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Lurgain JG, Ouaarab-Essadek H, Mellouki K, Malik-Hameed S, Sharif A, Brotons M, Bruni L, Peremiquel-Trillas P. Exploring self-care and cervical cancer prevention attitudes and practices among Moroccan and Pakistani immigrant women in Catalonia, Spain: a comparative qualitative study. BMC Public Health 2024; 24:388. [PMID: 38321465 PMCID: PMC10845717 DOI: 10.1186/s12889-023-17445-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 12/08/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Self-care and preventive health strategies may trigger health inequities when individuals' cultural values and health beliefs are not fully understood and considered. In the case of cervical cancer (CC) screening programs immigrant women have shown lower attendance compared with native women, which increases the risk of late diagnosis and, consequently, a lower probability of survival. HPV self-sampling for CC screening has been recently added to the World Health Organization's (WHO) list of self-care interventions as a promising tool to reduce this disparity and improve screening coverage. In Catalonia, Spain, the introduction of HPV self-sampling as a part of the new population-based CC screening program, is a significant step. However, there is a lack of research addressing self-care and prevention among immigrant populations in this region. This study aims to fill this gap exploring self-care and prevention attitudes and practices among Moroccan and Pakistani women. METHODS We conducted focus groups and individual interviews with 36 Moroccan and 37 Pakistani women in Barcelona, Spain. The topic guide of the focus groups included case vignettes to stimulate the discussion and a semi-structured questionnaire was used for the interviews. RESULTS Our findings show that most Moroccan and Pakistani women do not prioritize self-care and prevention. They seek care for symptom treatment rather than disease prevention. In this sense, they reported not having the habit of doing regular check-ups and their self-care and prevention attitudes and practices seemed to be conditioned by cultural values. The implementation of an effective call and recall system could enhance the engagement of these populations with CC screening services. CONCLUSION This study provides evidence on how universal concepts of self-care and prevention may not aligned with more collectivist societies, emphasizing the limited applicability and motivation of global self-care interventions guidelines for individuals with different cultural backgrounds and values. Therefore, the successful implementation of CC screening programs or any other self-care intervention requires the adoption of culturally appropriate strategies.
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Affiliation(s)
- Jone G Lurgain
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
| | - Hakima Ouaarab-Essadek
- Community & Public Health Team (ESPIC), Drassanes-Vall d'Hebron Centre for International Health and Infectious Diseases, Carrer de Sant Oleguer, 17, 08001, Barcelona, Spain
| | - Khadija Mellouki
- Community & Public Health Team (ESPIC), Drassanes-Vall d'Hebron Centre for International Health and Infectious Diseases, Carrer de Sant Oleguer, 17, 08001, Barcelona, Spain
| | - Sumaira Malik-Hameed
- Community & Public Health Team (ESPIC), Drassanes-Vall d'Hebron Centre for International Health and Infectious Diseases, Carrer de Sant Oleguer, 17, 08001, Barcelona, Spain
| | - Andleeb Sharif
- Community & Public Health Team (ESPIC), Drassanes-Vall d'Hebron Centre for International Health and Infectious Diseases, Carrer de Sant Oleguer, 17, 08001, Barcelona, Spain
| | - Maria Brotons
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute - IDIBELL, Av Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain
| | - Laia Bruni
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute - IDIBELL, Av Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain
| | - Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Av Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
- Bellvitge Biomedical Research Institute - IDIBELL, Av Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain
- Faculty of Medicine, University of Barcelona, C/ Casanova, 143, 08036, Barcelona, Spain
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Enden MR, Møen K, Igland J, Diaz E. Trends in cervical cancer screening in Norway 2012-2017: a comparison study of non-immigrant and immigrant women. Scand J Public Health 2024:14034948231217636. [PMID: 38166571 DOI: 10.1177/14034948231217636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
AIMS Immigrant women in Norway have lower cervical cancer screening participation than non-immigrant women. Our aim in this study was to assess whether the observed increase in screening participation during 2012-2017 was different between Norwegian-born women and immigrant women. METHODS Data were collected from three national registries. The study included 1,409,561 women, categorized according to country of birth and immigrant background: (i) Norway, Norwegian parents; (ii) Norway, immigrant parent(s); (iii) Europe, excluding Norway; (iv) Africa; (v) Asia, including Turkey; and (vi) other countries. Trends and differences between groups were analyzed using Poisson regression analyses with adjustments for variables other studies have found to influence screening participation. Trends were assessed by including half-years as a continuous variable in the models and reported as prevalence ratios with 95% confidence intervals. RESULTS Screening participation increased in all groups, but was not statistically significant among women from Africa in the adjusted model. The highest increase was among Norwegian women, with a 2.2% increase per year. Interaction tests showed significantly smaller increases in screening among women born in Europe (p interaction < 0.0001), Africa (p interaction < 0.0001), Asia (p interaction < 0.0001), and countries in the "Other" category (p interaction = 0.004). There was also a smaller increase among Norwegian-born women with one or more immigrant parent(s), but this was not significant (p interaction = 0.178). CONCLUSIONS The gap in screening participation and the increasing differences in trends suggest that healthcare services do not reach all women in Norway to the same extent. One should attempt to improve this while working toward further increasing screening participation for all.
