Abstract
This study explored Arabic, Chinese, South Asian, and Vietnamese immigrant women's experiences with a peer health educator program, a public health program that facilitated access to breast health information and mammography screening. Framed within critical social theory, this participatory action research project took place from July 2009 to January 2011. Ten focus groups and 14 individual interviews were conducted with 82 immigrant women 40 years of age and older. Qualitative methods were utilized. Thematic content analysis derived from grounded theory and other qualitative literature was employed to analyze data. Four dominant themes emerged: Breast Cancer Prevention focused on learning within the program, Social Support provided by the peer health educator and other women, Screening Services Access for Women centered on service provision, and Program Enhancements related to specific modifications required to meet the needs of immigrant women accessing the program. The findings provide insights into strategies used to promote breast health, mammography screening, and the improvement of public health programming. Perceived barriers that continue to persist are structural barriers, such as the provision of information on breast cancer and screening by family physicians. A future goal is to improve collaborations between public health and primary care to minimize this barrier.
Highlights
Breast cancer is the most common cancer diagnosed and the second leading cause of cancer death among North American women [1]
Immigrant women who settle in westernized countries such as the United States (USA), United Kingdom (UK), and Canada have lower mammography screening than nonimmigrant native born women [3,4,5]
A total of 82 immigrant women participated in 10 focus groups and 14 semistructured one-on-one interviews undertaken from April 2009 to June 2009
Summary
Breast cancer is the most common cancer diagnosed and the second leading cause of cancer death among North American women [1]. Detection of breast cancer using mammography is an effective strategy that has the potential to reduce mortality and morbidity in average risk women 50 years of age and older [2]. Mammography screening is not undertaken by all eligible women, and subgroups of women continue to be underscreened. Immigrant women who settle in westernized countries such as the United States (USA), United Kingdom (UK), and Canada have lower mammography screening than nonimmigrant native born women [3,4,5]. Despite unique differences in migration patterns and sociocultural context of settlement country, common barriers to breast cancer screening access exist. Settlement neighbourhood and a lack of tailored approaches for outreach perpetuate barriers to screening for some groups of immigrant women [9]
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