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Sarmiento-Medina MI, Velásquez-Jiménez CM, Ortiz-Hernández N. Experiences of a group of indigenous women from the Colombian Amazon with cervical cancer prevention screening. Qualitative study in the context of participatory research to reduce inequalities. ETHNICITY & HEALTH 2024:1-15. [PMID: 39107054 DOI: 10.1080/13557858.2024.2387112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 07/27/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVES Despite cervical cancer (CC) being a preventable disease, its incidence remains high in marginalized communities due to inequalities that restrict access to health services. This article investigates the experiences, perceptions, and attitudes regarding the screening of indigenous women in a region of the Colombian Amazon during a cervical cancer prevention initiative facilitated by community participation. DESIGN Qualitative study based on interviews conducted with women and indigenous leaders from Paujil reserve. They participated in research focused on cervical cancer prevention, which employed a methodology of collaboration between academia and communities aimed at enhancing women's health and reducing inequalities in access to healthcare services. The analysis utilized a deductive and inductive approach. RESULTS Five main themes were addressed: 'Barriers within health services'; 'Individual and cultural constraints'; 'Motivations and facilitators'; 'Positive experiences within the research framework'; and 'Suggestions for encouraging women's participation.' Challenges related to appointment scheduling and result delivery were frequently cited as obstacles to access. Misinformation, feelings of shame, fear, and distrust towards health services played significant roles in the reluctance to undergo screening. Factors such as support from family and community networks, respectful treatment, ease of scheduling appointments, the presence of female healthcare professionals, and involvement of leaders fluent in indigenous languages were identified as positive facilitators of screening acceptance. CONCLUSION Understanding the factors that influence access to screening is crucial for reducing inequalities in service delivery for indigenous women. The involvement of trained leaders who can identify these factors and motivate women can have a positive impact on the acceptance and guidance of cervical cancer prevention programs.
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Weschasat T, Wetchasat N, Chuemchit M. The edutainment program on knowledge, perception, and uptake of cervical cancer screening among Muslim women in Southern Thailand: a quasi experimental study. BMC Public Health 2024; 24:1803. [PMID: 38971727 PMCID: PMC11227195 DOI: 10.1186/s12889-024-19287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 06/26/2024] [Indexed: 07/08/2024] Open
Abstract
INTRODUCTION Cervical cancer is a significant global health concern and is the third most common cancer in women. Owing to their religious beliefs, Muslim women in Thailand are less likely to be screened for cervical cancer. OBJECTIVE This study aimed to explore how a Health Belief Model (HBM) (HBM = Health Belief Model)-Based Edutainment Program affects the knowledge, perception, and uptake of cervical cancer screening among Muslim women in Thailand. METHODS A quasi-experimental study was conducted in two rural districts of Southern Thailand with 83 Muslim women (intervention = 42, control = 41). The assessment was conducted through face-to-face interviews at baseline, post-intervention, and at 3-month follow-up. The intervention included four sessions involving video clips, folk songs, and short films. Data analysis was performed using repeated-measures ANOVA (ANOVA = Analysis of Variance) at a significance level of 0.05. RESULTS There were significant differences in the mean score of knowledge and perception between the intervention and control groups post-intervention and at 3-month follow-up (p < 0.001). The mean scores of knowledge and perception in the intervention group significantly increased post-intervention and at 3-month follow-up (p < 0.001). The uptake of cervical cancer screening tests in the intervention group was approximately twice as high as that in the control group (90.47% vs. 51.21%). CONCLUSION The findings revealed that the Edutainment Program could improve the knowledge, perception, and uptake of cervical cancer screening among Muslim women in Thailand. In future studies, the intervention suggests testing different population groups to improve access to primary care for everyone.
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Affiliation(s)
- Tassanapan Weschasat
- College of Public Health Sciences Chulalongkorn University, Bangkok, 10330, Thailand
| | | | - Montakarn Chuemchit
- College of Public Health Sciences Chulalongkorn University, Bangkok, 10330, Thailand.
- Excellent Center for Health and Social Sciences and Addition Research, College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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Garcia K, Iacob E, Dean-Smith M, Royce E, Alvarez G, Kepka D. Low Levels of Lifetime Pap Test Receipt Among Vulnerable Guatemalans. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:264-270. [PMID: 38376746 DOI: 10.1007/s13187-024-02405-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
Low and middle-income countries, such as Guatemala, shoulder a disproportionate share of cervical cancer, a preventable disease in high income countries. Tangible obstacles, such as lack of access to health care, cultural differences, and insufficient infrastructure, and facilitators, such as being Ladino, married, and educated, have been identified in the literature related to cervical cancer prevention. The aim of this survey was to explore barriers and facilitators to cervical cancer prevention, comparing rural Indigenous and urban Ladino populations. We surveyed 139 women in two health clinics. Participants answered questions about demographic information, cervical cancer knowledge, and health care behaviors. We analyzed survey data with four bivariate models. Our results suggest vulnerable populations, such as rural Indigenous women who are single, illiterate, and lack education, face higher cervical cancer risk. Partnerships should be formed with health promotors and lay midwives to educate and encourage vulnerable populations to prevent cervical cancer.