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Affiliation(s)
- Marta Røttingen Enden
- Institute of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
| | - Kathy Møen
- Institute of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
| | - Jannicke Igland
- Institute of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
| | - Esperanza Diaz
- Institute of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
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AlAbdulKader AM, AlAsfour A, Golembiewski M, Gullett H. Disparities in cervical cancer screening among Arabic-speaking women refugees. Ethn 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Dadipoor S, Alavi A, Kader Z, Mohseni S, Eshaghi Sani Kakhaki H, Shahabi N. Predictive power of PEN-3 cultural model in cervical cancer screening among women: a cross- sectional study in South of Iran. BMC Cancer 2023; 23:730. [PMID: 37553636 PMCID: PMC10408223 DOI: 10.1186/s12885-023-11240-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Cervical cancer (CC) can be prevented through early detection facilitated by screening as well as an early diagnosis and effective treatment of the precancerous lesions. The present research aimed to determine the predictors of cervical cancer screening (CCS) based on the PEN-3 model constructs. METHODS A cross-sectional study was conducted between September 2021- March 2022 with 840 women aged 15-49 in the city of Bandar Abbas, in the south of Iran, using a cluster sampling. The participants completed a valid and reliable self-administered questionnaire in person. The questionnaire included demographic characteristics, knowledge toward CC and the constructs of the PEN-3 model toward CCS. A multivariable logistic regression was used to determine the relationship and predictive power of model constructs with behavior as an outcome variable. The data were statistically analyzed in STATA14.2. The p-value < 0.05 was considered statistically significant. RESULTS A total of 810 questionnaires were analyzed (with a return of 95.63%). The mean and standard deviation of the participants' age was 30.97 ± 5.80 years. Pearson correlation coefficient analysis of all constructs and CCS behavior was statistically significant (P-value < 0.05). The multivariable logistic regression analytic results were enablers toward CCS (coefficient: 0.275) and Nurturers toward CCS (coefficient: 0.182), perceptions toward CCS (coefficient: 0.077) and knowledge toward CC (coefficient: 0.048, marginal significant) were predictors of CCS behavior. For the internal validity of the designed prediction model, a sample of 1000 was selected using the bootstrap sample replacement method which demonstrated the accuracy of the model PEN-3 is about 75% in predicting CCS behavior. CONCLUSIONS The results of the present research showed that personal factors such as perceptions and interpersonal factors such as enablers and nurturers toward CCS can predict CCS behavior. Therefore, in order to increase the acceptance of CCS in women, a set of intrapersonal and interpersonal factors should be taken into account.
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Affiliation(s)
- Sara Dadipoor
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azin Alavi
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zainab Kader
- The Centre for Interdisciplinary Studies of Children, Families and Society, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hadi Eshaghi Sani Kakhaki
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nahid Shahabi
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Svensson P, Asamoah BO, Agardh A. Facilitating an encounter with a new sexuality discourse: the role of civic communicators in building sexual health literacy among newly arrived migrants. Cult Health Sex 2022; 24:1303-1318. [PMID: 34288831 DOI: 10.1080/13691058.2021.1946156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 06/17/2021] [Indexed: 06/13/2023]
Abstract
Language and different sexual health discourses constitute barriers to the uptake of information on sexual and reproductive health and rights among migrants. Challenges remain with regards to the design and implementation of culturally appropriate programmes and interventions. This study explored the role of civic communicators in increasing access to sexual health information among migrants resettling in Sweden. Twenty in-depth interviews were conducted and analysed using qualitative content analysis. Findings illustrate the potential role of civic communicators in identifying sexual health needs, deconstructing misinformation and providing a space for reflective dialogue. Training in adult pedagogy, leadership, cultural competence and subject knowledge, and allocating sufficient time to cover themes that are culturally different, sensitive and politicised, are essential for good quality implementation and promoting rights-based sexual health.
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Affiliation(s)
- Pia Svensson
- Division of Social Medicine and Global Health, Department of Clinical sciences, Lund University, Malmö, Sweden
| | - Benedict Oppong Asamoah
- Division of Social Medicine and Global Health, Department of Clinical sciences, Lund University, Malmö, Sweden
| | - Anette Agardh
- Division of Social Medicine and Global Health, Department of Clinical sciences, Lund University, Malmö, Sweden
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Tatari CR, Andersen B, Brogaard T, Badre-Esfahani S, Jaafar N, Kirkegaard P. The SWIM study: Ethnic minority women's ideas and preferences for a tailored intervention to promote national cancer screening programmes-A qualitative interview study. Health Expect 2021; 24:1692-1700. [PMID: 34232543 PMCID: PMC8483185 DOI: 10.1111/hex.13309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 06/08/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Ethnic minority women from non-Western countries are less likely than the native women to participate in screening programmes for cervical cancer, breast cancer and colorectal cancer. This social inequality can result in loss of possibility for prevention, delayed diagnosis and treatment and, ultimately, lower chance of survival. Developing a tailored intervention might be the solution to reduce social inequalities in cancer screening, and a key feature in intervention research is to consult the target group. OBJECTIVE To explore ethnic minority women's own ideas and preferences for a cancer screening intervention and identify their attitudes to different strategies. METHODS An interview study with five focus group interviews, two group interviews with an interpreter and three individual interviews. Thirty-seven women from 10 non-Western countries contributed to the study. The interviews were audio-recorded and transcribed verbatim followed by a thematic analysis. RESULTS According to the women, a tailored intervention should focus on knowledge in the form of face-to-face teaching. The women further suggested information material in their own language with a simple, positive and concrete communication strategy. They would like to be involved in an awareness strategy and share the knowledge with their network. CONCLUSION Ethnic minority women were interested in a tailored intervention, and they were keen to contribute with ideas and preferences. The findings emphasized the potential of a tailored intervention with specific suggestions to the content when attempting to reduce inequality in cancer screening participation. PATIENT OR PUBLIC CONTRIBUTION Minority women were involved in the interview study.
