to promote health-related behaviors under the health system that they are not familiar with while living in another country.
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Sun Y, Yuan J, Liu W, Qin B, Hu Z, Li J, He Y. Predicting Rural Women's Breast Cancer Screening Intention in China: A PLS-SEM Approach Based on the Theory of Planned Behavior. Front Public Health 2022; 10:858788. [PMID: 35480590 PMCID: PMC9035887 DOI: 10.3389/fpubh.2022.858788] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIt was reported that the incidence of breast cancer (BC) was the highest among cancers worldwide. The breast cancer screening (BCS) program is regarded as an effective preventive measure. However, rural women's willingness to participate in the BCS program is relatively low. To provide measures to prevent BC, it is necessary for the government to identify the influencing factors of rural women's BCS intention.MethodsA cross-sectional study was conducted among 3,011 rural women by a convenience sampling method through face-to-face interviews on a self-designed questionnaire based on the theory of planned behavior (TPB). The partial least square structural equation model (PLS-SEM) was conducted to determine the predictors of BCS intention, and a multi-group analysis (MGA) of age was performed to identify if there were differences in all hypotheses between different age groups.ResultsThere were still rural women who have not been screened for BC in five years (41.7%). The research model of rural women's intention to accept this prevention against BC was rational. All of the hypotheses are supported. Especially, subjective norm (SN) (β = 0.345, p < 0.001) is found to be the strongest predictor followed by the perceived behavioral control 1 (PBC 1) (personal factors, including distance, transportation, busyness, etc.) (β = 0.165, p < 0.001), attitude (β = 0.152, p < 0.001), past behavior (PB) (β = 0.150, p < 0.001), knowledge (β = 0.121, p < 0.001), and perceived behavioral control 2 (PBC 2) (pain and cultural-social factors including embarrassment from a physician, etc.) (β = 0.042, p < 0.05). The advocacy and education (A&E), medical level and service attitude (ML&SA) of township health centers and village clinics can affect behavior intention (BI) via attitude, SN, and PBC. The results of MGA of age indicate that there are significant differences among rural women of different ages regarding the relationship between A&E and PBC 2 (p < 0.01) and the effect of PB on BI (p < 0.001).ConclusionThe TPB with the addition of PB, knowledge, ML&SA, and A&E can provide the theoretical basis for the policy intervention that aims to enhance the rural women's BCS willingness. MGA of age is conducive to promoting the implementation of the BCS policy. The findings are of great significance to improve rural women's health levels.
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Affiliation(s)
- Yanjun Sun
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Jiawei Yuan
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Wuqianhui Liu
- The First School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Banghui Qin
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Zhiqing Hu
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Jianwei Li
- Department of Material and Child Health, Lianyungang Material and Child Health Hospital, Lianyungang, China
| | - Yuan He
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
- Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, China
- *Correspondence: Yuan He
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Abdi HI, Hoover E, Fagan SE, Adsul P. Cervical Cancer Screening Among Immigrant and Refugee Women: Scoping-Review and Directions for Future Research. J Immigr Minor Health 2021; 22:1304-1319. [PMID: 32350683 DOI: 10.1007/s10903-020-01014-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study is to explore existing research on determinants of cervical cancer screening among immigrants and refugees in the U.S. A scoping review was conducted on 77 studies targeting immigrant and/or refugee women in the U.S., investigating factors related to cervical cancer screening. Sixty-three percent of studies were conducted in the past ten years, and included 122,345 women. Studies predominately explored knowledge, beliefs and barriers related to cervical cancer and screening. Common beliefs included fear of cancer, treatment and death. Participants perceived pap smears to be associated with embarrassment, pain and fear. Barriers to screening were reported in three categories: psychosocial (shame and embarrassment), communication (inability to speak in English), and barriers related to access (lack of insurance or primary care provider). Study findings indicate research focused at the individual-level and future research should focus on exploring multilevel influences on cancer screening uptake.
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Affiliation(s)
- Hamdi I Abdi
- Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware St. S.E., Minneapolis, MN, 55455, USA
| | | | | | - Prajakta Adsul
- Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Comprehensive Cancer Center, 1 University of New Mexico, 2325 Camino de Salud, Albuquerque, NM, 87131, USA.
