Barriers to cervical cancer screening faced by immigrant women in Canada: a systematic scoping review

Ferdous, Mahzabin; Lee, Sonya; Goopy, Suzanne; Yang, Huanming; Rumana, Nahid; Abedin, Tasnima; Turin, Tanvir Chowdhury

doi:10.1186/s12905-018-0654-5

Cited by 80 publications

(106 citation statements)

References 32 publications

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“…Previous studies suggest that economic restraints of immigrant women and GPs' time constraints are important barriers to screening, 15 Downloaded From: https://jamanetwork.com/ on 09/05/2020 significant. This finding concurs with another intervention study for the nonimmigrant population, 27 consisting of providing mailing lists to the GPs of women who were invited to receive testing but did not respond and inviting women to visit the GP at the office.…”

Section: Discussionmentioning

confidence: 99%

“…Barriers to immigrant women's participation in screening programs have been identified and include challenges not only at the individual level but also at the level of health care practitioners (HCPs) and the health care system. [14][15][16] However, few studies have described HCPs' perspectives on CCS among immigrants. [17][18][19] To our knowledge, no studies to date have investigated the effect of an intervention targeting GPs with a view to increasing participation in CCS among immigrants specifically.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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“…This is in agreement with recent report from Canada that taking time off work to go for cervical services is an economic barrier. 17 The maternal level of education was identified to be associated with level of uptake in a study in Hong Kong. 18 Also in a study in Germany, there was low uptake because the vaccine was for the lower age group of 8 to 26 years who have not been exposed to sex and mainly given to adolescents.…”

Section: Yes Nomentioning

confidence: 99%

“…This observation is agreement with known factors reported from other studies. 16,17 It had been reported that the future of cervical services in Europe would need to be diversified. 21 In Nigeria, a clarion call for well-planned and implemented program has been made, and the need for cost-effectiveness was recently emphasized.…”

Section: Yes Nomentioning

confidence: 99%

Factors influencing the acceptance of HPV vaccine among civil servants in Delta State Secretariat

Okwe¹,

Chime²,

Nwose³

2019

Int J Reprod Contracept Obstet Gynecol

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Background: The importance of cervical screening and HPV vaccination cannot be overemphasized. Yet, the level of uptake of HPV vaccination has never been evaluated among Secretariat personnel in Delta State of Nigeria. This part-of-four piece of study aimed to identify the barriers to the acceptance of HPV vaccination in Delta State, Nigeria.Methods: A cross-sectional, descriptive survey method was adopted using a structured questionnaire. 285 participants were included. The structured questionnaire included questions on acceptance of HPV vaccination and the factors influencing acceptability. Statistical analysis included percentage proportions of respondents. Absolute and relative frequencies of the factors were also determined. Chi-squared analysis was performed based on dichotomy of participants based on yes/no response to being vaccinated.Results: Less than 8% of respondents have completed the HPV vaccination program. Low income earners have accepted the vaccination more than the high income group (p <0.003). Nature of work implying time constraints was an absolute factor. Accessibility is one of four factors that were significantly associated (p <0.002).Conclusions: Given the observation on nature of work and associated implication of time constraints and also inaccessibility as potentially major factors; it suffices to suggest that acceptance of HPV vaccination may be improved by expounding the days and sites of vaccination programs to be closer to the offices and scheduled around lunch-break times.

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“…14 Further, gainfully employed have the attitude of procrastinating hospital visits and screening services due to many activities competing for limited time, especially due to exigencies of their job. 15,16 Therefore, the need for screening has been known and cannot be overemphasized. That is, the need to research into women who have yet to attend any screening program has remained imperative.…”

mentioning

confidence: 99%

Factors influencing the acceptance of cervical cancer screening among civil servants in Delta State Secretariat

Okwe

Chime

Nwose

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Cervical cancer is one of the top two cancers affecting Nigerian women. This has created impetus to investigate the situation. This third of a four-part series seeks to evaluate perception, acceptance and psychosocial factors of cervical screening among women who are gainfully employed in the State’s civil service within Delta State Secretariat.Methods: Based on cross-sectional descriptive survey using a structured questionnaire and ‘N=285’ participants. Statistical analysis assessed percentage proportions of respondents; as well as absolute and relative frequencies of the factors associated with acceptance of screening. Chi-squared analysis was based on no/yes response to have done cervical screening.Results: About 10% of respondents have undergone cervical screening. 16% of the lowest income earners have done the screening, compared to 8% and 10% of the mid income and high income group, respectively. Nature of work implying time constraints was an absolute factor. Knowledge of what cervical cancer is; the causes; how to detect and prevent it are significantly associated (p <0.01), while accessibility, fear of adverse effect and attitude of healthcare workers were significant psychosocial factors (p 0.01).Conclusions: This report affirms nature of work and accessibility as two of four major factors influencing acceptance of cervical screening among working class women in Delta State secretariat. It is hereby suggested to expound sites of cervical service programs.

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Barriers to cervical cancer screening faced by immigrant women in Canada: a systematic scoping review

Cited by 80 publications

References 32 publications

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

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

Factors influencing the acceptance of HPV vaccine among civil servants in Delta State Secretariat

Factors influencing the acceptance of cervical cancer screening among civil servants in Delta State Secretariat

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