Developing and testing an instrument for identifying culture-specific barriers to breast cancer screening in Israeli Arab women

Cohen, Miri; Azaiza, Faisal

doi:10.1080/02841860802078069

Cited by 24 publications

(38 citation statements)

References 30 publications

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“…Answers ranged from 1 = not at all, to 5 = very much. Convergence, criterion, and construct validity were confirmed for the subscales, with lower construct validity for traditional beliefs [8]. Internal consistency (a) for the subscales in the present study was 0.78 to 0.94.…”

Section: Questionnairessupporting

confidence: 54%

“…In addition, participants were asked to rate their level of religiosity, from 1 = secular to 4 = very religious. The Arab culture-specific barriers scale (ASCB) [8] has 21 items forming five subscales, of which four subscales were used covering the following domains: social barriers scale (e.g., shame of being seen at the clinic, loss of status in the family if ill with breast cancer); barriers-to-exposure scale (e.g., embarrassment at exposing the body to a male health professional, violating the humility command); environmental barriers scale (cost, distance, and accessibility); and traditional beliefs-about-cancer scale (e.g., cancer is punishment by God, cancer is a test by God). Answers ranged from 1 = not at all, to 5 = very much.…”

Section: Questionnairesmentioning

confidence: 99%

“…We recently described a model of culture-specific barriers among Arab (Muslim and Christian) women in Israel, which consists of five dimensions: social barriers, exposure barriers, environmental barriers, barriers of exposure of the body, and traditional beliefs concerning cancer [8]. We also showed that an intervention specifically targeting these barriers increased the rate of mammography and CBE screening, and intentions to do so, compared with a matched control group [15].…”

Section: Introductionmentioning

confidence: 95%

“…Today more attention is paid to diversity, especially the role of cultural beliefs and social contexts, for understanding women's screening behaviors [5]. Specific barriers related to traditional beliefs or social norms were found to predict lower screening rates [5][6][7][8][9]. Examples include fatalism [10][11][12], distrust of western medicine [6,13,14], barriers to exposing the body [6,10,12], and social barriers such as the negative implications of being seen at the breast clinic [10,11].…”

Section: Introductionmentioning

confidence: 96%

“…This difference was even more regarding being on schedule with the mammography [22]. This gap was thought attributable to higher personal, social, and cultural barriers [8,10,11].…”

Section: Introductionmentioning

confidence: 98%

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Traditional-Westernizing continuum of change in screening behaviors: comparison between Arab women in Israel and the West Bank

Azaiza

Cohen

Daoud

et al. 2010

Breast Cancer Res Treat

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Health perceptions are changing, but the pace of change varies across societies, exercising different effects on women's screening behaviors. Our aim is to assess the rate of mammography and clinical breast examination (CBE) attendance in younger and older Arab women in Israel and in the West Bank, and the effect of health beliefs on the screening behaviors. A random sample of 697 Arab women, 300 from Israel and 397 from the West Bank, aged 30-65 years, answered questionnaires on screening behaviors, the Arab culture-specific barriers, fatalism, worry, and health beliefs. The participation rate was 93.5% in Israel and 98.3% in the West Bank. Higher fatalistic perceptions, traditional beliefs, barriers to bodily exposure, and social, environmental, and personal barriers to screening were reported by women from the West Bank compared to Arab women in Israel and by older women compared to the younger women. Adjusted lower likelihood of attending screening was predicted by group (AOR 3.55, 95% CI 1.25-10.11 for mammography and AOR 2.36, 95% CI 1.19-3.65 for CBE), higher fatalism (AOR 0.52, 95% CI 0.30-76 for mammography and AOR 0.68, 95% CI 0.54-92 for CBE), more traditional beliefs (AOR 0.61, 95% CI 0.48-0.80 for mammography and AOR 0.51, 95% CI 0.39-0.68 for CBE), and higher barriers to self-exposure (AOR 0.69, 95% CI 0.48-0.83 for mammography and AOR 0.76, 95% CI 0.62-0.95 for CBE), higher perceived personal barriers (AOR 0.36, 95% CI 0.12-1.08 for mammography and AOR 0.77, 95% CI 0.60-0.98 for CBE), and lower perceived benefits (AOR 1.98, 95% CI 1.17-3.34 for mammography and AOR 1.39, 95% CI 1.06-1.81 for CBE). Also, adjusted lower likelihood of CBE attendance was predicted by younger age, higher religiosity, and higher social barriers. Differences in screening behaviors of younger and older Arab women from the West Bank and from Israel represent a traditional-westernizing continuum of change, but are also related to the social and situational context.

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Section: Questionnairessupporting

confidence: 54%

Section: Questionnairesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 96%

“…This difference was even more regarding being on schedule with the mammography [22]. This gap was thought attributable to higher personal, social, and cultural barriers [8,10,11].…”

Section: Introductionmentioning

confidence: 98%

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Traditional-Westernizing continuum of change in screening behaviors: comparison between Arab women in Israel and the West Bank

Azaiza

Cohen

Daoud

et al. 2010

Breast Cancer Res Treat

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Factors associated with low screening for breast cancer in the Palestinian authority

Azaiza

Cohen

Awad

et al. 2010

Cancer

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BACKGROUND:The current study was conducted to assess screening behaviors in relation to cultural and environmental barriers among Palestinian women in the West Bank. METHODS: The participants were 397 women, ages 30 to 65 years, residing in the Palestinian Authority, and a stratified sample method was used (98.3% participation rate). The participants completed questionnaires on breast examination behaviors and knowledge, on perceived cancer fatalism and health beliefs, and on environmental barriers scales. RESULTS: Greater than 70% of the women had never undergone mammography or clinical breast examination (CBE), whereas 62% performed self breast examination (SBE). Women were more likely to undergo mammography if they were less religious (odds ratio [OR], 0.59; 95% confidence interval [95% CI], 0.47-0.81) and if they expressed lower personal barriers (OR, 0.59; 95% CI, 0.29-0.76) and lower fatalism (OR, 0.39; 95% CI, 0.28-0.63). A higher likelihood for CBE was related to being Christian (OR, 2.91; 95% CI, 1.49-5.73) and being less religious (OR, 0.32; 95% CI, 0.13-0.78), to perceived higher effectiveness of CBE (OR, 1.46; 95% CI, 1.20-1.79), and to perceived lower cancer fatalism (OR, 0.35; 95% CI, 0.28-0.60). Women were more likely to perform SBE if they were more educated, resided in cities, were Christian, were less religious, had a firstdegree relative with breast cancer, perceived higher effectiveness and benefits of SBE, and perceived lower barriers and fatalism. CONCLUSIONS: Participants reported a combination of personal, cultural, and environmental barriers, which should be addressed by educational programs and followed by the allocation of resources for early detection and treatment of breast cancer. Cancer 2010;116:4646-55.

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Cancer Fatalism: Attitudes Toward Screening and Care

Cohen

2012

Psychological Aspects of Cancer

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Developing and testing an instrument for identifying culture-specific barriers to breast cancer screening in Israeli Arab women

Cited by 24 publications

References 30 publications

Traditional-Westernizing continuum of change in screening behaviors: comparison between Arab women in Israel and the West Bank

Traditional-Westernizing continuum of change in screening behaviors: comparison between Arab women in Israel and the West Bank

Factors associated with low screening for breast cancer in the Palestinian authority

Cancer Fatalism: Attitudes Toward Screening and Care

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