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Ebrahimi N, Amirmahani F, Sadeghi B, Ghanaatian M. Trichoderma longibrachiatum derived metabolite as a potential source of anti‐breast‐cancer agent. Biologia (Bratisl) 2021. [DOI: 10.1007/s11756-021-00705-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Adunlin G, Cyrus JW, Asare M, Sabik LM. Barriers and Facilitators to Breast and Cervical Cancer Screening Among Immigrants in the United States. J Immigr Minor Health 2019; 21:606-658. [PMID: 30117005 DOI: 10.1007/s10903-018-0794-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
To summarize the literature on barriers and facilitators to breast and cervical cancer screening among immigrants to the US. A literature review was conducted for studies on breast and cervical cancer screening among immigrant populations. A thematic analysis of 180 studies identified a variety of barriers and facilitators to screening at the personal and system levels. Personal barriers included lack of knowledge and insurance coverage, high cost of care, and immigration status. System barriers included poor access to services, lack of interpreter services, and insensitivity to patient needs. Facilitators to screening included knowledge of disease, access to information sources, physician recommendation, and social networks. Cultural norms and resource availability at the individual and system levels influence screening among immigrants. Health insurance coverage was found to be an important predictor of preventative screening use. Future research should seek to identify the best way to address this and other barriers to cancer screening among immigrants groups.
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Affiliation(s)
- Georges Adunlin
- McWhorter School of Pharmacy, Samford University, 2100 Lakeshore Dr, Homewood, AL, 35229, USA.
| | - John W Cyrus
- Tompkins-McCaw Library, Virginia Commonwealth University, 509 N 12th St, Richmond, VA, 23298-0430, USA
| | - Matthew Asare
- Department of Public Health, Baylor University, One Bear Place #97313, Waco, TX, 76798-7313, USA
| | - Lindsay M Sabik
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, 130 De Soto St., Pittsburgh, PA, 15261, USA
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Kwok C, Lee MJ, Lee CF. Breast Cancer Perceptions and Screening Behaviours Among Korean Women in Australia. J Immigr Minor Health 2019; 22:126-133. [DOI: 10.1007/s10903-019-00876-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Endeshaw M, Clarke T, Senkomago V, Saraiya M. Cervical Cancer Screening Among Women by Birthplace and Percent of Lifetime Living in the United States. J Low Genit Tract Dis 2018; 22:280-287. [PMID: 30063576 PMCID: PMC6664302 DOI: 10.1097/lgt.0000000000000422] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of the study was to provide national estimates of Pap test receipt, by birthplace, and percent of lifetime in the United States (US). MATERIALS AND METHODS Pooled nationally representative data (2005, 2008, 2013, 2015) from the National Health Interview Survey were used to examine differences in Pap test receipt among adult US women by birthplace and percent of lifetime in the US. Descriptive estimates were age-adjusted. Regression models were adjusted for selected sociodemographic and healthcare access and utilization factors and presented as predicted margins. RESULTS Foreign-born women 18 years and older were more than twice as likely to have never received a Pap test compared with US-born women (18.6% vs 6.8%). Regression models showed that foreign-born women from Mexico (9.8%), South America (12.6%), Caribbean (14.6%), Southeast Asia (13.7%), Central Asia (20.4%), South Asia (22.9%), Middle East (25.0%), Africa (27.8%), Europe (16.4%), and Former Soviet Union (28.2%) were more likely to be unscreened compared with US-born women (7.6%). Foreign-born women who spent less than 25% of their life in the US had higher prevalence of never having a Pap test (20%) compared with foreign-born who spent more than 25% of their life in the US (12.7%). CONCLUSIONS Using national survey, we found that where a woman is born and the percent of her lifetime spent residing in the US do impact whether she gets screened at least once in her lifetime. IMPACT These findings may inform cervical cancer screening efforts targeting foreign-born women.
