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The Doctor is Just a Messenger: Beliefs of Ultraorthodox Jewish Women in Regard to Breast Cancer and Screening

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Abstract

Screenings for the early detection of breast cancer greatly improve survival odds. Studies of minority groups have shown lower attendance of screenings; however, these studies seldom focused on religious minorities. This study examines perceptions of cancer and cancer screening among healthy ultraorthodox women in order to gain insight about ways to promote screening. In this qualitative-phenomenological study of two focus groups, three main themes were found: faith in God; the Rabbi as a guide; one’s relationship with the community. The study’s findings point to the importance of studying the unique needs of members of certain religious groups.

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Notes

  1. The Rambam is the Hebrew name for Maimonides, a noted medieval Jewish philosopher, religious scholar and physician.

References

  • Abraı´do-Lanza, A. F., Viladrich, A., Flo´ rez, K. R., Ce´spedes, A., Aguirre, A. N., & De La Cruz, A. A. (2007). Fatalismo reconsidered: A cautionary note for health-related research and practice with Latino populations. Ethnicity and Disease, 17, 153–158.

    Google Scholar 

  • Albert, S. M., Harlap, S., & Caplan, L. (2004). Cancer screening among older women in a culturally insular community. Preventive Medicine, 39(4), 649–656.

    Article  PubMed  Google Scholar 

  • Allison, M. A., Jensky, N. E., Marshall, S. J., Bertoni, A. G., & Cushman, M. (2012). Sedentary behavior and adiposity-associated inflammation: The multi-ethnic study of atherosclerosis. American Journal of Preventive Medicine, 42(1), 8–13.

    Article  PubMed Central  PubMed  Google Scholar 

  • Anis, E., Grotto, I., Moerman, L., Warshavsky, B., Slater, P. E., Lev, B., et al. (2009). Measles in a highly vaccinated society: The 2007–2008 outbreak in Israel. The Journal of Infection, 59(4), 252–258.

    Article  PubMed  Google Scholar 

  • Azaiza, F., & Cohen, M. (2006). Health beliefs and rates of breast cancer screening among Arab women. Journal of Women’s Health, 15(5), 520–530.

    Article  PubMed  Google Scholar 

  • Azaiza, F., & Cohen, M. (2008a). Between traditional and modern perceptions of breast and cervical cancer screenings: A qualitative study of Arab women in Israel. Psycho-Oncology, 17, 34–41.

    Article  PubMed  Google Scholar 

  • Azaiza, F., & Cohen, M. (2008b). Colorectal cancer screening, intentions, and predictors in Jewish and Arab Israelis: A population-based study. Health Education & Behavior, 35(4), 478–493.

    Article  Google Scholar 

  • Azaiza, F., Cohen, M., Awad, M., & Daoud, F. (2010). Factors associated with low screening for breast cancer in the Palestinian Authority: Relations of availability, barriers fatalism. Cancer, 116, 4646–4655.

    Article  PubMed  Google Scholar 

  • Azaiza, F., Cohen, M., Daoud, F., & Awad, M. (2011). Traditional-Westernizing continuum of change in screening behaviors: Comparison between Arab women in Israel and the West Bank. Breast Cancer Research and Treatment, 128, 219–227.

    Article  PubMed  Google Scholar 

  • Bandi, P., Cokkinides, V., Smith, R. A., & Jemal, A. (2012). Trends in colorectal cancer screening with home-based fecal occult blood tests in adults ages 50 to 64 years, 2000 to 2008. Cancer. doi:10.1002/cncr.27529.

    PubMed  Google Scholar 

  • Baron-Epel, O. (2010). Attitudes and beliefs Associated with mammography in a multiethnic population in Israel. Health Education & Behavior, 37(2), 227–242.

    Article  Google Scholar 

  • Baron-Epel, O., Friedman, N., & Lernau, O. (2008). Validity of self-reported mammography in a multicultural population in Israel. Preventive Medicine, 46, 489–491.

