ABSTRACT
This qualitative study explored the barriers and facilitators of cancer screening among women of Hmong origin. Using a community-based participatory research approach, we conducted focus groups (n=44) with Hmong women who represented four distinct demographic groups among the Hmong community. The participants described sociocultural barriers to screening, which included a lack of accurate knowledge about the causes of cervical cancer, language barriers, stigma, fear, lack of time, and embarrassment. Structural barriers included attitudes and practices of health care providers, lack of insurance, and negative perceptions of services at clinics for the uninsured. Health care providers may require additional training and increased time per visit to provide culturally sensitive care for refugee groups such as the Hmong. Health-related social marketing efforts aimed at improving health literacy may also help to reduce health inequities related to cancer screening among the Hmong.
Subject(s)
Asian People/psychology , Culture , Early Detection of Cancer/methods , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/ethnology , Adolescent , Adult , Community-Based Participatory Research , Fear , Female , Focus Groups , Health Education/organization & administration , Health Knowledge, Attitudes, Practice/ethnology , Humans , Language , Medicine, East Asian Traditional , Middle Aged , Patient Acceptance of Health Care/ethnology , Social Stigma , Socioeconomic Factors , Time Factors , Young AdultABSTRACT
This paper reports the baseline data on the proportion of Hmong women (n=402), ages 18-65, in Sacramento, California who reported that they had a Pap test for the early detection of cervical cancer. We assessed the association between sociodemographic characteristics and Pap test receipt using chi-squared and multiple logistic regression analyses. Only 74% had ever had a Pap test, with 61% tested in the previous three years, compared with 91% and 86%, respectively, of California women overall. Women were more likely to have had a recent Pap test if they were age 21-30 (OR=3.0 vs. age 51-65, 95% CI 1.4-6.7) or 31-40 (OR=3.0, 95% CI 1.4-6.4), and less likely if they were single (OR=0.4 vs. married/partnered, 95% CI 0.2-1.0) or born in the U.S. (OR=0.3 vs. <10 years in U.S., 95% CI 0.1-0.8).
Subject(s)
Asian/psychology , Early Detection of Cancer/psychology , Patient Acceptance of Health Care/ethnology , Uterine Cervical Neoplasms/ethnology , Vaginal Smears/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Asian/statistics & numerical data , California , Chi-Square Distribution , Early Detection of Cancer/methods , Female , Humans , Laos/ethnology , Logistic Models , Middle Aged , Patient Acceptance of Health Care/statistics & numerical data , Socioeconomic Factors , Uterine Cervical Neoplasms/diagnosis , Young AdultABSTRACT
This paper describes the development and implementation of a Hmong Cervical Cancer Intervention Program utilizing a patient navigation model to raise cervical cancer awareness for Hmong women through educational workshops and to assist Hmong women in obtaining a Pap test. Out of 402 women who participated in a baseline survey, the Patient Navigation Program was able to enroll 109 participants who had not had a Pap test in the past 3 years and had never had a Pap test. Through utilization of outreach, an awareness campaign and patient navigation support, at least 38 percent of 109 participants obtained a Pap test. Overall, 21 workshops and 43 outreach activities were conducted by the Hmong Women's Heritage Association, leading to 63 percent of those enrolled in the Patient Navigation Program who could be contacted to obtain a Pap test.