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Affiliation(s)
- Meheret Endeshaw
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Tainya Clarke
- Division of Health Interview Statistics, Centers for Disease Control and Prevention, National Center for Health Statistics, Atlanta, GA
| | - Virginia Senkomago
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
| | - Mona Saraiya
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA
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Bao Y, Kwok C, Lee CF. Breast cancer screening behaviors among Chinese women in Mainland China. Nurs Health Sci 2018; 20:445-451. [PMID: 29920900 DOI: 10.1111/nhs.12533] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 03/15/2018] [Accepted: 04/06/2018] [Indexed: 01/01/2023]
Abstract
In the present study, we reported on the current breast cancer screening rates among Chinese women in China and examined whether demographic factors and cultural beliefs were associated with their screening behavior. A cross-sectional survey was conducted with a convenience sample of 494 Chinese women who completed the modified Breast Cancer Screening Beliefs Questionnaire (BCSBQ). Two-sample t-tests and multivariable logistic regression were employed to analyze the data. The results indicated that participation in screening practices ranged from 27.5% for breast self-examination (BSE), 36.4% for clinical breast examination, 23.5% for mammography, and 40% for ultrasonography. Women who had previously engaged in one of the four screening practices had significantly higher scores on the three subscales of the modified BCSBQ. Being older and having a friend who had been diagnosed with breast cancer were shown to be predictors for BSE and participation in either mammography or ultrasonography, respectively. Education levels were also shown to be positively associated with the four screening measures. We suggest that cultural beliefs about breast cancer and screening practices play a significant role in Chinese women's screening behavior.
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Affiliation(s)
- Yingyi Bao
- School of Stomatology and Medicine, Foshan University, Foshan, China
| | - Cannas Kwok
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia
| | - Chun Fan Lee
- School of Public Health, The University of Hong Kong, Hong Kong
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Abulizi G, Abulimiti T, Li H, Abuduxikuer G, Mijiti P, Zhang SQ, Maimaiti A, Tuergan M, Simayi A, Maimaiti M. Knowledge of cervical cancer and Pap smear among Uyghur women from Xinjiang, China. BMC WOMENS HEALTH 2018; 18:21. [PMID: 29343254 PMCID: PMC5773149 DOI: 10.1186/s12905-018-0512-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 01/07/2018] [Indexed: 12/22/2022]
Abstract
Background Cervical cancer is a significant public health issue in Xinjiang China. In order to provide scientific basis for cervical cancer intervention in Xinjiang, women’s knowledge of cervical cancer was investigated in this study. Besides, relations between Uyghur women’s awareness and their age, educational background, yearly household were evaluated. Methods Questionnaire survey was conducted to 7100 Uyghur women from Karkax Hotan and Payzivat Kashgar during 2008 and 2009. Women aged 21 to 70 years, had sexual activity, no history of cervical lesion or cervical cancer were considered to be eligible to the study. Information include participants’ socio-demographic background, personal data, awareness about Pap smear, about cervical cancer and HPV, sources of information acquisition was investigated. Results 65.1% of the 7100 respondents with primary education level, and 95.0% participants were farmers. Only 7.4% had undertaken Pap smears before, not aware of the importance of the test (97.4% of 7100) was the main reason for not performing Pap smears. 29.3% of total participants had heard about cervical cancer, and only 0.14% (10 out of 7100) had heard about HPV. Top three route of knowledge acquire were television advertises (39.1%), neighbors (21.0%) and health care providers (15.0%). Women younger than 40 years, with higher educational levels and higher income had better awareness of cervical cancer and more willing to accept regular Pap smears. Conclusions Uyghur women in Xinjiang had poor knowledge of cervical cancer and HPV infection. Low awareness of women was associated with less household income and lower educational levels. TV shows and education from health care providers may increase women’s participation in cervical cancer control and prevention. Electronic supplementary material The online version of this article (doi: 10.1186/s12905-018-0512-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guzhalinuer Abulizi
- 5th Department of Gynecology, Affiliated Tumor Hospital of Xinjiang Medical University, No.789, Suzhou East Road, Urumqi, Xinjiang Uyghur Autonomous Region, 830054, China.