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Affiliation(s)
- Kimberly Garcia
- University of Utah College of Nursing, 10 2000 E, Salt Lake City, UT, 84112, USA.
| | - Eli Iacob
- University of Utah College of Nursing, 10 2000 E, Salt Lake City, UT, 84112, USA
| | - Mari Dean-Smith
- University of Utah College of Nursing, 10 2000 E, Salt Lake City, UT, 84112, USA
| | - Emily Royce
- University of Utah College of Nursing, 10 2000 E, Salt Lake City, UT, 84112, USA
| | | | - Deanna Kepka
- University of Utah College of Nursing, 10 2000 E, Salt Lake City, UT, 84112, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, USA
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Shariati Sarcheshme M, Mahdizadeh M, Tehrani H, Vahedian-Shahroodi M. Exploring the barriers to Pap smear test compliance: A qualitative study for improving cervical cancer screening in the primary health care. Health Promot Perspect 2024; 14:80-88. [PMID: 38623347 PMCID: PMC11016146 DOI: 10.34172/hpp.42485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/19/2024] [Indexed: 04/17/2024] Open
Abstract
Background Cervical cancer in Iran ranks as the fourth most frequent cancer among women. Pap smear (PS) is the best standard for detecting cervical cancer, but many people, even healthcare providers (HCPs), do not maintain it. HCPs play a critical role in promoting PS uptake. The purpose of the study was to explore barriers to cervical cancer PS screening compliance from the HCPs' perspective. Methods The present qualitative content analysis was conducted through semi-structured in-depth interviews. A total of 28 HCPs were interviewed between July and August 2020. A diverse sample of HCPs was selected using purposive sampling. Data analysis was based on the five steps proposed by Graneheim and Lundman. MAXQDA (2020) was used for data analyzing. Results Ten key sub-categories were identified and organized into three categories: individual, environmental, and socio-cultural factors. The sub-categories included inadequate risk perception, inappropriate attitude, low commitment, emotional factors, low priority over health, requirements and consequences of the test, deficiencies of health centers, organizational factors, traditions and religious believes. Conclusion HCPs face multiple barriers for PS. Exploring and decreasing barriers of PS in HCPs may increase compliance in them and their clients because they play an influential role in instructing and persuading women to take the PS. There is need to explore these barriers and identify possible interventions to change them. Insights from this study are useful for developing policies around national PS programs, too.
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Affiliation(s)
- Mansoore Shariati Sarcheshme
- Department of Midwifery, Neyshabur Branch, Islamic Azad University, Neyshabur, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrsadat Mahdizadeh
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Vahedian-Shahroodi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Shariati-Sarcheshme M, Mahdizdeh M, Tehrani H, Jamali J, Vahedian-Shahroodi M. Women's perception of barriers and facilitators of cervical cancer Pap smear screening: a qualitative study. BMJ Open 2024; 14:e072954. [PMID: 38191254 PMCID: PMC10806721 DOI: 10.1136/bmjopen-2023-072954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 11/16/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE Although Pap smear (PS) is considered the best standard in detecting cervical cancer, adherence to timely and regular PS is often lower than global standards in developing countries. Thus, the present study aimed to identify barriers and facilitators of adherence to cervical cancer screening in Mashhad, Iran. DESIGN A qualitative content analysis was done from July to December 2022 using semistructured in-depth interviews. SETTING The study was conducted in health centres in Mashhad, Iran. PARTICIPANTS A sample of 36 married women aged 18-70 years was selected using a purposive sampling, with maximum diversity. RESULTS The mean age of participants was 42.8±7.6 years. Among all, 66.7% had the PS test at least once; only 8.3% regularly had the test. The qualitative content analysis led to the extraction of four major themes: (1) individual challenges, (2) environmental limitations, (3) individual motivators, and (4) supportive and efficient environments. The most significant barriers were psychological stress, unhealthy attitudes, insufficient information, cultural issues and insufficient healthcare services. Facilitators included an active and efficient healthcare system, advice and support of important others, and positive emotions and individual beliefs. CONCLUSIONS Participants' perceptions showed that the main factors influencing the PS testing were supportive environments, individual motivators, individual challenges and environmental limitations. To encourage women to take the PS and reduce barriers, it may be necessary to revise current health system policies, promote individual and public awareness, reduce psychological stress and correct negative beliefs and attitudes.
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Affiliation(s)
- Mansoore Shariati-Sarcheshme
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrsadat Mahdizdeh
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinant of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinant of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamshid Jamali
- Social Determinant of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Vahedian-Shahroodi
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinant of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran
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