Table 2 - uploaded by Minna Song
Content may be subject to copyright.
Citations
... Among US immigrants of African descent, cervical cancer screening rates were markedly low, and significantly lower than the screening rates of US born women [23,26,27]. Specifically, low rates of cervical cancer screening have been observed among Caribbean-and African-born Black women [26,28]. Also, recent evidence suggests that Black immigrant women (BIW) were seven times less likely to report up-to-date cervical cancer screening than African American women in the USA [27]. ...
... Prior research on factors associated with cancer screening among immigrants can be understood within the context of the socioecological framework [28][29][30]. For instance, individual determinants of screening include cancer-related knowledge and personal attitudes or beliefs about screening (e.g., fear, embarrassment or modesty when seeking screening) [31,32]. ...
Background
Prior research has linked personal network characteristics with cancer screening uptake including Papanicolaou (Pap) screening, but less is known about the experiences of Black immigrant women (BIW) in the USA. We examined the relationship between network characteristics and Pap screening among BIW and explored how their network members influence their cancer related knowledge and prevention behaviors.
Methods
A mixed methods study of BIW, aged 21–65 years, in southeastern US included a cross-sectional survey ( N = 204) and in-depth individual interviews ( N = 13). We examined whether high-social connectedness, contact frequency, and social support were associated with Pap screening, using multivariable logistic regression models. Thematic analysis further assessed the roles of personal network factors on BIW’s cancer preventive behaviors.
Results
Pap screening was more likely among BIW with high- versus low-social connectedness (OR: 2.68, CI: 1.12, 6.46). However, the impact of high-social connectedness was attenuated, after adjusting for demographic factors and health insurance. Our qualitative findings revealed that both BIW and their personal networks had limited knowledge on cancer and related prevention measures. Close network members, particularly mother-figures, provided support for BIW’s care seeking efforts, including cancer screening, although some participants mentioned a lack of screening support.
Conclusion
These findings suggest that Black immigrant communities may benefit from tailored cancer prevention interventions among close network members, to improve knowledge and support for cancer control behaviors.
... African immigrants have tended to settle in 4 main cities in the United States: Washington DC, New York City, Minneapolis or St Paul, and Atlanta [3]. Prior research has established that most African immigrants come from Western (35.7%) and Eastern Africa (29.6%) [4]: from Nigeria (13.7%), Ethiopia (10.8%), ...
Cancer prevalence data for Black Americans is monolithic and fails to consider the diverse cultures and backgrounds within that community. For instance, African immigrants constitute a meaningful proportion of the foreign-born Black immigrants in the United States (42%), but the prevalence of cancer in the African immigrant community itself is unknown. Therefore, without accurate cancer prevalence data, it is impossible to identify trends and other key factors that are needed to support the health of African immigrants and their children. Moreover, it is impossible to understand how the culture and language of subgroups influence their cancer-related health behavior. While research in this area is limited, the existing literature articulates the need for culturally responsive and culturally tailored cancer education for African immigrants and their adolescent children, which is what we advocate for in this viewpoint paper. Existing projects demonstrate the feasibility of culturally responsive programming for adults; however, few projects include or focus on adolescents or children born to African immigrants. To best meet the needs of this understudied community, researchers must use culturally competent interventions alongside familiar, usable media. For adolescents, technology is ubiquitous thus, the creation of a culturally tailored digital intervention has immense potential to improve cancer awareness and prevention for youth and their community. More research is needed to address many of the existing research gaps and develop a rich understanding of the unique experience of cancer among African immigrant families that can be used to inform intervention development. Through this viewpoint, we review the current state of cancer-related research among African immigrant families in the United States. In this paper, we acknowledge the current knowledge gaps and issues surrounding measurement and then discuss the factors relevant to designing an educational intervention targeted at African immigrants and the role of African immigrant youth.
... Scientific breakthroughs have expanded our understanding of cervical cancer and facilitated the development of these screening and preventive measures. Notably, infection with human papillomavirus (HPV) is now known to increase risk of developing cervical cancer, with HPV genotypes 16 and 18 accounting for 70% of cervical carcinogenesis, as uninterrupted precancerous cells advance to malignant lesions [9][10][11][12]. Despite the availability of quadrivalent and 9-valent HPV vaccines, which have shown high efficacy in protection against high grade lesions and invasive cervical cancer, vaccination rates remain below the 80% goal set by the Healthy People 2020 initiative, particularly for African immigrants [13][14][15][16][17][18][19]. ...