| | - Tangnuer Abulimiti
- 5th Department of Gynecology, Affiliated Tumor Hospital of Xinjiang Medical University, No.789, Suzhou East Road, Urumqi, Xinjiang Uyghur Autonomous Region, 830054, China
| | - Hua Li
- 5th Department of Gynecology, Affiliated Tumor Hospital of Xinjiang Medical University, No.789, Suzhou East Road, Urumqi, Xinjiang Uyghur Autonomous Region, 830054, China
| | - Guzhalinuer Abuduxikuer
- 5th Department of Gynecology, Affiliated Tumor Hospital of Xinjiang Medical University, No.789, Suzhou East Road, Urumqi, Xinjiang Uyghur Autonomous Region, 830054, China
| | - Patiman Mijiti
- 5th Department of Gynecology, Affiliated Tumor Hospital of Xinjiang Medical University, No.789, Suzhou East Road, Urumqi, Xinjiang Uyghur Autonomous Region, 830054, China
| | - Su-Qin Zhang
- Surgery Department of Gynecological Oncology, Cancer Center of Guangzhou Medical University, No.78 Heng Ji Gang Road, Guangzhou, 510095, China
| | - Ayinuer Maimaiti
- 6th Department of Gynecology, Affiliated Tumor Hospital of Xinjiang Medical University, No.789, Suzhou East Road, Urumqi, Xinjiang Uyghur Autonomous Region, 830054, China
| | - Muyasier Tuergan
- 6th Department of Gynecology, Affiliated Tumor Hospital of Xinjiang Medical University, No.789, Suzhou East Road, Urumqi, Xinjiang Uyghur Autonomous Region, 830054, China
| | - Ayiguli Simayi
- Department of Gynecology, Kelamayi Central Hospital, No.67 Zhun Ge Er Road, Kelamayi, Xinjiang Uyghur Autonomous Region, 834000, China
| | - Miherinisha Maimaiti
- Department of Gynecology, People's Hospital of Xinjiang Uyghur Autonomous Region, No. 91 Tian Chi Road, Urumqi, Xinjiang Uyghur Autonomous Region, 834000, China
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Uysal Toraman A, Yildirim N. Knowledge About Cervical Cancer Risk Factors and Practices of Pap Testing Among Turkish Immigrant Women in the United States. J Immigr Minor Health 2017; 20:1222-1229. [PMID: 28929252 DOI: 10.1007/s10903-017-0653-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective of this study was to examine knowledge about cervical cancer risk factors and practices of Pap testing among female Turkish immigrants in the state of Florida in the United States of America (USA). This descriptive study was conducted between April and September 2012. The study sampling was consist of 156 Turkish women living in the state of Florida. A questionnaire-based survey was conducted among the population of Turkish immigrant women. On the survey form comprised of a total of 37 questions and three sections there are questions pertaining to the socio-demographic characteristics of the individuals, their knowledge on the cervical cancer risk factors and their approach to getting Pap smear tests. Statistical Package for Social Sciences (version 16.0) was used to compute frequency and descriptive statistics related to demographic data. The average age of the women is 35.67 ± 10.0. More than half of women (66%) women reported cervical cancer screening at least one. Over two-thirds knew that having abnormal vaginal bleeding (85.8%) and vaginal infections (78.2%), having sexual activity with a man who has had multiple sexual partners (61.5%), and having multiple sexual partners (61.5%) increase the risk of cervical cancer. The result of the multivariate regression analysis have determined that the age of immigrant women (OR 11.3, 95 % CI 5.1-25.2, p:0.000) and the number of children ( OR 3.4, 95 % CI 1.7-6.9, p:0.000) are factors that impact pap smear testing behavior. Our study findings confirm low levels of Pap testing and show important knowledge deficits about cervical cancer risk factors and the importance of Pap testing among Turkish immigrant women. It is recommended that the immigrant women be educated about cervical cancer by means of organizing conferences in their own language and preparing informative materials.
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Affiliation(s)
- Aynur Uysal Toraman
- Department of Public Health Nursing, Faculty of Nursing, Ege University, 35100, Bornova, Izmir, Turkey.
