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The Asian Women's Health Clinic: addressing cultural barriers to preventive health care.

https://arctichealth.org/en/permalink/ahliterature204409
Source
CMAJ. 1998 Aug 25;159(4):350-4
Publication Type
Article
Date
Aug-25-1998
Author
L. Sent
P. Ballem
E. Paluck
L. Yelland
A M Vogel
Author Affiliation
Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver. Isent@interchange.ubc.ca
Source
CMAJ. 1998 Aug 25;159(4):350-4
Date
Aug-25-1998
Language
English
Publication Type
Article
Keywords
Asian Continental Ancestry Group
Breast Neoplasms - ethnology - prevention & control
Canada - epidemiology
Cultural Deprivation
Female
Humans
Physician-Patient Relations
Preventive Health Services - economics - organization & administration - statistics & numerical data
Preventive Medicine - economics - organization & administration - statistics & numerical data
Retrospective Studies
Uterine Cervical Neoplasms - ethnology - prevention & control
Women's health
Notes
Cites: West J Med. 1992 Sep;157(3):260-41413766
Cites: Can J Public Health. 1992 Sep-Oct;83(5):344-51473059
Cites: Cancer Detect Prev. 1992;16(5-6):337-91473122
Cites: CMAJ. 1997 Sep 1;157(5):543-59294393
Cites: J Fam Pract. 1993 Dec;37(6):583-78245810
Cites: CMAJ. 1996 Jun 15;154(12):1847-538653644
Cites: Can J Public Health. 1993 Jul-Aug;84(4):283-58221505
PubMed ID
9758515 View in PubMed
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Breast and cervical cancer screening in Hispanic women: a literature review using the health belief model.

https://arctichealth.org/en/permalink/ahliterature190169
Source
Womens Health Issues. 2002 May-Jun;12(3):122-8
Publication Type
Article
Author
LaToya T Austin
Farah Ahmad
Mary Jane McNally
Donna E Stewart
Author Affiliation
University Health Network Women's Health Program, Toronto, Ontario, Canada.
Source
Womens Health Issues. 2002 May-Jun;12(3):122-8
Language
English
Publication Type
Article
Keywords
Adult
Breast Neoplasms - ethnology - prevention & control
Female
Health promotion
Hispanic Americans - psychology
Humans
Mammography - psychology
Mass Screening - psychology
Models, Theoretical
Ontario
Patient Acceptance of Health Care - ethnology
Uterine Cervical Neoplasms - ethnology - prevention & control
Vaginal Smears - psychology
Women's health
Abstract
The aim of this study was to review published studies that examined factors influencing breast and cervical cancer screening behavior in Hispanic women, using the Health Belief Model (HBM). MEDLINE and PsycINFO databases and manual search were used to identify articles. Cancer screening barriers common among Hispanic women include fear of cancer, fatalistic views on cancer, linguistic barriers, and culturally based embarrassment. In addition, Hispanic women commonly feel less susceptible to cancer, which is an important reason for their lack of screening. Positive cues to undergo screening include physician recommendation, community outreach programs with the use of Hispanic lay health leaders, Spanish print material, and use of culturally specific media. Critical review of the literature using the theoretical framework of the Health Belief Model identified several culturally specific factors influencing cancer screening uptake and compliance among Hispanic women. Future interventions need to be culturally sensitive and competent.
PubMed ID
12015184 View in PubMed
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Cervical cancer screening in ethnocultural groups: case studies in women-centered care.