This study aims to determine whether a novel cervical cancer screening toolkit will increase rates of pap test completion and HPV vaccination among Somali women living in the United States. We conducted a randomized controlled, pilot trial from June 2021 to February 2022. Somali women aged 21 to 70 were randomized to either receive a toolkit (infographic, video and an in-person health seminar) or not. Health passports confirming a completed pap test and/or HPV vaccination by clinician signature were used to measure outcomes. The primary outcome was pap test completion and the secondary outcome was HPV vaccination. We enrolled 57 participants. Patients randomized to the treatment arm were significantly more likely to have had a pap test (53.7% vs. 3.7%, p < 0.0001) and were also more likely to have received the HPV vaccine (10.7% vs. 3.7%, p = 0.6110). This toolkit increased rates of pap test completion and more participants in the intervention arm received HPV vaccination, though numbers were low. The study design may serve as a reproducible model to determine the effectiveness of patient education materials.
... Despite the growing presence of this population, little is known about the cancer burden among sub-Saharan Africans [6]. Available sparse data tends to be aggregated with the overall Black population and may mask important differences that can inform cancer prevention and control efforts among specific sub-groups [7]. Sub-Saharan African immigrants to the U.S. may encounter similar facilitators and challenges to obtaining cancer screening as native-born Blacks, however, it is likely that these two groups maintain differing beliefs that may account for variations in behavior. ...
... Fatalism has been found to negatively influence health promoting practices such as cancer screening among African Americans [27]. Fatalism is also a major factor that affects cancer preventive screening among sub-Saharan African immigrants, specifically breast and cervical cancers [7]. Health temporal orientation is the time perspective with which one makes health decisions and how an individual values distant outcomes relatively to present ones [28,29]. ...
... The screening rates found in this study suggest that Sub-Saharan African immigrants are disproportionately underusing colonoscopy screening and may be at risk for late-stage detection. In accordance with literature, Sub-Saharan African immigrants and other immigrants have lowest screening rates compared to native-born individuals [3,4,7,52]. One possible reason for this may be that sub-Saharan African immigrants do not receive recommendation to screen for colorectal cancer or are unaware of the colorectal cancer screening guidelines. ...
Background
Beliefs influence cancer screening. However, there are conflicting findings about how belief influence cancer screening among Black adults. The aim of this study was to evaluate the relationships between beliefs (religiosity, fatalism, temporal orientation, and acculturation) and cervical, breast, and colorectal cancer screening behaviors among African Americans and sub-Saharan African immigrants.
Methods
We conducted a cross-sectional survey of 73 African American and 59 English speaking Sub-Saharan immigrant adults recruited from Lexington and surrounding cities in Kentucky. Data collected included sociodemographic variables, cancer screening behaviors, and several instruments that characterize beliefs, including religiosity, fatalism, temporal orientation, and acculturation.
Results
Participants’ mean age was 43.73 years (SD = 14.0), 83% were females, and 45% self-identified as sub-Saharan immigrants. Based on eligibility for each screening modality, 64% reported having ever had a Pap test, 82% reported ever having mammogram, and 71% reported ever having a colonoscopy. Higher education (OR = 2.62, 95% CI = 1.43—4.80) and being insured (OR = 4.09, 95% CI = 1.10 – 15.18) were associated with increased odds of cervical cancer screening (pap test), while cancer fatalism (OR = 0.24, 95% CI = 0.07 – 0.88) was associated with decreased odds. Increased age (OR = 1.57, 95% CI = 1.06 – 2.32) and reduced present orientation (OR = 0.42, 95% CI = 0.22 – 0.80) were associated with receipt of a mammogram. Nativity was the only factor associated with colonoscopy screening. Compared to African Americans, sub-Saharan African immigrants were 90% less likely to have had a colonoscopy (OR = 0.10, 95% CI = 0.02 – 0.66).
Conclusion
This study contributes to the existing literature by confirming that beliefs are important in cancer screening behaviors among African American and sub-Saharan African immigrants. These findings should inform the development of cancer control and prevention programs for Black adults.
Trial registration
US National Library of Science identifier NCT04927494. Registered June 16, 2021, www.clinicaltrials.gov
... Sociodemographic characteristics of women adherent to breast cancer guidelines, by place of birth, NHIS 2015 U.S.-born counterparts regardless of length of time in the U.S.[20].Studies examining both BrCa and CRC screening among Black immigrant women are limited, and investigations of CRC screening adherence levels in this population report mixed results[17,20,[42][43][44][45][46]. Similarly, few large studies investigate both BrCa and CRC screening in Latina populations ...
