Barriers and facilitators of cervical cancer screening practices among African immigrant women living in Brisbane, Australia

Anaman-Torgbor, Judith A.; King, Julie; Correa‐Velez, Ignacio

doi:10.1016/j.ejon.2017.09.005

Cited by 58 publications

(83 citation statements)

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“…In addition, there have been a few projects aimed at understanding African immigrant health in other countries. Those studies revealed a number of barriers to African immigrants' healthcare access that were similar to U.S. studies [31][32][33]. For instance, African immigrants in other countries, like in the U.S., were found to be often viewed as a part of a larger homogeneous population [34][35][36].…”

Section: Introductionmentioning

confidence: 75%

Understanding the healthcare experiences and needs of African immigrants in the United States: a scoping review

2020

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Background: Africans immigrants in the United States are the least-studied immigrant group, despite the research and policy efforts to address health disparities within immigrant communities. Although their healthcare experiences and needs are unique, they are often included in the "black" category, along with other phenotypically-similar groups. This process makes utilizing research data to make critical healthcare decisions specifically targeting African immigrants, difficult. The purpose of this Scoping Review was to examine extant information about African immigrant health in the U.S., in order to develop lines of inquiry using the identified knowledge-gaps. Methods: Literature published in the English language between 1980 and 2016 were reviewed in five stages: (1) identification of the question and (b) relevant studies, (c) screening, (d) data extraction and synthesis, and (e) results. Databases used included EBSCO, ProQuest, PubMed, and Google Scholar (hand-search). The articles were reviewed according to title and abstract, and studies deemed relevant were reviewed as full-text articles. Data was extracted from the selected articles using the inductive approach, which was based on the comprehensive reading and interpretive analysis of the organically emerging themes. Finally, the results from the selected articles were presented in a narrative format. Results: Culture, religion, and spirituality were identified as intertwined key contributors to the healthcare experiences of African immigrants. In addition, lack of culturally-competent healthcare, distrust, and complexity, of the U.S. health system, and the exorbitant cost of care, were identified as major healthcare access barriers. Conclusion: Knowledge about African immigrant health in the U.S. is scarce, with available literature mainly focusing on databases, which make it difficult to identify African immigrants. To our knowledge, this is the first Scoping Review pertaining to the healthcare experiences and needs of African immigrants in the U.S.

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Section: Introductionmentioning

confidence: 75%

Understanding the healthcare experiences and needs of African immigrants in the United States: a scoping review

2020

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“…These include; the ignorance about the disease and its screening practices as well as perceptions and attitudes based on cultural and religious beliefs [9,22]. The poor health infrastructure and other competing health interests may be other reasons for this low coverage [5,6,14].…”

Section: Introductionmentioning

confidence: 99%

Cervical cancer screening practices among women in Ghana: evidence from wave 2 of the WHO study on global AGEing and adult health

et al. 2020

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Background: Cervical cancer is the third most common cancer that affects women worldwide. It has been and remains the leading cause of cancer mortality among women in Ghana. Despite the fact that cervical cancer is preventable through early detection and treatment of precancerous lesions, anecdotal evidence from gynaecological clinics in Ghana indicates that most patients present with a late stage of the disease. This study assesses the cervical cancer screening practices among women in Ghana. Methods: Data from the World Health Organization's (WHO) multi-country Study on AGEing and adult health (SAGE) wave 2 conducted between 2014 and 2015 in Ghana was used. We employed binary logistic regression models to analyse data on 2711 women to examine factors associated with having pelvic examination among women aged ≥18 years. Among those who had pelvic examination, we applied binary logistic regression models to analyse factors associated with receiving Pap smear test as a subgroup analysis. Results: Of the 2711 women aged 18 years or older surveyed, 225 (8.3%) had ever had a pelvic examination and only 66 (2.4%) of them reported ever having done a Pap smear test. For those who had pelvic examination, only 26.94% had Pap smear test. Ethnic group, marital status, father's educational level and difficulty with self-care were independently associated with undergoing pelvic examination. Only age and healthcare involvement were independently associated with pelvic examination within the past 5 years to the survey. Marital status, satisfaction with healthcare and healthcare involvement were independently associated with Pap smear test. Conclusion: Even though cervical cancer is preventable through early detection of precancerous lesions using Pap smear test, the patronage of this screening test is still very low in Ghana. Factors influencing the low patronage in Ghana include the marital status of women, their level of satisfaction with healthcare as well as their level of involvement with healthcare. These may be the consequences of a weak health system and the lack of a national policy on cervical cancer screening.

