Socioeconomic and cultural factors associated with pap smear screening among French women living in Réunion Island

BACKGROUND

Réunion Island is a French overseas territory located in the southern Indian Ocean, with a challenging socioeconomic and multicultural context. Compared to mainland France, Réunion has an overincidence and overmortality of cervical cancer. In order to investigate these two issues, it is important to evaluate the barriers and potential levers to Pap smear screening among female inhabitants of the island. We aimed to identify the specific socio-demographic factors, cultural factors, and living conditions associated with Pap smear screening in Réunion, with a view to increasing uptake.

METHODS

We conducted a Knowledge Attitude Behavior and Practices (KABP) survey on cervical cancer screening practices among women aged between 25 and 65 years old living in Réunion Island, selected using random digit dialing sampling. Data were collected using Computer Assistant Telephone Interviews. Weighted chi-squared tests and Student's t-tests were used to compare women who had up-to-date Pap smear screening with women who did not. Weighted logistic models were used to identify the factors associated with not having up-to-date screening.

RESULTS

A total of 1000 women were included in the study. Of these, 88.1% had a Pap smear test during the previous three years. Factors independently associated with not being up to date were as follows: aged over 55 (AOR 2.3 [1.2-4.3]), no children (AOR 2.5 [1.4-4.3]), having free universal health coverage (AOR 1.7 [1.1-2.7]), an income per unit consumption lower than 1500€ per month (AOR 2.0 [1.1-3.7]), low health literacy (AOR 2.7 [1.7-4.1]), not consulting a general practitioner in the prior 12 months (AOR 3.6 [2.0-6.5]), and a BMI > 30 (AOR 2.6 [1.5-4.4]).

CONCLUSIONS

This is the first large-scale survey focusing on recommended Pap smear screening uptake in Réunion Island. Although self-reported screening incidence was higher than in mainland France, national screening policies must take into account the island's diverse social and cultural characteristics (e.g., an ageing population, low health literacy), while implementing actions to fight against poverty and increase general access to healthcare.

Muslim Immigrant Parents’ Social Status Moderates the Link Between Religious Parenting and Children’s Identification with the Heritage and Host Culture

This study addresses the question of whether and when religious parenting is a bridge or a barrier to Muslim immigrant children’s integration. Integration was defined as children’s identification with the heritage culture and the host culture. Participants included 210 self-identified Turkish Muslim mothers, children (aged 9-14), and 115 fathers in Germany. All family members filled in questionnaires on identification with Turks and identification with Germans; in addition both parents reported on religious parenting and children on religiosity. Results of multivariate regression analyses revealed that religious parenting was negatively related to children’s identification with Germans but positively related to children’s identification with Turks through increased child religiosity. However, additional multiple-group analyses revealed that only the religious parenting of lower educated parents and first-generation mothers reduced the likelihood of children’s identification with Germans. The religious parenting of higher educated parents and second-generation mothers did not affect children’s identification with Germans but promoted children’s identification with Turks. Taken together, the findings highlight the diverse roles of religious parenting in cultural socialization processes in Muslim immigrant families.

Cross-cultural differences in emotion suppression in everyday interactions

Previous research suggests that in collectivistic cultures, people tend to suppress their emotions more than in individualistic cultures. Little research, however, has explored cross-cultural differences in emotion regulation in everyday interactions. Using a daily social interaction method, we examined whether people from collectivistic backgrounds (Chinese exchange students and immigrants from the Moluccas, Indonesia) living in the Netherlands differed from those from individualistic backgrounds (Dutch natives) in emotion suppression during everyday interactions. We also examined whether this depended on their relationship with the interaction partner(s). We found that Chinese participants suppressed positive and negative emotions more than Dutch and Moluccan participants and that this was related to differences in interdependent and independent self-construal across the samples. We also found that Chinese participants suppressed positive emotions less in interactions with close others, whereas Dutch participants suppressed negative emotions more with non-close others. No such differences were found for Moluccans. Our findings support the idea that people from collectivistic cultures suppress emotions more than those from individualistic cultures, but they also suggest that this depends on who the interaction partner is. Furthermore, they suggest that emotion suppression may change when people with collectivistic backgrounds have been raised in individualistic cultures.

Do “they” threaten “us” or do “we” disrespect “them”: Majority perceptions of intergroup relations and everyday contacts with immigrant minorities

The present study examined how majority perceptions of intergroup relations afford different contact experiences with immigrant minorities. Majority students attending culturally diverse high schools first completed a survey that measured the extent to which they perceived immigrant minorities as either threatening to the majority or discriminated by the majority. Two weeks later, the same majority students kept a 1-week diary of their contacts with immigrant minorities. As expected, perceived threat at premeasurement was positively associated with situated threat-related appraisals and emotions (e.g., fear) during everyday contacts with immigrant minorities 2–3 weeks later. In contrast, acknowledgment of discrimination at premeasurement was positively associated with perspective taking and enrichment-related appraisals and emotions (e.g., admiration). These findings suggest that generalized threat perceptions can become self-enforcing through repeated threatening contact experiences; but also that an alternative perception of minorities as disrespected by the majority may underlie more positive contact experiences.

Self-Construal and the Intra- and Interethnic Social Interactions of Ethnic Minorities

This study examined relationships between self-construal and the quality of daily interactions of three ethnic minority groups in Europe: ethnic Turks and Moroccans in the Netherlands and Chechens in Poland. They described the social interactions they had for 2 weeks and they completed measures of independent and interdependent self-construal. We expected that, regardless of whether individuals’ self-construals match with prevailing construals in the host society, interdependent self-construal would be positively related to the quality of intra- and interethnic contact. The results largely confirmed this expectation. Across the two samples, participants who were higher in interdependent self-construal had more positive (and less negative) interactions than participants who were lower in interdependent self-construal. Some of these relationships varied as a function of whether or not a majority group member was present, however. Persons with a more interdependent construal of self felt more liked, respected, accepted, and free to express opinion during interactions in which a majority group member was present, whereas no such relationships were found for intra-ethnic interactions. There were very few relationships between independent self-construal and the quality of either intra- or interethnic contact. The results suggest that for the quality of ethnic minorities’ daily interactions, their interpersonal orientation is more important than a match between their orientation and the dominant orientation of the majority culture.