Knowledge and experience of cancer prevention and screening among Gypsies, Roma and Travellers: a participatory qualitative study

Abstract

Background The incidence of cancer is increasing worldwide, which has led to greater public health focus on primary prevention. Ethnic minorities have lower awareness of cancer risk factors and services, and are at greater risk of cancer mortality. While Gypsies, Roma and Travellers have poor health outcomes even in comparison with other ethnic minorities, little is known about how they view and enact primary prevention. This study takes a participatory approach to explore knowledge and experience of cancer prevention and screening in these communities. Methods Peer researchers conducted interviews (n = 37) and a focus group (n = 4) with a purposive sample of community members in Wales and South-West England. Participants self-identified as Roma (from Slovakia and Romania) or as Gypsies, Travellers or Showpeople (here described as Gypsy/Travellers). A third of the sample were Roma, and a quarter male, with ages ranging from 18 to 77 years. Data were collected from October 2018 to March 2019. Results Women and men knew that lifestyle factors, such as healthy diet, stopping smoking, drinking less alcohol and using sun protection, contribute to cancer risk reduction. However, there was a widespread lack of confidence in the effectiveness of these measures, particularly in relation to smoking. Traditional cultural beliefs were shared by Roma and Gypsy/Travellers, but did not necessarily affect the behaviour of individuals. Most women participated in cervical and breast screening but few Gypsy/Traveller men would engage with bowel screening, which conflicted with community ideals of stoical masculinity. Roma participants described language barriers to screening, with confusion about differences in timing and eligibility between the UK and Slovakian programmes; this led some to access screening abroad. Conclusion This study provides new knowledge about how Gypsies, Roma and Travellers keep healthy and prevent disease, giving insights into similarities and differences between ages, sexes and communities. These culturally distinct and high-need ethnic minorities have specific needs in relation to cancer prevention and screening, which merit targeted and acceptable health promotion to reduce health inequalities.

Public involvement in participatory research: the experiences of peer interviewers from Roma, Gypsy and Traveller communities

“…We have reported elsewhere on our study of the views of Gypsies, Roma and Travellers concerning cancer prevention, treatment and care (Condon et al 2021a(Condon et al , 2021b. This study was highly participatory, with members of those communities involved in identifying the research topic, bidding for funding, collecting and analysing the data, and disseminating findings.…”

“…One researcher struggled with mentioning bowel screening as he viewed it as shameful. Thus, paradoxically, a shared ethnic identity could inhibit as well as promote disclosure -this limitation is underacknowledged in existing research, which focuses predominantly on the positives of peer research (Liamputtong 2007, Condon et al 2021a.…”

Mental health support needs within Gypsy, Roma, and Traveller communities: a qualitative study

“…Within collectivist GRT culture, this exclusion of family members heightens reluctance to access services (Marsh, 2017). Insufficient cultural sensitivity also encompasses poor gender consideration; GRT people emphasise that care providers should be of the same gender, a tradition that is frequently overlooked in healthcare (Condon et al , 2021; Smith et al , 2020).…”

“…There is a deficit of research that considers factors that could predispose, precipitate or perpetuate MH problems and the MH support needs of GRT people within the British Isles (Cemlyn et al , 2009; Walker, 2008). Current literature bears methodological issues, such as poor GRT representation and a focus on physical health (AITHST, 2010; Atterbury, 2010; Cemlyn et al , 2009; Condon et al , 2020; Condon et al , 2021; Parry et al , 2007; Smith et al , 2020). Studies that consider the MH support needs of GRT people using GRT participants are limited to geographical locations, which limits generalisability (Goward et al , 2006; Millan and Smith, 2019; Villani and Barry, 2021).…”

Geografia dezvoltării. Abordări centrate pe om

“…Furtunescu et al (2021) consideră cancerul la sân o problemă majoră pentru România, analizând statisticile de după aderarea la UE. Discutând cu romi europeni (unii originari din România), Condon et al (2021) au încercat să surprindă perspectiva lor cu privire la prevenția și depistarea cancerului. Ciutan et al (2016) subliniază nevoia creșterii accesibilității populației la serviciile medicale și a creșterii personalului medical, pentru a se putea preveni o serie de condiții medicale ce necesită internare, dar care ar putea fi evitate (avoidable hospital conditions).…”