Introduction
Colorectal cancer screening rates in the U.S. still fall short of national goals, while screening rates for other cancer sites, such as breast, remain high. Understanding characteristics associated with colorectal cancer screening among different groups of women adherent to breast cancer screening guidelines can shed light on the facilitators of colorectal cancer screening among those already engaged in cancer prevention behaviors. The purpose of this study was to explore which demographic characteristics, healthcare access factors, and cancer-related beliefs were associated with colorectal cancer screening completion among U.S. and foreign-born women adherent to mammography screening recommendations.
Methods
Analyses of the 2015 National Health Interview Survey were conducted in 2019. A sample of 1206 women aged 50–74 who had a mammogram in the past 2 years and were of average risk for colorectal cancer was examined. Logistic regression was used to determine demographic, health service, and health belief characteristics associated with colorectal cancer screening completion.
Results
Fifty-five percent of the sample were adherent to colorectal cancer screening recommendations. Women over the age of 65 (AOR = 1.76, 95% CI 1.06–2.91), with any type of health insurance, and who were bilingual (AOR = 3.84, 95% CI 1.83–8.09) were more likely to complete screening, while foreign-born women (AOR = 0.53, 95% CI 0.34–0.83) were less likely. Cancer-related beliefs did not influence adherence. Stratified analyses by nativity revealed additional associations.
Conclusions
Demographic and health service factors interact to influence colorectal cancer screening among women completing breast cancer screening. Colorectal cancer screening interventions targeting specific underserved groups and financing reforms may enhance women’s colorectal cancer screening rates.
... Fear caused by the lasting consequences of medical violence that Black, Indigenous and people of color (BIPOC) have been subjected to in western countries, lingers as symbolic violence that keeps African immigrants from accessing US healthcare. Lack of health insurance is also an obstacle among many immigrants in the U.S., despite the expansion of healthcare access granted by the Affordable Care Act, due to lack of or ineffective methods of enrollment [41]. Furthermore, we and others have found that insured individuals reported having problems navigating the healthcare system, particularly when it came to determining exactly what insurance benefits they were receiving [31]. ...
... However, it may be necessary to address the cultural attitudes and beliefs that we observed in order to most effectively reach African immigrant populations with preventative care. Other studies have found similar themes when examining the uptake of health care among African immigrants, including lack of health insurance [41], difficulty navigating the healthcare system [31,42], and barriers related to language and inadequate health [31,42]. However, our study fills an important gap in the existing literature in that we focused on an uptake of preventive health care overall as opposed to the uptake of care or prevention services for one specific health problem, and we focused on three East African immigrant communities rather than one community. ...
African immigrants make up a large subgroup of Black/African-Americans in the US. However, because African immigrant groups are typically categorized as “Black,” little is known about their preventative healthcare needs. Differences in culture, life and healthcare experiences between African immigrant populations and US-born people may influence preventive health care uptake. Thus, policymakers and healthcare providers lack information needed to make informed decisions around preventive care for African immigrants. This formative study was conducted among the largest East African immigrant communities in King County, WA. We recruited religious leaders, community leaders, health professionals, and lay community members to participate in thirty key informant interviews and five focus group discussions (n = 72 total), to better understand preventative healthcare attitudes in these communities. Through inductive coding and thematic analysis, we identified factors that impact preventative healthcare attitudes of the Somali, Ethiopian and Eritrean immigrant communities and deter them from accessing and utilizing healthcare. Cultural beliefs and attitudes around preventative healthcare, mistrust of westernized healthcare, religious beliefs/views, intersecting identities and shared immigrant experiences all influence how participants view preventative healthcare. Our results suggest that interventions that address these factors are needed to most effectively increase uptake of preventative healthcare in African immigrant communities.
... As a result, immigrants may be more likely to fall prey to misinformation. For example, African immigrants in the U.S. have been exposed to much misinformation about cervical cancer, they also had low HPV vaccination rates and high cervical cancer mortality rates (18). ...
... In addition, immigrant women often navigate an unfamiliar healthcare system with the added challenges of lack of insurance, language barriers, and legal statuses that bar them from certain government-funded services (Pitkin Derose et al., 2009;Waters & Gerstein Pineau, 2016). These challenges contribute to sexual and reproductive health disparities such as Black immigrant women being less likely to receive reproductive health-related cancer screenings when compared to their U.S.-born counterparts (Hurtado-de-Mendoza et al., 2014). Despite these documented health disparities, the extant literature regarding sexual and reproductive health among Black immigrant women remains insufficient (Tapales et al., 2018), necessitating the examination of factors that may affect sexual health behaviors such as mother-daughter sex communication. ...