    Article  PubMed  Google Scholar 

  • Baron-Epel, O., Friedman, N., & Lernau, O. (2009). Reducing disparities in mammography-use in a multicultural population in Israel. International Journal for Equity in Health. doi:10.1186/1475-9276-8-19.

  • Bellizzi, K. M., Breslau, E. S., Burness, A., & Waldron, W. (2011). Prevalence of cancer screening in older, racially diverse adults: Still screening after all these years. Archives of Internal Medicine, 171(22), 2031–2037.

    Article  PubMed  Google Scholar 

  • Berman, E. (2000). Sect, subsidy, and sacrifice: An economist’s view of ultra-orthodox Jews. The Quarterly Journal of Economics, 115(3), 905–953.

    Article  Google Scholar 

  • Bowen, D. J., Singal, R., Eng, E., Crystal, S., & Burke, W. (2003). Jewish identity and intentions to obtain breast cancer screening. Cultural Diversity & Ethnic Minority Psychology, 9, 79–87.

    Article  Google Scholar 

  • Central Bureau of Statistics. (2010). Social survey 2009—religiosity in Israel—characteristics of different groups. Jerusalem: Central Bureau of Statistics (in Hebrew).

    Google Scholar 

  • Central Bureau of Statistics. (2011). Statistical abstract of Israel 2011. Jerusalem: Central Bureau of Statistics (in Hebrew).

    Google Scholar 

  • Cohen, M. (2006). Breast cancer early detection, health beliefs, and cancer worries in randomly selected women with and without a family history of breast cancer. PsychoOncology, 15, 873–883.

    Article  PubMed  Google Scholar 

  • Cohen, M., & Azaiza, F. (2005). Early breast cancer detection practices, health beliefs and cancer worries in Jewish and Arab women. Preventive Medicine, 41, 852–858.

    Article  PubMed  Google Scholar 

  • Cohen, M., & Azaiza, F. (2007). Health-promoting behaviors and health locus of control from a multicultural perspective. Ethnicity and Disease, 17, 636–642.

    PubMed  Google Scholar 

  • Cohen, M., & Azaiza, F. (2010). Increasing breast examinations among Arab women using a tailored culture-based intervention. Behavioral Medicine, 36, 92–99.

    Article  PubMed  Google Scholar 

  • Coleman, K. (2008). Personal and communal reactions to cancer: An interpretative phenomenological analysis of the beliefs held by charedi Jewish breast cancer patients. In P. L. Twohig & V. Kalitzkus (Eds.), The Tapestry of Health, Illness and Disease (pp. 75–94). Amsterdam: Rodopi.

    Google Scholar 

  • Coleman, K., Koffman, J., & Daniels, C. (2007). Why is this happening to me? Illness beliefs held by haredi Jewish breast cancer patients: An exploratory study. Spirituality and Health International, 8, 121–134.

    Article  Google Scholar 

  • Coleman-Brueckheimer, K., & Dein, S. (2011). Health care behaviours and beliefs in Hasidic Jewish populations: A systematic review of the literature. Journal of Religion and Health, 50, 422–436.

    Article  PubMed  Google Scholar 

  • Coleman-Brueckheimer, K., Spitzer, J., & Koffman, J. (2009). Involvement of Rabbinic and communal authorities in decision-making by haredi Jews in the UK with breast cancer: An interpretative phenomenological analysis. Social Science and Medicine, 68, 323–333.

    Article  PubMed  Google Scholar 

  • Corbin, J., & Morse, J. M. (2003). The unstructured interactive interview: Issues of reciprocity and risks when dealing with sensitive topics. Qualitative Inquiry, 9, 335–354. doi:10.1177/1077800403009003001.

    Article  Google Scholar 

  • Finlay, L., & Gough, B. (2003). Reflexivity: A practical guide for researchers in health and social sciences. Bodmin, Great Britain: Blackwell.

    Book  Google Scholar 

  • Finney Rutten, L. J., & Iannotti, R. J. (2003). Health beliefs, salience of breast cancer family history, and involvement with breast cancer issues: Adherence to annual mammography screening recommendations. Cancer Detection and Prevention, 27, 353–359.

