Socioecological Perspectives on Cervical Cancer and Cervical Cancer Screening Among Asian American Women

Abstract

Although cervical cancer is one of the most commonly diagnosed cancers among Vietnamese American women (VAW) and Korean American women (KAW), both groups consistently report much lower rates of cervical cancer screening compared with other Asian ethnic subgroups and non-Hispanic Whites. This study aimed to explore multilevel factors that may underlie low screening rates among VAW and KAW living in a city where their ethnic communities are relatively small. The socioecological model was used as a conceptual framework. Thirty participants were conveniently recruited from ethnic beauty salons run by VA and KA cosmetologists in Albuquerque, New Mexico. The participants' average age was 44.6 years (SD = .50; range = 21-60). Most participants were married (80 %) and employed (73.3 %), and had health insurance (83.3 %). A qualitative interview was conducted in Vietnamese or Korean and transcribed verbatim. A thematic content analysis was used to identify major codes, categories, and patterns across the transcripts. The study identified several factors at the individual (e.g., pregnancy, poverty, personality), interpersonal (e.g., family responsibility, mother as influential referent), and community (e.g., lack of availability, community size) levels. The study sheds light on four major areas that must be taken into consideration in the development of culturally appropriate, community-based interventions aimed to reduce disparities in cervical cancer screening among ethnic minority women in the United States: (1) ethnic community size and geographic location; (2) cross-cultural similarities and dissimilarities; (3) targeting of not only unmarried young women, but also close referents; and (4) utilization of trusted resources within social networks.

Using the socioecological model to explore factors affecting health‐seeking behaviours of older Korean immigrants

“…We found that several factors across all levels of SEM were related to the participants’ sociocultural context and acted as barriers to healthcare services, such as lack of English proficiency, lack of available information written in Korean, current living circumstances due to immigration, limited coverage of health benefits and lack of support and community resources. These findings are consistent with previous studies in which Korean immigrants, regardless of their age, gender and geographic regions, experienced practical barriers to care in the United States (Lee & Carvallo, ; Rhodes et al., ; Seo et al, ). Most participants therefore had to rely on community services or health care provided in the Korean language within the Korean immigrant society, which was a limitation in terms of the amount and types of information and health care available.…”

“…Several studies have identified factors that influence healthcare access and utilisation experienced by Korean Americans, including language barriers, discrimination and mistrust of the US healthcare system (Jang et al., ; Lee & Carvallo, ; Rhodes, Song, Nam, Choi, & Choi, ; Seo et al, ; Sohn, ). However, these studies are primarily based on the general Korean immigrant population, whose length of stay in the United States varies from 1 year to more than 30 years.…”

Community-Based Cervical Cancer Education: Changes in Knowledge and Beliefs Among Vietnamese American Women

“…First, participants were recruited from Vietnamese community organizations, which could limit generalizability to those individuals who do not belong to or participate in such organizations. Second, in order to not overburden participants with lengthy questionnaires, the study did not capture information on interpersonal factors [25] or other variables that may inform attitudes and beliefs toward cervical cancer screening. Due to the study framework, assessments were focused on constructs from the HBM and SCT.…”

Cervical Cancer Screening Among Arab Women in the United States: An Integrative Review

“…Failure to receive cervical cancer screening is attributable to multiple interrelated reasons, including personal factors (e.g., fear of pain, embarrassment, threat to virginity, anxiety, inadequate knowledge, lack of time, misperception of risk), cultural factors (e.g., provider gender, acculturation, meaning of preventive medicine), religious factors, and systemic factors (e.g., lack of insurance, poverty, immigration status, geographic isolation, lack of providers, length of stay in the United States) (Daley et al, 2011; Johnson et al, 2008; Lee & Carvallo, 2014). …”