"I'm not Alone; He will be There for Me": A Mixed-Method Approach Exploring the Impact of Spousal Support on Mammogram Utilization and Health Beliefs.

Regular mammogram screenings are effective for early breast cancer (BC) detection and decreased mortality rate. However, immigrant Muslim Arab women (IMAW) are less likely to adhere to these screenings although the rate of BC among IMAW is high. Recent studies have explored low mammogram screening rates among immigrant Muslim and/or Arab women from a limited perspective, overlooking the fact that husbands have an influence in IMAW's health behaviors toward cancer screenings. Thus, this mixed-method approaches were employed to (a) explore the association between spousal support and IMAW's health beliefs toward mammograms and their utilization, (b) to understand IMAW's experiences of spousal influence related to their mammogram use and health beliefs. The quantitative portion of the study, recruitment and data collection were conducted via online surveys in Arabic and English. Logistic regressions were used to explore relationships between perceived spousal support and IMAW's mammogram utilization and health beliefs. The qualitative portion of the study was conducted on a purposive sample of IMAW. A semi-structured interview guide in Arabic and English was used during one-on-one interviews. Arabic interviews were translated into English and transcribed by professionals. Interviews were analyzed by thematic analysis according to Braun and Clarke (2008). A total of 184 IMAW completed the survey with mean age of 50.4 (SD = 5.58, range = 45-60). Results revealed low mammogram screening rate among IMAW. Only 32.6% adhered to mammograms. Spousal support was positively associated with ever having obtained a mammogram and IMAW's adherence to mammogram. The 20 qualitative interviews, 16 in Arabic and four in English, produced rich description supporting results from the survey which includes, (a) types of spousal support, (b) impact of spousal support on participants' mammogram utilization and experience, and (3) impact of spousal support on participants' health beliefs toward mammograms. Findings from surveys and interviews show that a husband's support is positively associated with IMAW's mammogram utilization and health beliefs. Suggesting a new approach to integrate husbands in culturally appropriate interventions to increase mammogram screening rates among IMAW.

"I Trust That Only God Can Protect Me, But ": The Religious Meaning Behind Mammogram Attitudes and Behaviors Among Immigrant Muslim Women.

Although breast cancer is the second leading cause of death among women in the United States, women from ethnic minorities still underutilize mammogram screenings. Immigrant Muslim women (IMW) demonstrated low mammogram screening rates compared to the national target of 77.1% determined by Healthy People 2030. Although IMW comprise an understudied population in the health field, a limited number of studies have proposed that Islamic religious beliefs have an impact on their behaviors and practices in regard to mammogram use. This study aimed to understand the meanings IMW ascribe to their religious beliefs in relation to mammogram utilization. A qualitative thematic analysis study was conducted on a purposive sample. A total of 28 IMW were recruited for one-on-one interviews in either Arabic or English, and inductive thematic analysis as per Braun and Clarke (2008) informed data analysis, guided by symbolic interactionism. A total of 28 interviews (10 in English and 18 in Arabic) were conducted with IMW whose mean age was 54.7. During these interviews, three major themes emerged regarding the participants' experience with mammograms, within the context of their religious beliefs: (a) 'Your body is a trust,' (b) the notions of al-tawakkul and al-tawaakoul, and (c) religious methods for coping with mammogram use. Results from this study suggests some religious means that can be integrated into an educational program designed for IMW to enhance their mammogram screening rates.

Breast cancer screening among immigrant Muslim arab women in the United States: Analyzing relationships between beliefs, knowledge, spousal support and mammogram utilization.

BACKGROUND: Regular mammogram screenings contribute to a decreased breast cancer (BC) mortality rate. Women from ethnic minorities in the United States, however, often underutilize mammogram screenings; in particular, immigrant Muslim Arab (IMAW) women have low mammogram screening rates. OBJECTIVE: To explore the associations between mammogram utilization and (a) health and religious beliefs, (b) level of knowledge about mammograms, (c) health care provider (HCP) recommendations, and (d) spousal support. METHODS: A cross-sectional study employed online data collection. An Arabic or English survey was completed by women who were 45 or older and married, had immigrated from Arab countries, and had no history of breast cancer. Logistic regression was conducted for data analyses. RESULTS: Of the 184 Immigrant Muslim Arab survey participants, 86.6% reported having had at least one mammogram in their lifetime, and 32.6% adhered to mammograms. Ever having obtained a mammogram and adherence to mammograms were negatively associated with perceived mammogram barriers and positively associated with (a) spousal support, (b) level of mammogram knowledge, and (c) perceived self-confidence. Receiving (HCP) recommendation increased the likelihood of ever having obtained a mammogram. Finally, participants who reported higher levels of perceived mammogram benefits were more likely to have obtained a mammogram within the last 2 years compared to their counterparts. CONCLUSIONS: IMAW have demonstrated low mammogram adherence rate. IMPLICATIONS: Nursing clinicians and scholars must play a role in designing and implementing interventions to promote women adherence to mammograms. Involving husbands in these interventions may improve immigrant Muslim Arab women's mammogram adherence rates.

Association between Breast Cancer Knowledge and Mammogram Utilization among Immigrant Muslim Arab Women in California: Cross-Sectional Design.

BACKGROUND: Regular mammogram screenings have contributed to early breast cancer (BC) diagnoses and lowered the mortality rate by 40% in the United States of America (USA). Nonetheless, ethnic women living in developed countries, such as immigrant Muslim Arab women (IMAW), are less likely to get mammograms. AIM OF THE STUDY: In our study, we aimed to understand health behaviors among IMAWs as understudied populations in the USA. METHODS: We conducted a cross-sectional study on a convenience sample of IMAW living in southern California. We used logistic regression and multivariate logistic regressions to analyze the data. RESULTS: The total number of participants who completed the survey was 184 IMAW. Participants who had a higher level of knowledge about BC signs and symptoms and mammogram knowledge were more likely to have obtained a mammogram at some point compared with their counterparts (OR = 1.23, p = 0.03, CI: 1.07-1.42; OR = 2.23, p = 0.23, CI: 1.11-4.46, respectively). CONCLUSIONS: Our results provide more evidence emphasizing the important influence of BC and mammogram knowledge on immigrant women's behavior regarding mammogram utilization. The average level of knowledge in all three domains (BC risk factors, BC signs and symptoms, and mammogram use) reported in this study is considered low.