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Affiliation(s)
- Camilla Rahr Tatari
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.,University Research Clinic for Cancer Screening, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.,University Research Clinic for Cancer Screening, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Sara Badre-Esfahani
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.,University Research Clinic for Cancer Screening, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Negin Jaafar
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Pia Kirkegaard
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.,University Research Clinic for Cancer Screening, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Marques P, Gama A, Santos M, Heleno B, Vermandere H, Dias S. Understanding Cervical Cancer Screening Barriers among Migrant Women: A Qualitative Study with Healthcare and Community Workers in Portugal. Int J Environ Res Public Health 2021; 18:ijerph18147248. [PMID: 34299698 PMCID: PMC8305801 DOI: 10.3390/ijerph18147248] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/22/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022]
Abstract
Cervical cancer screening (CCS) has been proven to reducing mortality of cervical cancer; yet migrant women show a lower participation in screening compared to non-migrants. This study explores the perspectives of healthcare workers and community workers on the factors influencing the CCS participation of migrant women living in Portugal. A qualitative study with online focus groups was conducted. Healthcare workers experienced in CCS and community workers working with migrant communities were purposively sampled. A semi-structured guide was used covering the participation of migrant women in CCS, barriers, and strategies to overcome them. Data were analyzed using content analysis. Participants considered that migrant women have low participation in CCS related to insufficient knowledge, low risk perception, and lack of interest on preventive care. Other barriers such as difficulties in accessing the healthcare services, relationship with healthcare workers, language, and cultural differences were highlighted. Promoting continuity of care, disseminating culturally tailored information, and use of self-sampling methods were suggested to improve participation in CCS. Inequalities in access to CCS among migrant women are mostly caused by information gaps and healthcare system-related barriers. Building a migrant-friendly healthcare system that creates opportunities for healthcare workers to establish relationships with their patients and delivering culturally and linguistically adapted information may contribute to overcoming those barriers and increasing the participation of migrant women in screening.
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Affiliation(s)
- Patrícia Marques
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (P.M.); (A.G.); (M.S.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
| | - Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (P.M.); (A.G.); (M.S.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
| | - Mário Santos
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (P.M.); (A.G.); (M.S.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
| | - Bruno Heleno
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
- NOVA Medical School, Universidade Nova de Lisboa, 1169-056 Lisbon, Portugal
| | - Heleen Vermandere
- International Centre for Reproductive Health, Ghent University, 9000 Ghent, Belgium;
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal; (P.M.); (A.G.); (M.S.)
- Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1169-056 Lisbon, Portugal;
- Correspondence:
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Qureshi SA, Igland J, Møen K, Gele A, Kumar B, Diaz E. Effect of a community-based intervention to increase participation in cervical cancer screening among Pakistani and Somali women in Norway. BMC Public Health 2021; 21:1271. [PMID: 34193096 PMCID: PMC8243573 DOI: 10.1186/s12889-021-11319-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 06/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Norway implemented a regular cervical cancer screening program based on triennial screening in 1995, recommending participation of all women between 25 and 69 years of age. Somali and Pakistani women have the lowest participation in cervical cancer screening in Norway. This study evaluates the effect of a community-based intervention aimed at increasing participation in the screening program among women from these two groups. METHODS The intervention consisted of an oral 20-25 min presentation in Urdu and Somali on cervical cancer and screening and practical information on how to make an appointment and payment for the test. The participants were invited to pose questions related to the topic after the presentation. This study was carried out in four geographical areas surrounding the capital Oslo between February and October 2017, among women aged 25-69 years from Pakistan and Somalia. We recruited women in the intervention group directly from different community institutions, households, and religious sites. Women from Pakistan and Somalia residing in Oslo were the controls. The absolute intervention effect was measured as difference in absolute proportion of women screened and estimated as the interaction between time and group allocation in a generalized estimation equation model with binomial distribution and identity link function. RESULTS The percentage of women screened in the intervention group increased, from 46 to 51%. The corresponding increase in proportion in the control group was from 44 to 45.5%. After adjustment for potential confounders the intervention group showed a significant larger increase in participation in the screening program as compared to the control group with an absolute difference in change in proportion screened of 0.03 (95% CI; 0.02- 0.06). CONCLUSIONS Our findings suggest that theory-based, culturally and linguistically sensitive educational interventions can raise awareness and motivate immigrant women to participate in cervical cancer screening program. In addition, approaching health professionals as well as immigrant women, might improve participation even more. TRIAL REGISTRATION NCT03155581 . Retrospectively registered, on 16 May 2017.
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Affiliation(s)
- Samera Azeem Qureshi
- Unit for Migration & Health, Norwegian Institute of Public Health (NIPH), P.O. Box 222, Skøyen, 0213, Oslo, Norway.