https://arctichealth.org/en/permalink/ahliterature193443
Source
Women Health. 2001;33(3-4):29-46
Publication Type
Article
Date
2001
Author
J L Bottorff
L G Balneaves
L. Sent
S. Grewal
A J Browne
Author Affiliation
School of Nursing, University of British Columbia, Vancouver, Canada. Bottorff@nursing.ubc.ca
Source
Women Health. 2001;33(3-4):29-46
Date
2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Asia - ethnology
Canada
Cultural Diversity
Ethnic Groups - psychology
Female
Humans
Indians, North American
Interviews as Topic
Mass Screening - organization & administration
Middle Aged
Organizational Case Studies
Patient Satisfaction - ethnology
Patient-Centered Care
Physician-Patient Relations
Uterine Cervical Neoplasms - ethnology - prevention & control
Vaginal Smears - psychology
Women's Health Services - organization & administration - standards
Abstract
The purpose of this study was to identify and describe critical elements of women-centered care within the context of providing cervical screening to three ethnocultural groups in Canada: Asian, South Asian and First Nations.
Data for this collective case study included open-ended interviews with purposive samples of women and key informants from each target group. Following thematic analysis, cross-case analysis was completed by comparing and contrasting issues and contextual factors influencing women's and providers' experiences.
Cervical screening services for each group were shaped by attention to ethnocultural values, women's desire for thorough explanations, and the importance of a comfortable setting. While participation rates varied across clinics, women were positive about their experiences in obtaining cervical screening. Some women's expectations that they could address a range of health concerns with female health providers at the clinics were stymied by structural barriers that prevented staff from addressing issues beyond those directly related to cervical screening. Cross-case analysis revealed three key elements of women-centered care: respectful and culturally appropriate interactions between women and health providers, the importance of providing acceptable alternatives for women, and the need for comprehensive health services.
While the establishment of Pap test clinics for ethnocultural groups has the potential to enhance participation in cervical screening, changes in health policy and the structure of health services are required for existing programs to fully implement the elements of women-centered health care identified in this study. Other models of providing health care to women in ethnocultural groups, including the use of clinics staffed by nurse practitioners, should be evaluated.
PubMed ID
11527105 View in PubMed
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Cultural issues in the development of cancer control programs for American Indian populations.

https://arctichealth.org/en/permalink/ahliterature219476
Source
J Health Care Poor Underserved. 1994;5(4):280-96
Publication Type
Article
Date
1994
Author
R. Michielutte
P C Sharp
M B Dignan
K. Blinson
Author Affiliation
Department of Family and Community Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157.
Source
J Health Care Poor Underserved. 1994;5(4):280-96
Date
1994
Language
English
Publication Type
Article
Keywords
Cause of Death
Cultural Characteristics
Female
Health education
Health Knowledge, Attitudes, Practice
Health Services, Indigenous - organization & administration
Humans
Indians, North American
North Carolina - epidemiology
Program Development
Survival Rate
Uterine Cervical Neoplasms - ethnology - prevention & control
Abstract
Cancer is the third-leading cause of death among American Indians. The persistent disadvantage in cancer survival rates among American Indian populations emphasizes the importance of developing effective cancer control programs for prevention and early detection. However, substantial cultural differences between American Indians and whites can affect the success of these programs. This paper examines the concept of cultural sensitivity in the context of developing cancer control programs for American Indian populations. It explores fundamental differences in beliefs, behaviors, and values between American Indian and white majority cultures, and presents examples of culturally sensitive health education programs. The paper highlights insights and experiences gained in developing the North Carolina Native American Cervical Cancer Prevention Project, and gives recommendations for the development of future programs.
PubMed ID
7841283 View in PubMed
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Immigrant women's experiences and views on the prevention of cervical cancer: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature271902
Source
Health Expect. 2015 Jun;18(3):344-54
Publication Type
Article
Date
Jun-2015
Author
Maria Grandahl
Tanja Tydén
Maria Gottvall
Ragnar Westerling
Marie Oscarsson
Source
Health Expect. 2015 Jun;18(3):344-54
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Attitude to Health
Condoms - utilization
Early Detection of Cancer - psychology
Emigrants and Immigrants - psychology
Female
Focus Groups
Health Knowledge, Attitudes, Practice - ethnology
Humans
Middle Aged
Papillomavirus Vaccines - therapeutic use
Qualitative Research
Sweden - epidemiology
Uterine Cervical Neoplasms - ethnology - prevention & control
Young Adult
Abstract
Many Western countries have cervical cancer screening programmes and have implemented nation-wide human papillomavirus (HPV) vaccination programmes for preventing cervical cancer.
To explore immigrant women's experiences and views on the prevention of cervical cancer, screening, HPV vaccination and condom use.
An exploratory qualitative study. The Health Belief Model (HBM) was used as a theoretical framework.
Eight focus group interviews, 5-8 women in each group (average number 6,5), were conducted with 50 women aged 18-54, who studied Swedish for immigrants. Data were analysed by latent content analysis.
Four themes emerged: (i) deprioritization of women's health in home countries, (ii) positive attitude towards the availability of women's health care in Sweden, (iii) positive and negative attitudes towards HPV vaccination, and (iv) communication barriers limit health care access. Even though the women were positive to the prevention of cervical cancer, several barriers were identified: difficulties in contacting health care due to language problems, limited knowledge regarding the relation between sexual transmission of HPV and cervical cancer, culturally determined gender roles and the fact that many of the women were not used to regular health check-ups.
The women wanted to participate in cervical cancer prevention programmes and would accept HPV vaccination for their daughters, but expressed difficulties in understanding information from health-care providers. Therefore, information needs to be in different languages and provided through different sources. Health-care professionals should also consider immigrant women's difficulties concerning cultural norms and pay attention to their experiences.
PubMed ID
23252449 View in PubMed
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Investigation and management of cervical intraepithelial neoplasia in Canadian Inuit: enhancing access to care.

