Barriers to Breast Cancer Screening among Diverse Cultural Groups in Melbourne, Australia

Abstract

This study explored the association between health literacy, barriers to breast cancer screening, and breast screening participation for women from culturally and linguistically diverse (CALD) backgrounds. English-, Arabic- and Italian-speaking women (n = 317) between the ages of 50 to 74 in North West Melbourne, Australia were recruited to complete a survey exploring health literacy, barriers to breast cancer screening, and self-reported screening participation. A total of 219 women (69%) reported having a breast screen within the past two years. Results revealed that health literacy was not associated with screening participation. Instead, emotional barriers were a significant factor in the self-reported uptake of screening. Three health literacy domains were related to lower emotional breast screening barriers, feeling understood and supported by healthcare providers, social support for health and understanding health information well enough to know what to do. Compared with English- and Italian-speaking women, Arabic-speaking women reported more emotional barriers to screening and greater challenges in understanding health information well enough to know what to do. Interventions that can improve breast screening participation rates should aim to reduce emotional barriers to breast screening, particularly for Arabic-speaking women.

Re-thinking health literacy: using a capabilities approach perspective towards realising social justice goals

“…When looking at the health and care experiences of vulnerable individuals and communities, research has highlighted the challenges faced by currenteven critical -health literacy approaches to meet the needs and realities of vulnerable groups such as Migrant and Minority Ethnic groups (MME) (7,21). MME groups have been consistently found to have low levels of health literacy, (7), poorer health outcomes and face inequalities in quality of care and barriers to healthcare access (4,22).…”

“…In addition, people's ability to engage with what is going on during the clinical consultation is not only the result of literacy levels, but also of more complex psychosocial processes beyond the care context (22,27). For example, research looking into access to breast screening services has found health literacy non-predictive of screening participation for women from minority ethnic backgrounds; emotional barriers such as fear and anxiety were central to participation (21).…”

The impact of translated reminder letters and phone calls on mammography screening booking rates: Two randomised controlled trials

“…The motivation for this study was recognition by State Government and BSV that innovative strategies were required to improve service provision in the region. This present study forms part of the Ophelia BreastScreen study, in which health literacy-based interventions were co-designed with community members and breast screen providers to improve the acceptability and accessibility of the screening program to Italian, Arabic, and Aboriginal and Torres Strait Islander women in the North-West screening region [24,25].…”

Health literacy strengths and limitations among rural fishing communities in Egypt using the Health Literacy Questionnaire (HLQ)

“…To improve readability, some specific Egyptian Arabic words were substituted for Arabic words that were less familiar to this population. This type of validity testing is essential when using a health literacy measure developed in a different culture [27] (Hawkins et al, 2018). This is especially important because health literacy is a reflection of an individual's personal skills but also the complexity of the environment in which, they live, which determines how difficult it is to navigate and access the available health information and services [37].…”

“…Feeling understood and supported by healthcare providers The HLQ has been widely used, and validity testing of the English HLQ has been undertaken in several communities [21,22] and translated into more than 30 languages. Validity testing of translated versions has been undertaken in several countries and these studies have contributed to the network of evidence for valid decisions using HLQ data in these cultural contexts [23][24][25][26][27][28].…”