Journal of Immigrant and Minority Health

, Volume 22, Issue 1, pp 87–95 | Cite as

Testing a Religiously Tailored Intervention with Somali American Muslim Women and Somali American Imams to Increase Participation in Breast and Cervical Cancer Screening

  • Rebekah PrattEmail author
  • Sharif Mohamed
  • Wali Dirie
  • Nimo Ahmed
  • Sey Lee
  • Michael VanKeulen
  • Sam Carlson
Original Paper


Somali American women have low rates of breast and cervical screening. This research aimed to test the feasibility and impact of religiously tailored workshops involving Somali American Muslim women and male imams to improve intention to undergo breast or cervical cancer screening. Religiously tailored workshops addressing cancer screening (each approximately 3 h in length) were conducted with 30 Somali American women and 11 imams. Pre- and post-test surveys measured attitudes toward screening, screening intention, and workshop experience. The workshops were feasible, and both the women and the imams found the workshops enjoyable as well as informative. The discussions of religiously tailored messages had a positive impact on attitudes toward cancer screening, and, for the women, a positive impact on intention to screen. Religiously tailored messages can be an important community asset for engaging Somali American Muslim women around the value of breast and cervical cancer screening.


Cancer screening Breast Cervical Religious Immigrant Muslim Somali Qualitative Focus group 



This work was supported by the Program in Health Disparities Research Small Grant Program, University of Minnesota.

Compliance with Ethical Standards

Conflict of interest

No potential conflict of interest was reported by the authors.