| | - Nilufer Yildirim
- Department of Public Health Nursing, Faculty of Nursing, Ege University, 35100, Bornova, Izmir, Turkey
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Idehen EE, Korhonen T, Castaneda A, Juntunen T, Kangasniemi M, Pietilä AM, Koponen P. Factors associated with cervical cancer screening participation among immigrants of Russian, Somali and Kurdish origin: a population-based study in Finland. BMC WOMENS HEALTH 2017; 17:19. [PMID: 28284203 PMCID: PMC5346186 DOI: 10.1186/s12905-017-0375-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 03/04/2017] [Indexed: 11/21/2022]
Abstract
Background Previous studies revealed low participation in cervical cancer screening among immigrants compared with non-immigrants. Only a few studies about factors associated with immigrants’ lower participation rates have been conducted in European countries that have universal access for all eligible women. Our study aimed to explore factors associated with cervical screening participation among women of Russian, Somali, and Kurdish origin in Finland. Methods We used data from the Migrant Health and Well-being Survey, 2010-2012. Structured face-to-face interviews of groups of immigrants aged 25-60 yielded 620 responses concerning screening participation in the previous five years. Statistical analysis employed logistic regression. Results The age-adjusted participation rates were as follows: among women of Russian origin 73.9% (95% CI 68.1-79.7), for Somalis 34.7% (95% CI 26.4-43.0), and for Kurds 61.3% (95% CI 55.0-67.7). Multiple logistic regressions showed that the most significant factor increasing the likelihood of screening participation among all groups was having had at least one gynecological check-up in the previous five years (Odds ratio [OR] = 6.54-26.2; p < 0.001). Other factors were higher education (OR = 2.63; p = 0.014), being employed (OR = 4.31; p = 0.007), and having given birth (OR = 9.34; p = 0.014), among Kurds; and literacy in Finnish/Swedish (OR = 3.63; p = 0.003) among Russians. Conclusions Our results demonstrate that women who refrain from using reproductive health services, those who are unemployed and less educated, as well as those with poor language proficiency, might need more information on the importance of screening participation. Primary and occupational healthcare services may have a significant role in informing immigrant women about this importance.
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Affiliation(s)
- Esther E Idehen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 7021, Kuopio, Finland. .,Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Tellervo Korhonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 7021, Kuopio, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anu Castaneda
- Department of Welfare, Equality and Inclusion Unit, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Teppo Juntunen
- Department of Welfare, Equality and Inclusion Unit, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Anna-Maija Pietilä
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
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15
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Participation in treatment decision-making among Chinese-Australian women with breast cancer. Support Care Cancer 2016; 25:957-963. [DOI: 10.1007/s00520-016-3487-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/07/2016] [Indexed: 11/27/2022]
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16
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Chen WT, Barbour R. Life priorities in the HIV-positive Asians: a text-mining analysis in young vs. old generation. AIDS Care 2016; 29:507-510. [PMID: 27684610 DOI: 10.1080/09540121.2016.1221029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
HIV/AIDS is one of the most urgent and challenging public health issues, especially since it is now considered a chronic disease. In this project, we used text mining techniques to extract meaningful words and word patterns from 45 transcribed in-depth interviews of people living with HIV/AIDS (PLWHA) conducted in Taipei, Beijing, Shanghai, and San Francisco from 2006 to 2013. Text mining analysis can predict whether an emerging field will become a long-lasting source of academic interest or whether it is simply a passing source of interest that will soon disappear. The data were analyzed by age group (45 and older vs. 44 and younger). The highest ranking fragments in the order of frequency were: "care", "daughter", "disease", "family", "HIV", "hospital", "husband", "medicines", "money", "people", "son", "tell/disclosure", "thought", "want", and "years". Participants in the 44-year-old and younger group were focused mainly on disease disclosure, their families, and their financial condition. In older PLWHA, social supports were one of the main concerns. In this study, we learned that different age groups perceive the disease differently. Therefore, when designing intervention, researchers should consider to tailor an intervention to a specific population and to help PLWHA achieve a better quality of life. Promoting self-management can be an effective strategy for every encounter with HIV-positive individuals.
