Health Beliefs Associated with Cervical Cancer Screening Among Vietnamese Americans

Abstract

Background: Vietnamese American women represent one of the ethnic subgroups at great risk for cervical cancer in the United States. The underutilization of cervical cancer screening and the vulnerability of Vietnamese American women to cervical cancer may be compounded by their health beliefs. Objective: The objective of this study was to explore the associations between factors of the Health Belief Model (HBM) and cervical cancer screening among Vietnamese American women. Methods: Vietnamese American women (n = 1,450) were enrolled into the randomized controlled trial (RCT) study who were recruited from 30 Vietnamese community-based organizations located in Pennsylvania and New Jersey. Participants completed baseline assessments of demographic and acculturation variables, health care access factors, and constructs of the HBM, as well as health behaviors in either English or Vietnamese. Results: The rate of those who had ever undergone cervical cancer screening was 53% (769/1450) among the participants. After adjusting for sociodemographic variables, the significant associated factors from HBM included: believing themselves at risk and more likely than average women to get cervical cancer; believing that cervical cancer changes life; believing a Pap test is important for staying healthy, not understanding what is done during a Pap test, being scared to know having cervical cancer; taking a Pap test is embarrassing; not being available by doctors at convenient times; having too much time for a test; believing no need for a Pap test when feeling well; and being confident in getting a test. Conclusion: Understanding how health beliefs may be associated with cervical cancer screening among underserved Vietnamese American women is essential for identifying the subgroup of women who are most at risk for cervical cancer and would benefit from intervention programs to increase screening rates.

Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study

“…Circumcision has also been reported as a barrier to cervical screening tests, as described by Somali women. Moreover, similar findings were reported from Somalis in the Netherlands 26. This perception may be explained by the fact that 98% of Somali women have experienced female genital mutilation, particularly the type three form, which involves cutting the tissues and stitching the labia together, leaving only a narrow opening for urine to pass.…”

“…This perception may be explained by the fact that 98% of Somali women have experienced female genital mutilation, particularly the type three form, which involves cutting the tissues and stitching the labia together, leaving only a narrow opening for urine to pass. Therefore, a “closed” woman is considered safe from sexually transmitted diseases; consequently, they may rarely go for screenings 26. Another explanation could be that women may fear that the examination of their closed genitals may cause them pain.…”

Creencias sobre el cancer cervicouterino y Papanicolaou y su relación con la adherencia al tamizaje

“…A pesar que las mujeres pueden considerar que el CC es una enfermedad seria, no se perciben a sí mismas en riesgo de desarrollarlo 13,14,15,16,17 , afectando por lo tanto las conductas preventivas 18 . Lo anterior concuerda con nuestros hallazgos, ya que las mujeres adherentes perciben un mayor riesgo de desarrollo de la enfermedad, sin embargo la severidad de la misma no resulta ser un factor que afecte la adherencia.…”

“…Respecto a las barreras relacionadas con las características del examen, los resultados reportados concuerdan con investigaciones previas donde se señala la vergüenza que genera el examen 14,16,[20][21][22] y el miedo que les provoca el diagnostico de cáncer 4,6,16,23 . En relación a esto último, se ha descrito que hay mujeres que prefieren "no saber de enfermedades que no tienen tratamiento y que pueden llevar a la muerte" 19,22 .…”

“…Muchas mujeres piensan que el PAP sólo se realiza si hay síntomas 13,14,16,25 , concordando con los resultados reportados, siendo una causa que determina diferencias en la adherencia al tamizaje. Respecto de la necesidad de tener hijos o estar teniendo relaciones sexuales actualmente, si bien la mayoría responde acertadamente, el 10% que no lo hizo.…”