Understanding Hmong Women's Beliefs, Feelings, Norms, and External Conditions About Breast and Cervical Cancer Screening

Lor, Maichou; Khang, Pa Yiar; Xiong, Pa Kou; Moua, Kao Feng; Lauver, Diane

doi:10.1111/phn.12043

Cited by 34 publications

(75 citation statements)

References 27 publications

(35 reference statements)

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“…In addition, cancer itself is an unfamiliar concept to Hmong people, making it more difficult for physicians to explain the rationale behind each screening (Lor & Bowers 2014). This study adds to the current literature because we provide information about physicians’ perspectives regarding barriers and facilitators to screening and demonstrate how the factors they identified are very similar to those previously identified by LEP patients (Akers et al 2007; Watts et al 2009; Fang & Baker 2013; Lor et al 2013). Additionally, we propose a multifactorial model that includes patient, physician, interpreter and system level facilitators or barriers as a way of organizing and conceptualizing these barriers (Figure 1).…”

Section: Discussionsupporting

confidence: 53%

“…The literature also suggests that culture is an important influence to patients’ beliefs about cancer screening. In a study of Hmong women’s beliefs about breast and cervical cancer screenings, Lor et al found that Hmong women encountered cultural barriers such as embarrassment undressing for an exam and listening to authority figures (2013). In addition, cancer itself is an unfamiliar concept to Hmong people, making it more difficult for physicians to explain the rationale behind each screening (Lor & Bowers 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Qualitative studies on the barriers to preventive cancer screening in LEP populations support the crucial role of language in this disparity (Natale-Pereira et al 2008; Fang & Baker 2013). These studies also suggest that there are other significant factors that affect LEP populations’ preventive care-seeking behavior, including low knowledge and awareness of cancer, lack of insurance, undocumented legal status, seeking care only when sick, low prioritization of health care, stigmatization, fear, embarrassment, lack of time, and use of traditional medicine and rituals (Natale-Pereira et al 2008; Fang & Baker 2013; Lor et al 2013). …”

Section: Introductionmentioning

confidence: 96%

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Barriers and facilitators to preventive cancer screening in Limited English Proficient (LEP) patients: Physicians’ perspectives

Bruce

Schwei

Park

et al. 2014

CAM

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Background Limited English proficient (LEP) patients receive fewer recommended preventive screenings than English-speaking patients. Studies have explored patients’ perceptions of the factors that contribute to this disparity, but little research has focused on physicians’ perceptions. Objective To describe physicians’ perceptions of the barriers and facilitators to preventive cancer screening in LEP patients. Design Qualitative interview study using a semi-structured interview guide. Participants Eight primary care physicians from Wisconsin. Approach Each interview was systematically coded to illuminate important themes. Key Results A variety of barriers specifically hinder LEP patients’ receipt of cancer screening, including poor language proficiency, lack of transportation, unfamiliarity with the concept of prevention, complex scheduling systems, poor interpretation, and limited physician time to discuss preventive care. While physicians identified many factors that facilitate preventive screening in general, they mentioned few that are perceived as specific to LEP patients. Conclusion We found that primary care physicians attribute the low rates of preventive cancer screening among LEP populations to a variety of patient, provider, interpreter, and system factors, most of which go beyond simple language barriers. Interventions designed to reduce these barriers and enhance the impact of identified facilitators should be multifactorial and designed to engage primary care physicians.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Barriers and facilitators to preventive cancer screening in Limited English Proficient (LEP) patients: Physicians’ perspectives

Bruce

Schwei

Park

et al. 2014

CAM

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“…Many other studies in Africa [12, 14] and in female immigrants and minority groups in the United States [20, 21] found this to also be a common theme in women’s lack of awareness regarding screening. Many studies also cited reasons related to husbands not giving consent for screening [12, 22–27] which was very marginal in our study, with only one participant out of the 351 having mentioned this reason as a barrier to her screening for cervical cancer. Other barriers were fear of being diagnosed with cancer, neglect and distance from the screening center.…”