Communication about sex between mothers and daughters is important when preparing adolescents for adulthood. Yet, Black immigrant mothers are more reluctant to discuss sex related topics with their daughters, possibly motivated by discomfort, feeling ill-prepared, or the culturally taboo nature of such conversations. Despite the documented health disparity, the extant literature regarding sexual and reproductive health among Black immigrant women remains insufficient. The study will explore the narratives of Black adult immigrant daughters, their retrospective report of what their mothers told them about sex, and how these messages impacted them in adulthood. Findings indicate that daughters felt that their mothers used fear to deter them from having premarital sex but did not directly educate them about sex. Daughters also felt that their lack of knowledge about sex negatively impacted them as adults. Clinical implications are provided.
... Studies on cancer prevention among ethnic/racial minorities in many developed countries often treat Blacks (African immigrants, Afro-Caribbean, and nativeborn Blacks) as a homogenous group even when evidence shows that the health behaviors (i.e. cancer screening) of these various subgroups are impacted by diverse cultural, structural, and socio-demographic factors [15][16][17]. Studies have also shown that among Blacks, African immigrants record the lowest cancer screening rates and also suffer the worst cancer outcomes [16,18]. ...
... cancer screening) of these various subgroups are impacted by diverse cultural, structural, and socio-demographic factors [15][16][17]. Studies have also shown that among Blacks, African immigrants record the lowest cancer screening rates and also suffer the worst cancer outcomes [16,18]. The objective of this systematic review is to critically evaluate existing studies on the prevalence of Pap test screening among AI women in developed countries, and explore the factors influencing their Pap testing behaviors. ...
... This systematic review examines the prevalence of Pap testing, and factors that impact the Pap testing behaviors of AI women living in developed nations. The evidence from this review demonstrated a low prevalence of Pap testing among AI women, which is consistent with previous findings on the suboptimal Pap test screening behaviors of AI women in comparison to other minority groups [16]. The prevalence of Pap testing (ranging from 4.6% to 73%) reported in this review were based on women's self-reported receipt of Pap tests. ...
Background
African immigrant (AI) women remain burdened by cervical cancer, but the prevalence and correlates of Pap testing remains unclear in this population.
Objective
To review studies on the prevalence and determinants of Pap testing among AI women living in developed countries.
Methods
PubMed, CINAHL, Embase, and Scopus were searched for relevant articles that included African-born immigrant participants; were published in English; addressed the prevalence of Pap testing; conducted in a developed country; and identified correlates of Pap testing behavior. The Andersen Behavioral Model guided synthesis of the key findings.
Results
Sixteen studies met the inclusion criteria. The prevalence of Pap testing ranged from 4.6% to 73.0%. Having a female provider and access to primary care facilitated Pap testing. Barriers to Pap testing included low income, male healthcare providers, and no history of gynecological exam.
Conclusions
Healthcare providers and social determinants-particularly income and healthcare access, play an important role in improving Pap testing among AI women. Larger qualitative and mixed methods studies are needed to explore other important determinants of Pap testing such as disease knowledge, self-efficacy, health literacy to reduce the burden of cervical cancer among AI women.
... African immigrants and refugees resettling in the USA account for one of the largest growing populations (Hurtado-de- Mendoza et al., 2014), with Congolese refugees representing the most substantial proportion (United Nations High Commissioner for Refugees, [UNHCR], 2019). The migration process for refugees is often involuntary because they are forced to leave their home country to escape war and/or persecution due to race, religion or political or social group affiliation (UNHCR, 2019), while in contrast, immigrants might voluntarily migrate in search of better economic opportunities or educational purposes. ...
Acculturation consists of a process of learning and adapting the behaviours and cultural values of another cultural group. However, the conceptualisation and measurement of acculturation is inconsistent across scholars. Therefore, the authors systematically reviewed the acculturation literature to identify and assess the psychometric properties of acculturation measures with African immigrants in the USA. This systematic review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Studies were included if they used a quantitative methodology, were published in English and used acculturation measure, and involved immigrants from any African country. The search resulted in 1,882 studies, of which ten studies were included in the review. This review identified that studies utilised nine different acculturation measures originally developed for other ethnic groups. Findings also indicated that some studies reported reliability and validity scores, while others did not report psychometric analysis. Our findings highlight the need to adapt and test reliable and valid acculturation measures. Future studies should consider robust psychometric assessments to ensure the accuracy of the instrument with the target population. Such information is pertinent to social workers in understanding the acculturation experiences of African immigrants and refugees and developing cultural interventions.