    Article  PubMed  Google Scholar 

  • Flannelly, K. J., Stern, S., Costa, K. G., Weaver, A. J., & Koenig, H. G. (2006). Rabbis and health: A half-century review of the mental and physical health care literature: 1950–1999. Pastoral Psychology, 54(6), 545–554.

    Article  Google Scholar 

  • Friedman, M. (1991). The Haredi ultra-orthodox society: Sources trends and processes. Jerusalem: The Jerusalem Institute for Israel Studies.

    Google Scholar 

  • Goldblatt, H., Cohen, M., Azaiza, F., & Manassa, R. (2012). Being within or being between? The cultural context of Arab women’s experience of coping with breast cancer in Israel. Psycho-Oncology. doi:10.1002/pon.3078.

    PubMed  Google Scholar 

  • Gonzales, M., Nelson, H., Rhyne, R. L., Stone, S. N., & Hoffman, R. M. (2012). Surveillance of colorectal cancer screening in New Mexico Hispanics and non-Hispanic whites. Journal of Community Health. doi:10.1007/s10900-012-9568-6.

    PubMed  Google Scholar 

  • Goodman, Y., & Witztum, E. (2002). Cross-cultural encounters between care providers: Rabbis’ referral letters to a psychiatric clinic in Israel. Social Science and Medicine, 55, 1309–1323.

    Article  PubMed  Google Scholar 

  • Gurovich, N., & Cohen-Kastro, E. (2004). Ultra-orthodox Jews geographic distribution and demographic, social and economic characteristics of the ultra-orthodox Jewish population in Israel 1996–2001. Jerusalem: Central Bureau of Statistics (in Hebrew).

    Google Scholar 

  • Harmon, M. P., Castro, F. G., & Coe, K. (1996). Acculturation and cervical cancer: Knowledge, beliefs, and behaviors of Hispanic women. Women and Health, 24(3), 37–57.

    Article  CAS  PubMed  Google Scholar 

  • Katapodi, M. C., Lee, K. A., Facione, N. C., & Dodd, M. J. (2004). Predictors of perceived breast cancer risk and the relation between perceived risk and breast cancer screening: A meta-analytic review. Preventive Medicine, 38(4), 388–402.

    Article  PubMed  Google Scholar 

  • Lange, L. J., & Piette, J. D. (2006). Personal models for diabetes in context and patients’ health status. Journal of Behavioural Medicine, 29(3), 239–253.

    Article  Google Scholar 

  • Liamputtong, P. (2010). Performing qualitative cross-cultural research. Cambridge, United Kingdom: Cambridge University Press.

    Book  Google Scholar 

  • Lopez-McKee, G., McNeill, J., Bader, J., & Morales, P. (2008). Comparison of factors affecting repeat mammography screening of low-income Mexican-American women. Oncology Nursing Forum, 35(6), 941–946.

    Article  PubMed  Google Scholar 

  • Mason, J. (1996). Qualitative researching. London: Sage.

    Google Scholar 

  • Miranda, P. Y., Tarraf, W., González, P., Johnson-Jennings, M., & González, H. M. (2012). Breast cancer screening trends in the United States and ethnicity. Cancer Epidemiology, Biomarkers and Prevention, 21(2), 351–357.

    Article  PubMed Central  PubMed  Google Scholar 

  • Mor, P., & Oberle, K. (2009). Ethical issues related to BRCA gene testing in orthodox Jewish women. Nursing Ethics, 15(4), 512–522.

    Article  Google Scholar 

  • Moustakas, C. (1994). Phenomenological research methods. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Palmer, R. C., Emmons, K. M., Fletcher, R. H., Lobb, R., Miroshnik, I., Kemp, J. A., et al. (2008). Familial risk and colorectal cancer screening health beliefs and attitudes in an insured population. Preventive Medicine, 45, 336–341.

    Article  Google Scholar 

  • Pasick, R. J., & Burke, N. J. (2008). A critical review of theory in breast cancer screening promotion across cultures. Annual Review of Public Health, 9, 351–368.