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, N-5020, Bergen, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Kathy Møen
- The Norwegian Research Centre (NORCE) Alrek Helseklynge, Årstadveien 17, 5009, Bergen, Norway
| | - Abdi Gele
- Unit for Migration & Health, Norwegian Institute of Public Health (NIPH), P.O. Box 222, Skøyen, 0213, Oslo, Norway
| | - Bernadette Kumar
- Unit for Migration & Health, Norwegian Institute of Public Health (NIPH), P.O. Box 222, Skøyen, 0213, Oslo, Norway
| | - Esperanza Diaz
- Unit for Migration & Health, Norwegian Institute of Public Health (NIPH), P.O. Box 222, Skøyen, 0213, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, N-5020, Bergen, Norway
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Gremyr I, Elg M, Eriksson E, Halldórsson Á, Smith F, Gustavsson S. Exploring power shifts as an enabler for a strengthened patient role in quality improvements: a Swedish survey study. BMJ Open Qual 2021; 10:bmjoq-2020-001185. [PMID: 33648954 PMCID: PMC7925245 DOI: 10.1136/bmjoq-2020-001185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 02/11/2021] [Accepted: 02/13/2021] [Indexed: 11/27/2022] Open
Abstract
Objectives This study examined the relationship between professionals’ perceptions of a strengthened role for the patient and of patient involvement in quality improvement (QI) and whether professionals’ experiences in improvement science were a moderator on such a relationship. Design From a predominantly close-ended, 44-item questionnaire, 4 questions specifically concerning professionals′ perception on patient involvement in QI were analysed. Setting Three Swedish regions. Participants 155 healthcare professionals who had previously participated in courses in improvement science. Results The covariate patient involvement was significantly related to a perceived strengthened patient role. There was also a significant interaction effect between degree of patient involvement and professionals’ experience in the area of improvement science on a strengthened patient role. The result shows that there is a relationship between the perceived level of patient involvement in improvements and professionals’ perceptions of a strengthened patient role. In this study, the covariate, perceived patient involvement, was significantly related to experiences of more equal relationships between patients and healthcare professionals. There was also a significant interaction effect between the degree of patient involvement and professionals’ experience in the area of improvement science, for a more equal relationship between patients and healthcare professionals. Conclusion Increased patient involvement in QI is a means of strengthening the patient role and supporting a more equal relation between patients and healthcare professionals. Furthermore, empirical evidence shows that the healthcare professionals’ experiences in the area of improvement science support a strengthened patient role and a more equal power relationship, but for this to happen, the mindset of professionals is key. Future research is needed to capture and investigate the experiences from patients and relatives about being involved in QI in healthcare, and to study the effects on quality in care processes.
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Affiliation(s)
- Ida Gremyr
- Department of Technology Management and Economics, Chalmers University of Technology, Goteborg, Sweden
| | - Mattias Elg
- Department of Management and Engineering, Linköpings Universitet, Linkoping, Sweden
| | - Erik Eriksson
- Department of Technology Management and Economics, Chalmers University of Technology, Goteborg, Sweden
| | - Árni Halldórsson
- Department of Technology Management and Economics, Chalmers University of Technology, Goteborg, Sweden
| | - Frida Smith
- Department of Technology Management and Economics, Chalmers University of Technology, Goteborg, Sweden.,Department of Care Development, Regional Cancer Centre West, Goteborg, Sweden
| | - Susanne Gustavsson
- Hospital Administration Management, Skaraborg Hospital Skövde, Skovde, Sweden
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Christie-de Jong F, Reilly S. Barriers and facilitators to cervical screening for Filipino women – a narrative literature review. IJMHSC 2021. [DOI: 10.1108/ijmhsc-04-2019-0043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Purpose
Mortality rates of cervical cancer are high amongst Filipino women; however, uptake of cervical screening is low. The purpose of this paper is to identify known barriers and facilitators to cervical screening for Filipino migrant women.
Design/methodology/approach
A systematic approach was adopted for the search, data extraction, critical appraisal and synthesis processes of this review. Eight electronic databases were searched. Studies published in peer review journals in English between 1995 and 2019 were reviewed.
Findings
In total, 20 relevant studies were identified. Studies were heterogeneous in design and focus and mostly conducted in the USA. A complex multifactorial picture of barriers to cervical screening was identified, which included: demographic, cognitive, access, health-care provider and cultural factors. None of the studies incorporated all factors.
Practical implications
This review demonstrates the complexity and multifactorial characteristic of cervical screening for Filipino migrant women. To increase uptake of screening, barriers to cervical screening for Filipino migrant women need to be fully understood. Future research should be conducted in different locations, focussing on multiple factors.
Originality/value
Aggregation of barriers and facilitators for Asian women combined tends to ignore cultural differences between groups. This review synthesises the existing but scarce literature to identify known barriers and facilitators to cervical screening for this specific population of Filipino migrant women.
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11
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Marques P, Nunes M, Antunes MDL, Heleno B, Dias S. Factors associated with cervical cancer screening participation among migrant women in Europe: a scoping review. Int J Equity Health 2020; 19:160. [PMID: 32917224 PMCID: PMC7488650 DOI: 10.1186/s12939-020-01275-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/02/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cervical cancer screening has been effective in reducing incidence and mortality of cervical cancer, leading European countries to implement screening programs. However, migrant women show lower screening participation compared to nationals. This scoping review aims to provide a synthesis of the growing evidence on factors associated with participation in cervical cancer screening among migrant women in Europe. METHODS Electronic peer-reviewed databases were searched in November 2019 for studies on factors related to the participation of migrants in cervical cancer screening conducted in EU/EFTA countries, using comprehensive search expressions. Retrieved articles were screened and those eligible were selected for data extraction. Quantitative and qualitative studies were included. Factors were classified in barriers and facilitators and were divided into further categories. RESULTS Twenty out of 96 articles were selected and analyzed. Factors associated with participation in cervical cancer screening were classified in categories related to sociodemographic, healthcare-system, psychological, migration, knowledge, language, and cultural factors. Lack of information, lack of female healthcare providers, poor language skills, and emotional responses to the test (especially fear, embarrassment and discomfort) were the most reported barriers to cervical cancer screening. Encouragement from healthcare providers and information available in migrants' languages were frequently stated as facilitators. Results on the role of sociodemographic factors, such as age, education, employment and marital status, are the most conflicting, highlighting the complexity of the issue and the possibility of interactions between factors, resulting in different effects on cervical cancer screening participation among migrant women. Several identified barriers to screening are like those to access to healthcare services in general. CONCLUSIONS Efforts to increase migrant women's participation in CCS must target barriers to access to healthcare services in general but also specific barriers, including cultural differences about sexuality and gender, past traumatic personal experiences, and the gender and competences of healthcare professionals performing CCS. Healthcare services should strengthen resources to meet migrants' needs, including having CCS information translated and culturally adapted, as well as healthcare providers with skills to deal with cultural background. These findings can contribute to improve CCS programs among migrant women, reducing health disparities and enhancing their overall health and well-being.