https://arctichealth.org/en/permalink/ahliterature4093
Source
Arctic Med Res. 1995;54 Suppl 1:117-21
Publication Type
Article
Date
1995
Author
B. Martin
W. Smith
P. Orr
F. Guijon
Author Affiliation
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
Source
Arctic Med Res. 1995;54 Suppl 1:117-21
Date
1995
Language
English
Publication Type
Article
Keywords
Arctic regions - ethnology
Canada - epidemiology
Carcinoma in Situ - ethnology - prevention & control
Colposcopy
Delivery of Health Care
Electrosurgery
Female
Humans
Inuits
Uterine Cervical Neoplasms - ethnology - prevention & control
Abstract
Cervical intraepithelial neoplasia (CIN) is a major cause of morbidity among Circumpolar women. Cervical cancer comprised 15% of all cancers in Canadian Inuit women from 1969-1988. The age standardized incidence for invasive cervical cancer in Canadian Inuit women is 3.1 times the rate in the general Canadian population. Management of CIN in women of remote Arctic regions has traditionally required multiple visits to specialized medical centres for diagnosis, therapy and follow-up. Such centralized care requires separation of women from their families, resulting in significant medical, emotional and economic costs for the patient, her family and community. In the Canadian Central Arctic, a program for the diagnosis and therapy of CIN has been established using colposcopy with loop electrosurgery, performed by a trained local family practitioner and visiting gynecologist. Early program evaluation has indicated reduction in medical expenditures due to travel costs, minimal procedure-related morbidity and discomfort, and improved patient satisfaction associated with reduced separation from family and community. It is hoped that the program design, which harnesses technology in order to provide improved care closer to home, will be applicable to other Circumpolar regions.
PubMed ID
7639897 View in PubMed
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Monitoring disease burden and preventive behavior with data linkage: cervical cancer among aboriginal people in Manitoba, Canada.

