Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study

Abstract

BackgroundScreening rates for breast and cervical cancer for Muslim women in the United States are low, particularly for first-generation immigrants. Interpretations of the Muslim faith represent some of the barriers for breast and cervical cancer screening. Working to understand how faith influences breast and cervical screening for Somali women, and working with the community to identify and utilize faith-based assets for promoting screening, may lead to life-saving changes in screening behaviors.MethodsWe partnered with an Imam to develop faith-based messages addressing the concerns of modesty and predetermination and promoting cancer testing and screening. A total of five focus groups were convened, with 34 Somali women (three groups) and 20 Somali men (two groups). Each focus group first discussed participant views of breast and cervical cancer screening in general and then viewed and discussed video clips of the Imam delivering the faith-based messages.ResultsBoth Somali women and men had an overwhelmingly positive response to the faith-based messages promoting breast and cervical cancer screening. The faith-based messages appeared to reinforce the views of those who were already inclined to see screening positively, with participants describing increased confidence to engage in screening. For those who had reservations about screening, there was feedback that the faith-based messages had meaningfully influenced their views.ConclusionsSomali immigrant women and men found faith-based messages addressing topics of predestination and modesty and encouraging the use of screening and treatment to be both acceptable and influential. Faith can play an important role as an asset to promote breast and cervical cancer screening, and there may be substantial benefits to adding faith-based messaging to other interventions that focus on improving screening uptake. This may help to address health disparities for Somali women in this area.

Facilitators and Barriers of Cervical Cancer Screening and Human Papilloma Virus Vaccination Among Somali Refugee Women in the United States: A Qualitative Analysis

“…This fits well with an earlier study of Somalis that found Somalis are much more likely to make a health care decision after speaking with family members or friends (Lightfoot et al, 2016;Simmelink et al, 2013). Another recent study in this population that included both men and women found that men were encouraging of the women in their families in seeking cervical cancer screening once they were more aware of cervical cancer and screening (Pratt et al, 2017). Our findings are consistent with these and suggest that future interventions should include men in conversations about cervical cancer, screening, HPV, and HPV vaccination.…”

Barriers to cervical cancer screening: A qualitative study among Somali women in Oslo Norway

“…This study supports the suggestion of a recent study that recommended developing a culturallytailored intervention to potentially increase participation in cervical cancer screening among Somali and other immigrant women in Norway [9]. A previous study that accounted for the views of Somali women and men demonstrated that faith-based messages can potentially reinforce the views of those already inclined to screening and encourage those with reservations [22]. Therefore, this study recommends the use of faithbased messages by engaging local imams who might dispel or at least mediate fatalistic understandings and address concerns about matters of modesty and sexuality as part of an intervention alongside other practical suggestions raised by the participants.…”

“…The finding that the research participants did not fully trust the doctors who might examine them is consistent with the findings of a previous study in which mistrust of the health system was based on reports from friends or relatives regarding problems that they had encountered [20,22]. Furthermore, the study findings also revealed a poor doctor-patient relationship, in which the participants perceived themselves as poorly received and their doctors as predominantly and problematically concerned about the number of children they chose to have, as a barrier to screening.…”

A qualitative study of barriers and enablers associated with colorectal cancer screening among Somali men in Minnesota

“…However, the nonprofit organization MN Community Measurement (2018) found that Somali immigrants ages 50–74 in Minnesota have a CRC screening rate of 27%, significantly below the statewide average (73%) and the screening rate for whites (74%). This agrees with a small yet consistent body of research showing lower rates of cancer screening and preventive services among African and other immigrant communities (Abdullahi et al, 2009; Consedine et al, 2011; Ghebre et al, 2015; Harcourt et al, 2014; Koo et al, 2012; Hurtado-de-Mendoza et al, 2014; Morrison et al, 2013; Morrison et al, 2012; Paszat et al, 2017; Pratt et al, 2017; Raymond et al, 2014; Redwood-Campbell et al, 2011; Sewali et al, 2015; Shankar et al, 2016; Shen et al, 2018; Upvall et al, 2009). For example, Koo et al (2012) found that physicians were less likely to recommend CRC screening to immigrant patients and that the ethnicity of both the provider (independent of medical training) and the patient influenced screening rates.…”

“…Barriers to screening uptake included access (e.g., insurance, transportation) and psychosocial concerns (e.g., shame). Recent research by Pratt et al (2017) on screening for breast and cervical cancer among Somali women revealed that faith-based messaging substantially improved screening uptake. Sewali and colleagues (2015) found that Somali men generally lacked knowledge about cancer screening and that most believed they were less at risk because of their Islamic faith.…”