Sunday, 28 July 2019
Purpose: The purpose of this poster presentation is to present the preliminary findings of a research aimed at assessing knowledge, attitudes, and behaviors associated with breast cancer self-examination, breast awareness, and the use of early screening programs among Islamic/Muslim refugee women in the Canadian province of Saskatchewan. Problem Statement: Cancer represents a global health issue, and breast cancer is the second most common cancer and one of the leading causes of mortality and morbidity in the world (Canadian Cancer Society, 2016). Women in Arabic-speaking countries appear to have the lowest rates of breast cancer screening among ethnocultural groups living in Western countries (Wu et al., 2016; Avci, 2008; Petro-Nustas, Norton, Wihauer, et al., 2012; Soskolne, Marie, & Manor, 2007). Literature Review: Cultural beliefs, attitudes, and knowledge affect immigrant or refugee women's decisions regarding breast cancer (Lee, Nandy, Szalacha et al., 2016; Poonawall, Goyal, Mechrotra, Allicock, & Balasubramanian, 2014; Wu, West, Chen, & Hergert, 2016; Knok, Fethney, & White, 2012). Muslim women have low participation rates in breast cancer screening measures in their home countries (Abolfotouh et al., 2015; Hashemian, Shokravi, Lamyan, Hassanpour, & Akaberi, 2014; Nahcivan & Secginli, 2007; Petro-Nustas, Norton, Wihauer, et al., 2012; Yilmaz & Sayin, 2014). Compared with the numerous studies on Asian women in Western countries, the literature on breast cancer screening behaviors among Islamic/Muslim women either in their country of origin or as immigrants to Western countries remains sparse. Research Questions: The project explores the following two research questions: 1) What are Islamic/Muslim refugee women’s perceptions of susceptibility and seriousness about breast cancer? 2) What are the barriers and benefits that may influence Islamic/Muslim refugee women’s participation in breast self-examination (BSE) and mammograms? Theoretical Framework: The Health Belief Model (HBM) guides the data collection and analysis. The HBM is one of the first models that adapted from the psychology and behavioral sciences to health problems (Champion, 1984; Champion, 2008). The underlying theoretical assumption of the Health Belief Model (HBM) is that health behavior is determined by personal beliefs and perceptions about a disease (Glanz, Rimer & Viswanath, 2008). Perceived susceptibility to the illness, perceived seriousness, perceived benefits and barriers to the behavior represent the major concepts of the theory and predictors of health-related behaviors. Methods: A convenient sample composed of 60 Islamic/Muslim refugee women has been recruited to participate in the study through immigrant settlement agencies. A quantitatively-driven (QUANT-QUAL) mixed method design (Morse & Niehaus, 2009) is used to answer the research questions. In Strands 1(QUANT), the Demographic Data Form documents to women’s demographic characteristics. The Champion Health Belief Model Scale (CHBMS) measures perceived susceptibility to illness perceived seriousness of illness perceived benefits for the presumed action, perceived barriers to the presumed action, confidence in one’s ability and health motivation. The Cultural Barriers to Screening Scale (CBSC) (Champion, 1999) measures culture-based behaviors of women with breast cancer screening. The Cancer Stigma Scale (CASS) (Marlow & Wardle, 2014) assesses stigma associate to a cancer diagnosis. The Women's Information about Breast Cancer Information Form measures women’s breast cancer risk factors and screening methods. The Arab Culture-Specific Scale (ACSS) (Cohen & Azaiza, 2008) measures barriers to detect breast cancer associated with Muslim culture. In Strand 2 (QUAL), qualitative semi-structured interviews (n = 12 to 15) will be conducted to explore Islamic/Muslim refugee women’s knowledge of breast cancer, cultural barriers, benefits, and stigma. Qualitative data will contribute to a better understanding of the quantitative data. Correlation and regression analyses will be done to test the relationships between knowledge of breast cancer, cultural barriers, health beliefs and likelihood to engage in health-promoting behaviors. Knowledge of breast cancer and cultural barriers, stigma are predictive; health beliefs is a moderator variable and likelihood to engage in health-promoting behaviors is an outcome variable of the study. In the evaluation of the data, variance analysis, Bonferroni method, and chi-square tests will be used. The level of significance will be p <0.05. Thematic analysis will be used to analyze qualitative data (Braun & Clarke, 2008). Thematic analysis is a qualitative data analysis method that aims to “identify, analyze, and report patterns of similarities and differences in the dataset” (Braun & Clarke, 2008, p. 79). Results: Data analysis is in progress. Conclusion: This project will contribute to a better knowledge of the perceived susceptibility, perceptions of risks, barriers to and benefits of screening practices, confidence in performing breast self-examination (BSE) and motivation in doing BSE among Islamic/Muslim refugee women who recently migrated to Canada due to Syrian and Middle-East conflicts. Results will inform the planning of health promotion programs designed to address the specific needs of this population.