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Affiliation(s)
- Wei-Ti Chen
- a School of Nursing , Yale University , Orange , CT , USA
| | - Russell Barbour
- b Center for Interdisciplinary Research on AIDS (CIRA) , Yale School of Public Health , New Haven , CT , USA
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17
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Roué T, Labbé S, Belliardo S, Plenet J, Douine M, Nacher M. Predictive Factors of the Survival of Women With Invasive Breast Cancer in French Guiana: The Burden of Health Inequalities. Clin Breast Cancer 2016; 16:e113-8. [PMID: 27036361 DOI: 10.1016/j.clbc.2016.02.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 02/16/2016] [Accepted: 02/29/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND The prognosis of patients with breast cancer in French Guiana is worse than in France, with 23 deaths per 100 incident cases versus 17 per 100 in metropolitan France. This study aimed to compare the relative survival of patients with invasive breast cancer (IBC) between women from French Guiana and metropolitan France and to determine risk factors influencing breast cancer survival in French Guiana. MATERIALS AND METHODS Data were collected from the Cancer Registry of French Guiana. We compared the relative survival of women with IBC between French Guiana and metropolitan France. We used the Cox proportional hazard regression to evaluate the effect of prognostic factors on cancer-specific mortality in French Guiana. RESULTS We included all 269 cases of IBC in women diagnosed in French Guiana between 2003 and 2009. The overall 5-year relative survival rate of patients with IBC was 79% in French Guiana and 86% in metropolitan France. The place of birth (foreign country vs. French territory), the tumor stage at the time of diagnosis, the mode of diagnosis (symptoms vs. screening), the presence of hormone receptors in the tumor, and the histologic type were the variables associated with survival differences. None of the other study variables were significantly associated with prognosis. CONCLUSION Access to care for migrants is challenging, which leads to health inequalities. Early detection through prevention programs is crucial to increase IBC survival, notably for foreign-born patients.
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Affiliation(s)
- Tristan Roué
- The Cancer Registry of French Guiana, Cayenne, French Guiana.
| | - Sylvain Labbé
- The Cancer Registry of French Guiana, Cayenne, French Guiana; Service d'Anatomie Pathologique, Cayenne, French Guiana
| | | | - Juliette Plenet
- The Cancer Registry of French Guiana, Cayenne, French Guiana
| | - Maylis Douine
- Centre d'Investigation Clinique, Epidemiologie Clinique Antilles Guyane, Cayenne, French Guiana; Centre Hospitalier Andree Rosemon, Cayenne, French Guiana
| | - Mathieu Nacher
- Centre d'Investigation Clinique, Epidemiologie Clinique Antilles Guyane, Cayenne, French Guiana; Centre Hospitalier Andree Rosemon, Cayenne, French Guiana
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Lee J, Carvallo M, Lee T. Psychometric Properties of a Measure Assessing Attitudes and Norms as Determinants of Intention to Use Oral Contraceptives. Asian Nurs Res (Korean Soc Nurs Sci) 2015; 9:138-45. [PMID: 26160243 DOI: 10.1016/j.anr.2015.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 02/13/2015] [Accepted: 02/24/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Asian immigrant and Asian American women are less likely to use oral contraceptives (OCs) and tend to rely on low-efficacy methods of contraception. This contraceptive pattern remains poorly understood, in part, because no theory-driven measurement exists to assess psychosocial determinants essential in explaining behaviors related to OC use in this population. The current study aimed to evaluate the psychometric properties of a measure of attitudes and subjective norms toward OC use among Korean American women as a first step to determine whether the measure can be used in this population and, potentially, in other Asian ethnic groups. METHODS The sample consisted of 329 Korean immigrant women living in New York City. The theory of reasoned action guided the development of the measure assessing attitudes and norms. Psychometric evaluation included item analysis, internal consistency estimates of reliability, and construct validity (i.e., factorial, discriminant, and predictive). RESULTS All item-total correlations were above the recommendation of .30. The Cronbach's alpha for the attitudes and subjective norms measure was .88 and .86, respectively. Exploratory factor analyses revealed four interpretable factors, and confirmatory factor analyses confirmed that the factor structures derived from the exploratory factor analyses fit the data well. Discriminant and predictive validity of the measure were also established. CONCLUSIONS The study provides support for the validity and reliability of the measure and its use for determining the degree to which Korean immigrant women intend to use OCs.