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“…6 The participation in the CCS program among immigrants is lower in Norway compared with nonimmigrants, 7,8 as is the case in other high-income countries. [9][10][11][12][13] One study 8 showed that 52% of immigrants and 32% of native Norwegian individuals were nonadherent to CCS.…”

Section: Introductionmentioning

confidence: 99%

Effect of an Intervention in General Practice to Increase the Participation of Immigrants in Cervical Cancer Screening

et al. 2020

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IMPORTANCE Immigrant women have lower participation in cervical cancer screening (CCS) programs. At the same time, some groups of immigrants have higher prevalence of cervical cancer. Targeted interventions are therefore necessary. OBJECTIVE To determine whether an intervention among general practitioners (GPs) could influence immigrant women's participation in the Norwegian CCS program. DESIGN, SETTING, AND PARTICIPANTS Cluster-randomized clinical trial using the 20 subdistricts of the Bergen, Norway, municipality as clusters. The clusters were matched in 10 pairs according to the number of immigrant women living in them and randomized thereafter. The intervention was implemented between January and June 2017 among urban, primary care, general practices in Bergen. Follow-up ended in January 2018. General practices belonging to the control areas continued treatment as usual. A total of 10 360 women who attended 73 general practices in the 20 subdistricts were included as participants. INTERVENTION The intervention consisted of 3 elements: an educational session for GPs at lunch describing the importance of CCS among immigrants and giving advice about how to invite them to participate, a mouse pad as a reminder, and a poster placed in waiting rooms. In the educational session, we elaborated the need for GPs to ask every immigrant woman about CCS, regardless of their reason for contacting their GP. MAIN OUTCOMES AND MEASURES The main outcome, screening status of immigrant women by January 1, 2018, was obtained from the Norwegian Cancer Registry. The effect of the intervention was measured as odds ratio (OR) for CCS status as of January 1, 2018, for the intervention group vs the control group, with 3 levels of adjustments: baseline CCS status at January 1, 2017 (model 1), additional adjustment for women's age, marital status, income level, and region of origin (model 2), and further adjustment for the GP's sex, age, and region of origin (model 3). Two subgroup analyses, screening status at baseline and women's country of origin, were conducted to assess whether these factors had any influence on the effect of the intervention. Data were analyzed as intention to treat. RESULTS A total of 10 360 immigrant women, 5227 (50.4%; mean [SD] age, 44.0 [12.0] years) in the intervention group and 5133 (49.6%; mean [SD] age, 44.5 [11.6] years) in the control group, belonging to 39 general practices in the intervention area and 34 in the control area, were included in the study. The proportion of immigrant women screened increased by 2.6% in the intervention group and 0.6% in the control group. After adjustment for screening status at baseline, women in the intervention group were more likely to have participated in CCS (OR, 1.24 [95% CI, 1.11-1.38]). This statistically significant effect remained unchanged after adjustment for women's characteristics (OR, (continued) Key Points Question Can an educational intervention for general practitioners increase participation in cervical cancer screening among immigrants? Findings In thi...

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Barriers and facilitators of cervical cancer screening practices among African immigrant women living in Brisbane, Australia

Abstract: There is a need to provide culturally appropriate approaches to cervical screening practices and to enhance cultural competence among health professionals to apply service delivery models that honour group cultures.

Cited by 58 publications

References 20 publications

Understanding the healthcare experiences and needs of African immigrants in the United States: a scoping review

Understanding the healthcare experiences and needs of African immigrants in the United States: a scoping review

Cervical cancer screening practices among women in Ghana: evidence from wave 2 of the WHO study on global AGEing and adult health

Effect of an Intervention in General Practice to Increase the Participation of Immigrants in Cervical Cancer Screening

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