Section: Discussionmentioning

confidence: 69%

Barriers to Cervical Cancer Screening in Burkina Faso: Needs for Patient and Professional Education

et al. 2015

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Background Cervical cancer is among the leading causes of cancer deaths for women in low-income African countries, such as Burkina Faso. Given that cervical cancer is a preventable disease through early detection and vaccination, this study aimed at understanding the barriers to cervical cancer early detection in Ouagadougou, the capital city of Burkina Faso. Women seeking screening and treatment for cervical cancer (n=351) during the period of May-August 2014, at the Yalgado Ouedraogo University Hospital were interviewed about their knowledge, attitudes, and practices toward cervical cancer. Interview questions elicited information about socio-demographic of participants, history of screening, knowledge of cervical cancer, and attitudes toward cervical screening. Scores were assigned to responses of questions and knowledge and tertites of distributions were used for comparison. A multivariate logistic regression was performed to predict cervical screening. Results Study participants were relatively young (37.5 ± 10.7 years), predominately resident of urban areas (83.8%), and over half had no or less than high school education. Over 90% of participants had heard about cervical cancer and about 55% of them had intermediate level knowledge of the disease, its screening, and/or risk factors. Knowledge level was lower among rural than urban residents. Predictors of screening included higher level of education (OR=2.2; 95% CI: 1.48–3.23), older age (OR=1.1; 95% CI: 1.06–1.12), higher socioeconomic standard (SES) (OR=1.5; 95% CI: 1–2.37), urban residence (OR= 2.0; 95% CI: 1.19–3.25), encouragement for screening by a healthcare worker (1.98; 95% CI: 1.06–3.69) and employment (OR=1.9; 95% CI: 1.13–3.11). Conclusion Low awareness and socioeconomic barriers lead to underutilization of screening services of women. Motivation and education by healthcare workers are important factors for increasing screening rates. Organized patient and professional education programs in gynecologic services are warranted for improving screening in Burkina Faso and other low-resources countries in Africa.

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“…In the Hmong culture, there is a strong sense of modesty and embarrassment related to body parts and the intrusiveness of gynecologic exams [3, 6, 7]. Fear of discovering they have cancer has also been shown to prevent Hmong women from seeking cancer screening [6, 11]. …”

Section: Introductionmentioning

confidence: 99%

Evaluating Teaching Techniques in the Hmong Breast and Cervical Cancer Health Awareness Project

Lor

Bowers

2014

J Canc Educ

Self Cite

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Background Cancer health disparities are a reality for Hmong women who are often diagnosed at a later stage, have low literacy, and experienced care that is not culturally appropriate. Lack of attention to cultural appropriateness and literacy levels of cancer screening materials may contribute to disproportionately low levels of cancer screening among Hmong women. Purpose To evaluate the Hmong Health Awareness Project (HHAP), a program designed to create awareness and acceptance of breast and cervical cancer screening, and to examine participants’ perceptions of the utility of the content of the workshops. Methods Hmong researchers partnered with three Midwestern Hmong community centers to implement six workshops. Three teaching techniques: pictographs, videos, and hands-on activities were utilized to teach Hmong participants about cancer screening. Participants included 150 Hmong (male=30, female = 120). Teach back method was used to assess participants’ understanding of cancer screening throughout the workshops. Qualitative data were collected in focus groups to assess the feasibility of teaching methods and participants’ perceptions of the utility of the content of the workshops. Directed content analysis was used to analyze participants’ responses. Results The three teaching techniques were helpful in increasing the Hmong people’s understanding about breast and cervical cancer screening. Nearly all participants perceived an increased in their understanding, greater acceptance of cancer screening, and increased willingness to be screened. Men expressed support for screening after the workshops. Conclusion Findings can guide future interventions to improve health communications and screening and reduce diagnostic disparities among Hmong and immigrant populations.

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Understanding Hmong Women's Beliefs, Feelings, Norms, and External Conditions About Breast and Cervical Cancer Screening

Abstract: Consistent with the TCSB, Hmong women's beliefs, affect, cultural norms and external conditions helped to understand their use of breast and cervical screening. Findings could guide nursing and public health interventions to improve culturally sensitive, cancer screening for Hmong women.

Cited by 34 publications

References 27 publications

Barriers and facilitators to preventive cancer screening in Limited English Proficient (LEP) patients: Physicians’ perspectives

Barriers and facilitators to preventive cancer screening in Limited English Proficient (LEP) patients: Physicians’ perspectives

Barriers to Cervical Cancer Screening in Burkina Faso: Needs for Patient and Professional Education

Evaluating Teaching Techniques in the Hmong Breast and Cervical Cancer Health Awareness Project

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