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Affiliation(s)
- Patrícia Marques
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Mariana Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Maria da Luz Antunes
- ESTeSL (Instituto Politécnico de Lisboa), Lisbon, Portugal
- APPsyCI - Applied Psychology Research Center Capabilities & Inclusion, ISPA, Lisbon, Portugal
| | - Bruno Heleno
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
- NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.
- Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal.
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Hull R, Mbele M, Makhafola T, Hicks C, Wang SM, Reis RM, Mehrotra R, Mkhize-Kwitshana Z, Kibiki G, Bates DO, Dlamini Z. Cervical cancer in low and middle-income countries. Oncol Lett 2020; 20:2058-2074. [PMID: 32782524 PMCID: PMC7400218 DOI: 10.3892/ol.2020.11754] [Citation(s) in RCA: 150] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/16/2019] [Indexed: 12/11/2022] Open
Abstract
Cervical cancer is a malignant tumour that occurs in the cervix and is classified into two histological types, adenocarcinoma and squamous cell carcinoma (SCC); SCC is more common and accounts for 70% of all cases. In 2018 there were ~569,000 new cases of cervical cancer diagnosed worldwide and ~311,000 deaths were attributed to cervical cancer. Of these, between 84 and 90% occurred in low- and middle-income countries (LMICs) such as South Africa, India, China and Brazil. The most common cause of cervical cancer is persistent infection caused by the sexually transmitted human papilloma virus. Other factors that contribute to the incidence of cervical cancer include geography, traditional practices and beliefs, the screening levels, socioeconomic status, healthcare access, public awareness, use of oral contraceptives, smoking and co-infection with HIV. An estimated 11 million women from LMICs will be diagnosed with cervical cancer in the next 10-20 years. The aim of this review was to explore various types of genetic and epigenetic factors that influence the development, progression or suppression of cervical cancer.
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Affiliation(s)
- Rodney Hull
- SA-MRC/UP Precision Prevention and Novel Drug Targets for HIV-Associated Cancers Extramural Unit, Pan African Cancer Research Institute, Faculty of Health Sciences, University of Pretoria, Hatfield 0028, South Africa
| | - Mzwandile Mbele
- SA-MRC/UP Precision Prevention and Novel Drug Targets for HIV-Associated Cancers Extramural Unit, Pan African Cancer Research Institute, Faculty of Health Sciences, University of Pretoria, Hatfield 0028, South Africa
| | - Tshepiso Makhafola
- SA-MRC/UP Precision Prevention and Novel Drug Targets for HIV-Associated Cancers Extramural Unit, Pan African Cancer Research Institute, Faculty of Health Sciences, University of Pretoria, Hatfield 0028, South Africa
| | - Chindo Hicks
- Bioinformatics and Genomics Centre, School of Medicine, Department of Genetics, Louisiana State University, New Orleans, LA 70112, USA
| | - Shao-Ming Wang
- National Cancer Centre, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P.R. China
| | - Rui Manuel Reis
- Molecular Oncology Research Centre, Barretos Cancer Hospital, Sao Paulo 14784-400, Brazil
| | - Ravi Mehrotra
- Indian Council of Medical Research, New Delhi, Delhi 110029, India
| | | | - Gibson Kibiki
- East African Health Research Commission, East African Community, Bujumbura, Bujumbura Mairie 350, Burundi
| | - David O Bates
- Queen's Medical Centre, University of Nottingham, Nottingham, Nottinghamshire NG7 2UH, UK
| | - Zodwa Dlamini
- SA-MRC/UP Precision Prevention and Novel Drug Targets for HIV-Associated Cancers Extramural Unit, Pan African Cancer Research Institute, Faculty of Health Sciences, University of Pretoria, Hatfield 0028, South Africa
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Abstract
Purpose
The purpose of this paper is to illuminate strengths and limitations in quality improvement work, when involving patients.
Design/methodology/approach
The experience-based co-design (EBCD) method was used when improving care for patients undergoing otosclerosis surgery. Individual interviews and focus groups were interpreted using qualitative content analysis.
Findings
Strengths mentioned by patients were that their participation made a difference. The first steps were found effective in giving an in-depth view of patients’ experiences and the staff got an increased understanding about specific patient needs. However, weaknesses were found in the latter phases, those of improving and follow-up, health care staff had difficulties to keep their focus on patients’ experiences and invite patients to be involved. Patients’ participation decreased, and there was a lack of tools to support the process.
Research limitations/implications
The content in this paper is mainly based on one case. However, the findings are in congruence with earlier research and add further knowledge to the research area.
Practical implications
The findings can be used in healthcare when involving patients in improvement work.
Originality/value
There is no earlier study which involves patients with otosclerosis when using EBCD. Furthermore, this paper illuminates that there is a need to increase collaboration with patients. The latter phases often seem to be handled by health care professionals without involving patients; this paper suggest a development using dedicated quality tools.