    Article  Google Scholar 

  • Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Perez-Stable, E. J., Sabogal, E., & Otero-Sabogal, R. (1995). Use of cancer-screening tests in the San Francisco Bay area: Comparison of Latinos and Anglos. Journal of the National Cancer Institute Monographs, 18, 147–153.

    PubMed  Google Scholar 

  • Pfeffer, N. (2004). Screening for breast cancer: Candidacy and compliance. Social Science and Medicine, 58(1), 151–160.

    Article  PubMed  Google Scholar 

  • Philip, E. J., DuHamel, K., & Jandorf, L. (2010). Evaluating the impact of an educational intervention to increase CRC screening rates in the African American community: A preliminary study. Cancer Causes and Control, 21(10), 1685–1691.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pruitt, S., Shim, M., Mullen, P., Vernon, S., & Amick, B. (2009). Association of area socioeconomic status and breast, cervical, and colorectal cancer screening: A systematic review. Cancer Epidemiology Biomarkers and Prevention, 18(10), 2579.

    Article  Google Scholar 

  • Ribner, D. S. (2003). Modifying sensate focus for use with Haredi (Ultra-Orthodox) Jewish couples. Journal of Sex and Marital Therapy, 29, 165–171.

    Article  PubMed  Google Scholar 

  • Rier, D. A., Schwartzbaum, A., & Heller, C. (2008). Methodological issues in studying an insular, traditional population: A women’s health survey among Israeli Haredi (Ultra-orthodox) Jews. Women and Health, 48(4), 363–381.

    Article  PubMed  Google Scholar 

  • Russell, K. M., Champion, V. L., & Skinner, C. S. (2006). Psychosocial factors related to repeat mammography screening over 5 years in African American women. Cancer Nursing, 29, 236–243.

    Article  PubMed  Google Scholar 

  • Sanders Thompson, V. L., Lewis, T., & Williams, S. L. (2011). Refining the use of cancer-related cultural constructs among African Americans. Health Promotion Practice. doi:10.1177/1524839911399431.

    PubMed  Google Scholar 

  • Schnitzer, G., Loots, G., Escudero, V., & Schechter, I. (2011). Negotiating the pathways into care in a globalizing world: Help-seeking behaviour of ultra-orthodox Jewish parents. International Journal of Social Psychiatry, 57(2), 153–165.

    Article  PubMed  Google Scholar 

  • Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. Los Angeles, CA: Sage.

    Google Scholar 

  • Spurlock, W. R., & Cullins, L. S. (2006). Cancer fatalism and breast cancer screening in African American women. The ABNF Journal, 17(1), 38–43.

    PubMed  Google Scholar 

  • Stadler, N., Lomsky-Feder, E., & Ben-Ari, E. (2008). Fundamentalism’s encounters with citizenship: The Haredim in Israel. Citizenship Studies, 12(3), 215–231.

    Article  Google Scholar 

  • Strauss, E. (2007). Factors effecting health behavior, related to breast cancer screening, among Jewish Ultra orthodox women in comparison to Jewish non-ultra orthodox women. Doctoral Dissertation, Tel-Aviv University.

  • Talbert, P. Y. (2008). The relationship of fear and fatalism with breast cancer screening among a selected target population of African American middle class women. Journal of Social, Behavioral, and Health Sciences, 2, 96–110.

    Google Scholar 

  • Teman, E., Ivry, T., & Bernhardt, B. A. (2011). Pregnancy as a proclamation of faith: Ultra-orthodox Jewish women navigating the uncertainty of pregnancy and prenatal diagnosis. American Journal of Medical Genetics Part A, 155, 69–80.

    Article  Google Scholar 

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Correspondence to Anat Freund.

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Freund, A., Cohen, M. & Azaiza, F. The Doctor is Just a Messenger: Beliefs of Ultraorthodox Jewish Women in Regard to Breast Cancer and Screening. J Relig Health 53, 1075–1090 (2014). https://doi.org/10.1007/s10943-013-9695-0

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