https://arctichealth.org/en/permalink/ahliterature197284
Source
Am J Public Health. 2000 Sep;90(9):1466-8
Publication Type
Article
Date
Sep-2000
Author
T K Young
E. Kliewer
J. Blanchard
T. Mayer
Author Affiliation
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada. tkyoung@cc.umanitoba.ca
Source
Am J Public Health. 2000 Sep;90(9):1466-8
Date
Sep-2000
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Databases, Factual
European Continental Ancestry Group - psychology - statistics & numerical data
Female
Health Behavior - ethnology
Humans
Incidence
Indians, North American - psychology - statistics & numerical data
Insurance Claim Reporting - statistics & numerical data
Manitoba - epidemiology
Mass Screening - psychology - statistics & numerical data
Medical Record Linkage - methods
Middle Aged
Morbidity
Needs Assessment
Papanicolaou test
Population Surveillance - methods
Registries
Uterine Cervical Neoplasms - ethnology - prevention & control
Vaginal Smears - psychology - statistics & numerical data
Abstract
This study sought to estimate rates of cervical cancer and Papanicolaou testing among Aboriginal and non-Aboriginal women in Manitoba, Canada.
Data were derived through linking of administrative databases.
In comparison with non-Aboriginal women, Aboriginal women had 1.8 and 3.6 times the age-standardized incidence rates of in situ and invasive cervical cancer, respectively. With the exception of those aged 15 to 19 years, Aboriginal women were less likely to have had at least 1 Papanicolaou test in the preceding 3 years.
Data linkage provides a rapid and inexpensive means to estimate disease burden and preventive behavior in the absence of registries. There is an urgent need for an organized Papanicolaou test screening program in the Aboriginal population.
Notes
Cites: CMAJ. 1991 Nov 15;145(10):1301-251933712
Cites: Int J Epidemiol. 1991 Jun;20(2):323-71833348
Cites: Can J Public Health. 1992 Sep-Oct;83(5):344-51473059
Cites: Cancer Detect Prev. 1992;16(5-6):337-91473122
Cites: Am J Public Health. 1993 Nov;83(11):1589-988238684
Cites: Cancer. 1996 Oct 1;78(7 Suppl):1587-918839576
Cites: Cancer. 1996 Oct 1;78(7 Suppl):1592-78839577
Cites: Sex Transm Dis. 1997 May;24(5):293-89153740
Cites: Ann Intern Med. 1967 May;66(5):870-836025228
Cites: Arthritis Rheum. 1967 Jun;10(3):2596028076
Cites: Scand J Rheumatol. 1981;10(4):301-67323787
Cites: Am J Public Health. 1983 May;73(5):515-206837814
Cites: Can Med Assoc J. 1984 Jan 1;130(1):25-326317154
Cites: Can Med Assoc J. 1985 Jun 1;132(11):1269-723995446
Cites: Am J Epidemiol. 1989 Feb;129(2):388-942912048
Cites: CMAJ. 1992 Dec 15;147(12):1802-41458421
PubMed ID
10983210 View in PubMed
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Pap prevalence and cervical cancer prevention among Alaska Native women.

https://arctichealth.org/en/permalink/ahliterature3487
Source
Health Care Women Int. 1999 Sep-Oct;20(5):471-86
Publication Type
Article
Author
A P Lanier
J J Kelly
P. Holck
Author Affiliation
Alaska Native Health Board, Anchorage 99508, USA.
Source
Health Care Women Int. 1999 Sep-Oct;20(5):471-86
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alaska
Attitude to Health - ethnology
Female
Health Education - organization & administration
Health Knowledge, Attitudes, Practice
Humans
Indians, North American - education - psychology - statistics & numerical data
Middle Aged
Program Evaluation
Questionnaires
Research Support, U.S. Gov't, P.H.S.
Uterine Cervical Neoplasms - ethnology - prevention & control
Vaginal Smears - psychology - utilization
Women's health
Abstract
The goals of the Alaska Native Women's Health Project (WHP) were to determine the following: (1) Pap prevalence based on chart review before and during an intervention period; (2) the level of understanding of cancer and cancer screening services with emphasis on cervical cancer; (3) use and satisfaction with current health maintenance services; and (4) improvement in knowledge and cancer screening rates following intervention. A random sample of 481 Alaska Native (Eskimo, Aleut, Indian) women living in Anchorage were interviewed face to face about their understanding of cancer risk factors (tobacco use, sexually transmitted diseases (STDs), reproductive issues), cancer screening examinations (Pap test, breast self-examination (BSE), breast exam by a provider, mammography), and their attitudes about health care and health care services. Sixty-two percent of control women were documented to have had at least one Pap test within the 3-year period prior to the beginning of the study; however, only 9% were documented to have had annual Pap screening. The intervention included distribution of educational materials, counseling on any woman's health issue, special evening clinics, and reminders (mail/phone call) of scheduled Pap appointments.
PubMed ID
10776116 View in PubMed
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Physician-related determinants of cervical cancer screening among Caribbean women in Toronto.