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Qureshi SA, Gele A, Kour P, Møen KA, Kumar B, Diaz E. A community-based intervention to increase participation in cervical cancer screening among immigrants in Norway. BMC Med Res Methodol 2019; 19:147. [PMID: 31299912 PMCID: PMC6626362 DOI: 10.1186/s12874-019-0795-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 07/03/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The attendance to cervical cancer screening is low among immigrants in many high-income countries. Although several interventions have been experimentally tested,implementation remains a challenge. Several factors are an impediment, including the lack of methodological descriptions of the development and implementation of such interventions. In this paper,we present in detail the development, methodological challenges and practical implementation of a community based intervention aimed to increase the participation of immigrant women in cervical cancer screening in Norway. METHODS This study was initially designed as a cluster randomized trial to be carried out in four geographical areas near Oslo between Feb-October 2017. Participants were immigrant women aged 25-69 years from Pakistan and Somalia. This paper describes the theoretical background for the development of the intervention,followed by challenges,the changes in the original design and solutions adopted related to the study design,recruitment and implementation of the intervention. The intervention was developed based on two theoretical frameworks, the Ecological and the Heron's six categories intervention framework. An oral 20-25 min presentation in the language of participants encompassing topics of cervical cancer and screening was given according to the needs detected in focus groups conducted at the beginning of the study,followed by an opportunity to raise questions and answering a short questionnaire. RESULTS Contrary to the initial study design, this had to be converted into a non-randomised trial due to the difficulties associated with randomization of immigrant families who are finely scattered in heavily populated towns and a high risk of contamination. We therefore adopted a pragmatic approach and recruited women in the intervention areas through a variety of channels and institutions. Neighboring areas were considered to be non-randomised controls. Female researchers with Pakistani and Somali background invited as many women as possible in the intervention areas. Among the women who were invited to participate,42% of the Pakistani and 78% of Somali attended the meetings. CONCLUSION Despite the careful development of a culturally adapted health intervention in collaboration with the community; randomization and recruitment of immigrants for community trials remains challenging. Nevertheless, sharing strategies to overcome specific challenges related to promoting health interventions for immigrants, can be of potential help to scale-up interventions and for building new research projects. TRIAL REGISTRATION NCT03155581 . Retrospectively registered, on 16 May 2017.
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Affiliation(s)
- Samera A Qureshi
- Norwegian Centre for Migrant & Minority Health (NAKMI), Norwegian Institute of Public Health (NIPH), P.O.Box 222 Skøyen, 0213, Oslo, Norway.
| | - Abdi Gele
- Norwegian Centre for Migrant & Minority Health (NAKMI), Norwegian Institute of Public Health (NIPH), P.O.Box 222 Skøyen, 0213, Oslo, Norway
| | - Prabhjot Kour
- Norwegian Centre for Migrant & Minority Health (NAKMI), Norwegian Institute of Public Health (NIPH), P.O.Box 222 Skøyen, 0213, Oslo, Norway.,Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.O.Box 104, 2381, Brumunddal, Norway
| | - Kathy A Møen
- Norwegian Centre for Migrant & Minority Health (NAKMI), Norwegian Institute of Public Health (NIPH), P.O.Box 222 Skøyen, 0213, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, P.O.Box 7804, N-5020, Bergen, Norway
| | - Bernadette Kumar
- Norwegian Centre for Migrant & Minority Health (NAKMI), Norwegian Institute of Public Health (NIPH), P.O.Box 222 Skøyen, 0213, Oslo, Norway
| | - Esperanza Diaz
- Norwegian Centre for Migrant & Minority Health (NAKMI), Norwegian Institute of Public Health (NIPH), P.O.Box 222 Skøyen, 0213, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, P.O.Box 7804, N-5020, Bergen, Norway
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15
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Bergerum C, Thor J, Josefsson K, Wolmesjö M. How might patient involvement in healthcare quality improvement efforts work-A realist literature review. Health Expect 2019; 22:952-964. [PMID: 31044517 PMCID: PMC6803394 DOI: 10.1111/hex.12900] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 03/07/2019] [Accepted: 04/06/2019] [Indexed: 01/12/2023] Open
Abstract
Introduction This realist literature review, regarding active patient involvement in healthcare quality improvement (QI), seeks to identify possible mechanisms that contribute to success or failure. Furthermore, the paper outlines key considerations for organizing and supporting patient involvement in healthcare QI efforts. Methods Two literature searches were performed. Altogether, 1204 articles from a healthcare context were screened, focusing on improvement efforts that involve patients, healthcare professionals and/or managers and leaders. Among these, 107 articles fulfilled the chosen study selection criteria and were further analysed. Eighteen articles underwent a full realist review. In the realist synthesis, context‐mechanism‐outcome configurations were articulated as middle‐range theories and organized thematically to generate a program theory on how active patient involvement in QI efforts might work. Results The articles exhibited a diversity of patient involvement approaches at different levels of healthcare organizations. To be successful, organizations’ support of QI efforts that actively involved patients tailored the QI efforts to their context to achieve the desired outcomes, and involved the relevant microsystem members. Furthermore, it promoted interaction and partnership within the microsystem, and supported the behavioural change that follows. Conclusion This realist synthesis generates a program theory for active patient involvement in QI efforts; active patient involvement can be a tool (resource), if tailored for interaction and partnership (reasoning), that leads to behaviour change (outcome) within healthcare QI efforts. The theory explains essential resource and reasoning mechanisms, and outcomes that together form guidance for healthcare organizations when managing active patient involvement in QI efforts.
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Affiliation(s)
- Carolina Bergerum
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Johan Thor
- School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Karin Josefsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Maria Wolmesjö
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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16
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Eriksson EM, Lau M, Jönsson C, Zhang C, Risö Bergerlind LL, Jonasson JM, Strander B. Participation in a Swedish cervical cancer screening program among women with psychiatric diagnoses: a population-based cohort study. BMC Public Health 2019; 19:313. [PMID: 30885177 PMCID: PMC6421650 DOI: 10.1186/s12889-019-6626-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/05/2019] [Indexed: 11/12/2022] Open
Abstract
Background In Sweden, organized screening programs have significantly reduced the incidence of cervical cancer. For cancers overall, however, women with psychiatric diagnoses have lower survival rates than other women. This study explores whether women with psychiatric diagnoses participate in cervical cancer screening programs to a lesser extent than women on average, and whether there are disparities between psychiatric diagnostic groups based on grades of severity. Methods Between 2000 and 2010, 65,292 women within screening ages of 23–60 had at least two ICD-10 (International Statistical Classification of Diseases and Related Health Problems – Tenth Revision) codes F20*–F40* registered at visits in primary care or psychiatric care in Region Västra Götaland, Sweden. Participation in the cervical cancer screening program during 2010–2014 was compared with the general female population using logistic regression adjusted for age. Results Relative risk for participation (RR) for women diagnosed within psychiatric specialist care RR was 0.94 compared with the general population, adjusted for age. RR for diagnoses outside specialist care was 0.99. RR for psychoses (F20*) was 0.81. Conclusions Women with less-severe psychiatric diagnoses participate in the screening program to the same extent as women overall. Women who have received psychiatric specialist care participate to a lesser extent than women overall. The lowest participation rates were found among women diagnosed with psychoses.