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Affiliation(s)
- Jongwon Lee
- College of Nursing, University of New Mexico, Albuquerque, NM, USA.
| | | | - Taehun Lee
- Department of Psychology, University of Oklahoma, Norman, OK, USA
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19
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Abd El-Rahman AAEM, El-Shafei SMAEA, Ivanova EV, Fattakhova AN, Pankova AV, El-Shafei MAEA, El-Morsi EMAEF, Alimova FK. Cytotoxicity of Trichoderma spp. cultural filtrate against human cervical and breast cancer cell lines. Asian Pac J Cancer Prev 2015; 15:7229-34. [PMID: 25227819 DOI: 10.7314/apjcp.2014.15.17.7229] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Trichoderma spp. are known as a rich source of secondary metabolites with biological activity belonging to a variety of classes of chemical compounds. These fungi also are well known for their ability to produce a wide range of antibiotic substances and to parasitize other fungi. In search for new substances, which might act as anticancer agents, the overall objective of this study was to investigate the cytotoxic effects of Trichoderma harzianum and Trichoderma asperellum cultural filtrates against human cervical and breast cancer cell lines (HeLa and MCF-7 cells respectively). To achieve this objective, cells were exposed to 20, 40, 60, 80 and 100 mg/ ml of both T. harzianum cultural filtrate (ThCF) and T. asperellum cultural filtrate (TaCF) for 24h, then the cell viability and the cytotoxic responses were assessed by using trypan blue and 3-(4,5-dimethylthiazol-2yl)- 2,5-biphenyl tetrazolium bromide (MTT) assays. Morphological changes in cells were investigated by phase contrast inverted microscopy. The results showed that ThCF and TaCF significantly reduce the cell viability, have cytotoxic effects and alter the cellular morphology of HeLa and MCF-7 cells in a concentration dependent manner. A concentration of 80 and 100mg/ml of ThCF resulted in a sharp decline in the cell viability percent of HeLa and MCF-7 respectively (25.2%, 26.5%) which was recorded by trypan blue assay. The half-maximal inhibitory concentrations (IC50) of ThCF and TaCF in HeLa and MCF-7 were recorded as 16.6, 12.0, 19.6 and 0.70 mg/ml respectively by MTT assay. These results revealed that ThCF and TaCF have a substantial ability to reduce the viability and proliferation of human cervical and breast cancer cells.
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Chen WT, Guthrie B, Shiu CS, Wang L, Weng Z, Li CS, Lee TSH, Kamitani E, Fukuda Y, Luu BV. Revising the American dream: how Asian immigrants adjust after an HIV diagnosis. J Adv Nurs 2015; 71:1914-25. [PMID: 25740206 DOI: 10.1111/jan.12645] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 12/13/2022]
Abstract
AIM We explored how acculturation and self-actualization affect depression in the HIV-positive Asians and Pacific Islanders immigrant population. BACKGROUND Asians and Pacific Islanders are among the fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate. DESIGN A mixed-methods study was conducted. METHODS Thirty in-depth interviews were conducted with HIV-positive Asians and Pacific Islanders in San Francisco and New York. Additionally, cross-sectional audio computer-assisted self-interviews were conducted with a sample of 50 HIV-positive Asians and Pacific Islanders. Content analysis was used to analyse the in-depth interviews. Also, descriptive, bivariate statistics and multivariable regression analysis was used to estimate the associations among depression, acculturation and self-actualization. The study took place from January-June 2013. DISCUSSION Major themes were extracted from the interview data, including self-actualization, acculturation and depression. The participants were then divided into three acculturation levels correlating to their varying levels of self-actualization. For those with low acculturation, there was a large discrepancy in the Center for Epidemiologic Studies Depression Scale scores between those who had totally lost their self-actualization and those who believed they could still achieve their 'American dreams'. Among those who were less acculturated, there was a significant difference in depression scores between those who felt they had totally lost their ability to self-actualize and those who still believed they could 'make their dreams come true.' CONCLUSION Acculturation levels influence depression and self-actualization in the HIV-positive Asians and Pacific Islanders population. Lower acculturated Asian Americans achieved a lower degree of self-actualization and suffered from depression. Future interventions should focus on enhancing acculturation and reducing depression to achieve self-actualization.