https://arctichealth.org/en/permalink/ahliterature190158
Source
Ethn Dis. 2002;12(2):268-75
Publication Type
Article
Date
2002
Author
Ilene Hyman
Punam Mony Singh
Marta Meana
Usha George
Lilian M Wells
Donna E Stewart
Author Affiliation
Centre for Research in Women's Health, Sunnybrook and Women's College Health Sciences Centre, Department of Public Health Science, University of Toronto, Ontario. ilene.hyman@swchsc.on.ca
Source
Ethn Dis. 2002;12(2):268-75
Date
2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Caribbean Region - ethnology
Female
Humans
Male
Mass Screening
Middle Aged
Ontario - epidemiology
Patient Education as Topic
Physician's Practice Patterns
Practice Guidelines as Topic
Uterine Cervical Neoplasms - ethnology - prevention & control
Vaginal Smears - utilization
Abstract
Minority women in Canada are less likely to be screened for cervical cancer than their counterparts in the general population, despite the fact that the proportion of these women who consult a general practitioner about their health each year is similar to minority women. This study examined the physician and practice characteristics associated with Pap testing and perceived barriers to Pap testing of family physicians serving the Caribbean community of Toronto.
A mail-back questionnaire was sent to Toronto family physicians practicing in neighborhoods with a high proportion of Caribbean Canadians.
Although 79.7% of the 64 participating physicians reported that they were 'very likely" to include Pap testing during an annual check-up, nearly half did not believe that the majority of Caribbean patients were actually screened. The amount of time a physician spent on patient education was significantly associated with his/her likelihood of screening. Male physicians who reported a high proportion of Caribbean female patients in their practices were significantly less likely to screen for cervical cancer than those who saw fewer Caribbean patients.
These findings suggest that an increased emphasis on patient education is important to increase screening practice and that physician gender may be of major importance to the Caribbean community.
PubMed ID
12019937 View in PubMed
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Pilot test of a cervical cancer prevention video developed for Alaska Native women.

https://arctichealth.org/en/permalink/ahliterature4088
Source
Public Health Rep. 1995 Mar-Apr;110(2):211-4
Publication Type
Article
Author
B. Stillwater
V A Echavarria
A P Lanier
Author Affiliation
Alaska Native Area Health Service, Division of HP/DP, Anchorage 99501, USA.
Source
Public Health Rep. 1995 Mar-Apr;110(2):211-4
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alaska - epidemiology
Female
Health Education - methods - statistics & numerical data
Health Knowledge, Attitudes, Practice
Humans
Indians, North American
Inuits
Middle Aged
Pilot Projects
Uterine Cervical Neoplasms - ethnology - prevention & control
Videotape Recording
Abstract
Cancer of the cervix is twice as likely to occur among Alaska Native women than among Caucasian women in the United State. To understand some of the factors associated with this high incidence, a random sample of 528 Alaska Native women were surveyed about their knowledge, attitudes, and behavior regarding cervical cancer and its risk factors. From the results of the Alaska Native Women's Health Project study, the need for more public education related to cervical cancer prevention was identified. A review of existing educational resources revealed that no culturally appropriate materials related to cervical cancer had been developed for Alaska Native women. To increase Native women's knowledge about cervical cancer and to motivate them to obtain annual Papanicolaou tests, a 12-minute videotape presentation was developed specifically for this population. The videotape portrayed Alaska Native women as role models from the community discussing cervical cancer and Papanicolaou tests and engaging in healthy lifestyles. The videotape was pilot tested with several groups of Alaska Native women. The women were surveyed before and after watching the video and were asked to rate the tape and make comments about it. The results of the posttest demonstrated a significant increase in the knowledge level of the participants. The videotape was well received because of its cultural sensitivity and appropriateness. On the basis of this study, the development of additional culturally appropriate educational materials related to cancer prevention of Alaska Native women is recommended.
PubMed ID
7631000 View in PubMed
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11 records – page 1 of 2.