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Affiliation(s)
- Erik M Eriksson
- Service Management and Logistics/Centre for Health Care Improvement, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden.
| | - Malena Lau
- Centre for Equity in Healthcare, Gothenburg, Region Västra Götaland, Sweden
| | - Claes Jönsson
- Department of Healthcare, Gothenburg, Region Västra Götaland, Sweden.,Sahlgrenska Academy, Institute of Clinical Sciences, Gothenburg, Sweden
| | | | | | | | - Björn Strander
- Sahlgrenska Academy, Institute of Clinical Sciences, Gothenburg, Sweden.,Regional Cancer Centre West Sweden, Gothenburg, Sweden
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17
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Vaughn LM, Whetstone C, Boards A, Busch MD, Magnusson M, Määttä S. Partnering with insiders: A review of peer models across community-engaged research, education and social care. Health Soc Care Community 2018; 26:769-786. [PMID: 29512217 DOI: 10.1111/hsc.12562] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 06/08/2023]
Abstract
Within community-engaged research, education and social care, peer models that partner with local "insiders" are increasingly common. Peer models are composed of insider "lay" community members who often share similarities or background with a project's target population. Peers are not academically trained, but work alongside researchers and professionals to carry out specific tasks within a project, or in the truest sense of partnership, peers collaborate throughout the project from start to finish as an equal member of the team. Although peer models are used widely, the literature lacks consistency and clarity. This systematic review of literature used a qualitative thematic synthesis to examine and report how, where and why peer models have been used in research, education and social care. We examined the language and titles used to describe the peers, details of their involvement in community-engaged projects, the setting, content/topic of study, level of engagement and related benefits/outcomes of such models. Focusing on the last 10 years, we conducted a comprehensive literature search twice between September 2016 and June 2017. The search resulted in 814 articles which were assessed for eligibility. Overall, 251 articles met our inclusion criteria and were categorised into three categories: empirical (n = 115); process/descriptive (n = 93); and "about" peers (n = 43). Findings suggest that there is a wide variety of peers, titles and terminology associated with peer models. There is inconsistency in how these models are used and implemented in research studies and projects. The majority of articles used an employment peer model, while only a handful involved peers in all phases of the project. The results of this literature review contribute to understanding the use, development and evolution of peer models. We highlight potential benefits of peer models for peers, their communities and community-engaged work, and we offer recommendations for future implementation of peer models.
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Affiliation(s)
- Lisa M Vaughn
- Pediatrics, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Alicia Boards
- Educational and Community-Based Action Research, University of Cincinnati, Cincinnati, OH, USA
| | - Melida D Busch
- Edward L. Pratt Research Library, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Sylvia Määttä
- Department of Healthcare Improvement, Western Region, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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18
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Idehen EE, Koponen P, Härkänen T, Kangasniemi M, Pietilä AM, Korhonen T. Disparities in cervical screening participation: a comparison of Russian, Somali and Kurdish immigrants with the general Finnish population. Int J Equity Health 2018; 17:56. [PMID: 29728104 PMCID: PMC5935973 DOI: 10.1186/s12939-018-0768-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 04/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background Cervical cancer is currently ranked as the fourth commonly diagnosed cancer in women globally. A higher incidence has been reported in low- and-middle-income countries, and the disease poses significant public health challenges. Evidence suggests that this disease is preventable by means of regular screening using the Papanicolaou (Pap) test. However, limited knowledge exists about disparities in cervical screening participation among immigrants compared with non-immigrants, in countries with universal cervical screening programmes. We aimed to examine disparities in cervical screening participation among women of Russian, Somali, and Kurdish, origin in Finland, comparing them with the general Finnish population (Finns). We controlled for differences in several socio-demographic and health-related variables as potential confounders. Methods We employed data from the Finnish Migrant Health and Well-being Study 2010–2012 and the National Health 2011 Survey. Data collection involved face-to-face interviews. Data on screening participation in the previous five years from women aged 29–60 were available from 537 immigrants (257 Russians, 113 Somalis, 167 Kurds) and from 436 Finns. For statistical analyses, we used multiple logistic regression. Results Age-adjusted screening participation rates were as follows: Russians 79% (95% CI 72.9–84.4), Somalis 41% (95% CI 31.4–50.1), and Kurds 64% (95% CI 57.2–70.8), compared with 94% (95% CI 91.4–95.9) among Finns. After additionally adjusting for socio-demographic and health-related confounders, all the immigrant groups showed a significantly lower likelihood of screening participation when compared with Finns. The Odds Ratios were as follows: Russians 0.32 (95% CI 0.18–0.58), Somalis 0.10 (95% CI 0.04–0.23), and Kurds 0.17 (95% CI 0.09–0.35). However, when additionally accounting for country of origin-confounder interactions, such differences were attenuated. Conclusions Our results indicate disparities in screening participation among these immigrants and a lower likelihood of screening participation compared with the general Finnish population. To improve equity in cervical cancer screening participation, appropriate culturally tailored intervention programmes for each immigrant group might be beneficial.