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Affiliation(s)
- Wei-Ti Chen
- School of Nursing, Yale University, Orange, Connecticut, USA
| | - Barbara Guthrie
- School of Nursing, Northeastern University, Boston, Massachusetts, USA
| | - Cheng-Shi Shiu
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Lixuan Wang
- School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Zhongqi Weng
- School of Nursing, Yale University, Orange, Connecticut, USA
| | - Chiang-Shan Li
- Department of Psychiatry and Neurobiology, Yale University, New Haven, Connecticut, USA
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Education, National Taiwan Normal University, Taipei, Taiwan
| | - Emiko Kamitani
- School of Nursing, University of California, San Francisco, California, USA
| | - Yumiko Fukuda
- APICHA Community Health Center, New York, New York, USA
| | - Binh Vinh Luu
- HIV/AIDS Service, Chinese-American Planning Council Inc, New York, New York, USA
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Spence AR, Alobaid A, Drouin P, Goggin P, Gilbert L, Provencher D, Tousignant P, Hanley JA, Franco EL. Screening histories and contact with physicians as determinants of cervical cancer risk in Montreal, Quebec. ACTA ACUST UNITED AC 2014; 21:294-304. [PMID: 25489256 DOI: 10.3747/co.21.2056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cervical cancer (cca) is largely a preventable disease if women receive regular screening, which allows for the detection and treatment of preinvasive lesions before they become invasive. Having been inadequately screened is a common finding among women who develop cca. Our primary objective was to determine the Pap screening histories of women diagnosed with cca in Montreal, Quebec. Secondary objectives were to determine the characteristics of women at greatest risk of cca and to characterize the level of physician contact those women had before developing cca. METHODS The Invasive Cervical Cancer Study, a population-based case-control study, consisted of Greater Montreal residents diagnosed with histologically confirmed cca between 1998 and 2004. Respondents to the 2003 Canadian Community Health Survey and a sample of women without cca obtained from Quebec medical billing records served as controls. RESULTS During the period of interest, 568 women were diagnosed with cca. Immigrants and women speaking neither French nor English were at greatest risk of cca. Most of the women in the case group had been screened at least once during their lifetime (84.8%-90.4%), but they were less likely to have been screened within 3 years of diagnosis. Having received care from a family physician or a medical specialist other than a gynecologist within the 5 years before diagnosis was associated with a greater risk of cca development. CONCLUSIONS Our findings provide evidence of the need for an organized population-based screening program. They also underscore the need for provider education to prevent missed opportunities for cca screening when at-risk women seek medical attention.
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Affiliation(s)
- A R Spence
- Division of Cancer Epidemiology, McGill University, Montreal, QC
| | - A Alobaid
- Department of Obstetrics and Gynecology, King Khaled University Hospital, Riyadh, Saudi Arabia
| | - P Drouin
- Division of Gynecologic Oncology, Centre hospitalier de l'Université de Montréal, Montreal, QC
| | - P Goggin
- Institut national de santé publique du Québec, Montreal, QC
| | - L Gilbert
- Department of Obstetrics and Gynecology, Mc-Gill University Health Centre, Montreal, QC
| | - D Provencher
- Division of Gynecologic Oncology, Centre hospitalier de l'Université de Montréal, Montreal, QC
| | - P Tousignant
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC. ; Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montreal, QC
| | - J A Hanley
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC
| | - E L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, QC. ; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC
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Chen WT, Guthrie B, Shiu CS, Yang JP, Weng Z, Wang L, Kamitani E, Fukuda Y, Luu BV. Acculturation and perceived stress in HIV+ immigrants: depression symptomatology in Asian and Pacific Islanders. AIDS Care 2014; 26:1581-5. [PMID: 25059642 DOI: 10.1080/09540121.2014.936816] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Asians and Pacific Islanders (API) are among the fastest growing minority groups within the USA, and this growth has been accompanied by an increase in HIV incidence. Between 2000 and 2010, the API HIV infection rate increased from 4.5% to 8.7%; however, there is a paucity of HIV-related research for this group, and even less is known about the prevalence and correlates of antiretroviral therapy adherence behavior, quality of life, impact of stress, and efficacious self-management among HIV+ API Americans. This paper examines how acculturation and perceived stress affect depression symptomatology and treatment seeking in the HIV+ API population. A series of cross-sectional audio computer-assisted self-interviews were conducted with a convenience sample of 50 HIV+ API (29 in San Francisco and 21 in New York City). The relationship between acculturation and perceived stress was analyzed, and the results indicate that for those HIV+ API who reported low or moderate acculturation (as compared to those who reported high acculturation), stress was significantly mediated by depression symptomology. Interventions to address acculturation and reduce perceived stress among API generally and Asians specifically are therefore needed.
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Affiliation(s)
- Wei-Ti Chen
- a School of Nursing , Yale University , Orange , CT , USA
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