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Affiliation(s)
- Esther E Idehen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 70211, Kuopio, Finland.
| | - Päivikki Koponen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tommi Härkänen
- Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anna-Maija Pietilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Tellervo Korhonen
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 70211, Kuopio, Finland.,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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19
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Broberg G, Wang J, Östberg AL, Adolfsson A, Nemes S, Sparén P, Strander B. Socio-economic and demographic determinants affecting participation in the Swedish cervical screening program: A population-based case-control study. PLoS One 2018; 13:e0190171. [PMID: 29320536 DOI: 10.1371/journal.pone.0190171] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/08/2017] [Indexed: 12/03/2022] Open
Abstract
Background Cervical screening programs are highly protective for cervical cancer, but only for women attending screening procedure. Objective Identify socio-economic and demographic determinants for non-attendance in cervical screening. Methods Design: Population-based case-control study. Setting: Sweden. Population: Source population was all women eligible for screening. Based on complete screening records, two groups of women aged 30–60 were compared. The case group, non-attending women, (N = 314,302) had no smear registered for 6–8 years. The control group (N = 266,706) attended within 90 days of invitation. Main outcome measures: Risk of non-attendance by 9 groups of socioeconomic and demographic variables. Analysis: Unadjusted odds ratios (OR) and OR after adjustment for all variables in logistic regression models were calculated. Results Women with low disposable family income (adjOR 2.06; 95% confidence interval (CI) 2.01–2.11), with low education (adjOR 1.77; CI 1.73–1.81) and not cohabiting (adjOR 1.47; CI 1.45–1.50) were more likely to not attend cervical screening. Other important factors for non-attendance were being outside the labour force and receiving welfare benefits. Swedish counties are responsible for running screening programs; adjusted OR for non-participation in counties ranged from OR 4.21 (CI 4.06–4.35) to OR 0.54 (CI 0.52–0.57), compared to the reference county. Being born outside Sweden was a risk factor for non-attendance in the unadjusted analysis but this disappeared in certain large groups after adjustment for socioeconomic factors. Conclusion County of residence and socio-economic factors were strongly associated with lower attendance in cervical screening, while being born in another country was of less importance. This indicates considerable potential for improvement of cervical screening attendance in several areas if best practice of routines is adopted.
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Abstract
Purpose
– The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care.
Design/methodology/approach
– Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients’ Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis.
Findings
– Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient.
Research limitations/implications
– Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed.
Practical implications
– Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer’s value creating network, which may also include knowledge and skills from other sources, such as relatives.
Originality/value
– Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides aggregated information on cancer patients’ and relatives’ complaints concerning interpersonal issues, which can increase knowledge about patient healthcare service perceptions.
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Eriksson EM, Eliasson K, Hellström A, Määttä S, Vaughn L. When they talk about motherhood: a qualitative study of three groups' perceptions in a Swedish child health service context. Int J Equity Health 2016; 15:99. [PMID: 27342849 PMCID: PMC4920994 DOI: 10.1186/s12939-016-0387-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 06/20/2016] [Indexed: 12/03/2022] Open
Abstract
Background In light of the growing emphasis on individualization in healthcare, it is vital to take the diversity of inhabitants and users into consideration. Thus, identifying shared perceptions among group members may be important in improving healthcare that is relevant to the particular group, but also perceptions of the staff with whom interactions take place. This study investigates how motherhood is perceived among three groups: Somali-born mothers; Swedish-born mothers; and nurses at Swedish child health centers. Inequities in terms of access and satisfaction have previously been identified at the health centers. Methods Participants in all three groups were asked to finalize two statements about motherhood; one statement about perfect motherhood, another about everyday motherhood. The responses were analyzed using qualitative coding and categorization to identify differences and similarities among the three groups. Results The responses to both statements by the three groups included divergences as well as convergences. Overall, biological aspects of motherhood were absent, and respondents focused almost exclusively on social matters. Working life was embedded in motherhood, but only for the Somali-born mothers. The three groups put emphasis on different aspects of motherhood: Somali-born mothers on the community; the Swedish-born mothers on the child; and the nurses on the mother herself. The nurses – and to some extent the Swedish-born mothers – expected the mother to ask for help with the children when needed. However, the Somali-born mothers responded that the mother should be independent, not asking for such help. Nurses, more than both groups of mothers, largely described everyday motherhood in positively charged words or phrases. Conclusion The findings of this paper suggest that convergences and divergences in perceptions of motherhood among three groups may be important in equitable access and utilization of healthcare. Individualized healthcare requires nuance and should avoid normative or stereotypical encounters by recognizing social context and needs that are relevant to specific groups of the population.
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Affiliation(s)
- Erik Masao Eriksson
- Department of System Development and Strategy, Western Region of Sweden/Västra Götalandsregionen, Regionens Hus, SE-405 44, Göteborg, Sweden. .,Centre for Healthcare Improvement and Division of Service Management and Logistics, Chalmers University of Technology, Teknikens ekonomi och organisation, SE-412 96, Göteborg, Sweden.
| | - Kristin Eliasson
- Department of System Development and Strategy, Western Region of Sweden/Västra Götalandsregionen, Regionens Hus, SE-405 44, Göteborg, Sweden
| | - Andreas Hellström
- Centre for Healthcare Improvement and Division of Service Management and Logistics, Chalmers University of Technology, Teknikens ekonomi och organisation, SE-412 96, Göteborg, Sweden
| | - Sylvia Määttä
- Department of System Development and Strategy, Western Region of Sweden/Västra Götalandsregionen, Regionens Hus, SE-405 44, Göteborg, Sweden
| | - Lisa Vaughn
- Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, 3333 Burnet Ave ML 2008, Cincinnati, OH, 45229, USA
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