  1. 1.
    Omar YS. Social integration and the sense of hope among Somali youth in Austrailia and the United States. Bildhaan: Int J. 2013;12:34Google Scholar
  2. 2.
    Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90.Google Scholar
  3. 3.
    Minnesota Community Measures. Cedar Riverside People’s Center|Minnesota HealthScores. Accessed 3 Nov 2017.
  4. 4.
    CDC. CDC—cancer screening in the United States. Accessed 8 Oct 2017.
  5. 5.
    Goldie SJ, Gaffikin L, Goldhaber-Fiebert JD, Gordillo-Tobar A, Levin C, Mahé C, et al. Cost-effectiveness of cervical-cancer screening in five developing countries. N Engl J Med. 2005;353(20):2158–68.PubMedGoogle Scholar
  6. 6.
    Peirson L, Fitzpatrick-Lewis D, Ciliska D, Warren R. Screening for cervical cancer: a systematic review and meta-analysis. Syst Rev. 2013;2(1):35.PubMedPubMedCentralGoogle Scholar
  7. 7.
    US Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151(10):716.Google Scholar
  8. 8.
    Morrison TB, Wieland ML, Cha SS, Rahman AS, Chaudhry R. Disparities in preventive health services among Somali immigrants and refugees. J Immigr Minor Health. 2012;14(6):968–74.PubMedGoogle Scholar
  9. 9.
    Gele AA, Torheim LE, Pettersen KS, Kumar B. Beyond culture and language: access to diabetes preventive health services among Somali women in Norway. J Diabetes Res. 2015;2015:549795.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Raymond NC, Osman W, O’Brien JM, Ali N, Kia F, Mohamed F, et al. Culturally informed views on cancer screening: a qualitative research study of the differences between older and younger Somali immigrant women. BMC Public Health. 2014;14(1):1188.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Sewali B, Pratt R, Abdiwahab E, Fahia S, Call KT, Okuyemi KS. Understanding cancer screening service utilization by Somali men in Minnesota. J Immigr Minor Health. 2014;17(3):773–80.Google Scholar
  12. 12.
    Ghebre RGR, Sewali B, Osman S, Adawe A, Nguyen HT, Okuyemi KS, et al. Cervical cancer: barriers to screening in the Somali community in Minnesota. J Immigr Minor Health. 2014;17(3):722–8.Google Scholar
  13. 13.
    Hasnain M, Connell KJK, Menon U, Tranmer PA. Patient-centered care for Muslim women: provider and patient perspectives. J Womens Health. 2011;20(1):73–83.Google Scholar
  14. 14.
    Swan J, Breen N, Coates RJ, Rimer BK, Lee NC. Progress in cancer screening practices in the United States: results from the 2000 National Health Interview Survey. Cancer. 2003;97(6):1528–40.PubMedGoogle Scholar
  15. 15.
    Szczepura A, Price C, Gumber A. Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics. BMC Public Health. 2008;8(1):346.PubMedPubMedCentralGoogle Scholar
  16. 16.
    DeSantis CE, Siegel RL, Sauer AG, Miller KD, Fedewa SA, Alcaraz KI, et al. Cancer statistics for African Americans, 2016: progress and opportunities in reducing racial disparities. CA Cancer J Clin. 2016;66(4):290–308.PubMedGoogle Scholar
  17. 17.
    Ahmed AT, Welch BT, Brinjikji W, Farah WH, Henrichsen TL, Murad MH, et al. Racial disparities in screening mammography in the United States: a systematic review and meta-analysis. J Am Coll Radiol. 2017;14(2):157–65.PubMedGoogle Scholar
  18. 18.
    Dalton HJ, Farley JH. Racial disparities in cervical cancer: worse than we thought. Cancer. 2017;123(6):915–6.PubMedGoogle Scholar
  19. 19.
    Pavlish CL, Noor S, Brandt J. Somali immigrant women and the American health care system: discordant beliefs, divergent expectations, and silent worries. Soc Sci Med. 2010;71(2):353–61.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Carroll J, Epstein R, Fiscella K, Volpe E, Diaz K, Omar S. Knowledge and beliefs about health promotion and preventive health care among Somali women in the United States. Health Care Women Int. 2007;28(4):360–80.Google Scholar
  21. 21.
    Al-Amoudi S, Cañas J, Hohl SD, Distelhorst SR, Thompson B. Breaking the silence: breast cancer knowledge and beliefs among Somali muslim women in Seattle. Wash Health Care Women Int. 2015;36(5):608–16.Google Scholar
  22. 22.
    Downs LS, Scarinci I, Einstein MH, Collins Y, Flowers L. Overcoming the barriers to HPV vaccination in high-risk populations in the US. Gynecol Oncol. 2010;117(3):486–90.PubMedGoogle Scholar
  23. 23.
    Bigby J, Ko LK, Johnson N, David MMA, Ferrer B. A community approach to addressing excess breast and cervical cancer mortality among women of African descent in Boston. Public Health Rep. 2003;118(4):338–47.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Khaja K, Lay K, Boys S. Female circumcision: toward an inclusive practice of care. Health Care Women Int. 2010;31(8):686–99.PubMedGoogle Scholar
  25. 25.
    Degni F, Suominen S, Essén B, El Ansari W, Vehviläinen-Julkunen K. Communication and cultural issues in providing reproductive health care to immigrant women: health care providers’ experiences in meeting the needs of Somali women living in Finland. J Immigr Minor Health. 2012;14(2):330–43.PubMedGoogle Scholar
  26. 26.
    Johnson CE, Ali SA, Shipp MP-L. Building community-based participatory research partnerships with a Somali refugee community. Am J Prev Med. 2009;37(6 Suppl 1):230-6.Google Scholar
  27. 27.
    Pratt R, Mohamed S, Dirie W, Ahmed N, VanKeulen M, Ahmed H, et al. Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study. BMC Public Health. 2017;17(1):270.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Morrison TB, Flynn PM, Weaver AL, Wieland ML. Cervical cancer screening adherence among Somali immigrants and refugees to the United States. Health Care Women Int. 2013;34(11):980–8.PubMedGoogle Scholar
  29. 29.
    Paisley J, Haines J. An examination of cancer risk beliefs among adults from Toronto’s Somali, Chinese, Russian and Spanish-speaking communities. Can J Public Health. 2002;93(2):138–41.PubMedGoogle Scholar
  30. 30.
    Shirazi M, Shirazi A, Bloom J. Developing a culturally competent faith-based framework to promote breast cancer screening among Afghan immigrant women. J Relig Health. 2015;54(1):153–9.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Padela AI, Vu M, Muhammad H, Marfani F, Mallick S, Peek M, et al. Religious beliefs and mammography intention: findings from a qualitative study of a diverse group of American Muslim women. Psychooncology. 2016;25(10):1175–82.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Abdullahi A, Copping J, Kessel A, Luck M, Bonell C. Cervical screening: perceptions and barriers to uptake among Somali women in Camden. Public Health. 2009;123(10):680–5.PubMedGoogle Scholar
  33. 33.
    Escribà-Agüir V, Rodríguez-Gómez M, Ruiz-Pérez I. Effectiveness of patient-targeted interventions to promote cancer screening among ethnic minorities: a systematic review. Cancer Epidemiol. 2016;44:22–39.PubMedGoogle Scholar
  34. 34.
    Padela AI, Killawi A, Forman J, DeMonner S, Heisler M. American Muslim perceptions of healing key agents in healing, and their roles. Qual Health Res. 2012;22(6):846–58.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Padela AI, Killawi A, DeMonner S, Heisler M. The role of imams in American Muslim health: perspectives of Muslim community leaders in Southeast Michigan. J Relig Health 2011;50(2):359–73.PubMedGoogle Scholar
  36. 36.
    Padela A, Shanawani H, Greenlaw J. The perceived role of Islam in immigrant Muslim medical practice within the USA: an exploratory qualitative study. J Med Ethics. 2008;34(5):365–9.PubMedGoogle Scholar
  37. 37.
    Harandy TF, Ghofranipour F, Montazeri A, Anoosheh M, Bazargan M, Mohammadi E, et al. Muslim breast cancer survivor spirituality: coping strategy or health seeking behavior hindrance? Health Care Women Int. 2010;31(1):88–98.PubMedGoogle Scholar
  38. 38.
    Levano W, Miller JW, Leonard B, Bellick L, Crane BE, Kennedy SK, et al. Public education and targeted outreach to underserved women through the National Breast and Cervical Cancer Early Detection Program. Cancer. 2014;120:2591–6.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Richard L, Gauvin L, Raine K. Ecological models revisited: their uses and evolution in health promotion over two decades. Annu Rev Public Health. 2011;32:307–26.PubMedGoogle Scholar
  40. 40.
    Campbell MK, Hudson MA, Resnicow K, Blakeney N, Paxton A, Baskin M. Church-based health promotion interventions: evidence and lessons learned. Annu Rev Public Health. 2007;28(1):213–34.PubMedGoogle Scholar
  41. 41.
    Bandura A. Self-efficacy. New York: Wiley Online Library; 1994.Google Scholar
  42. 42.
    Bandura A. Social cognitive theory: an agentic perspective 1. Asian J Soc Psychol. 1999;2:21–41.Google Scholar
  43. 43.
    Sarkar U, Fisher L, Schillinger D. Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy? Diabetes Care. 2006;29(4):823–9.PubMedGoogle Scholar
  44. 44.
    Schaubroeck J, Lam SSK, Xie JL. Collective efficacy versus self-efficacy in coping responses to stressors and control: a cross-cultural study. J Appl Psychol. 2000;85(4):512–25.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Program in Health Disparities Research, Department of Family Medicine and Community HealthUniversity of MinnesotaMinneapolisUSA
  2. 2.Islamic Civil Society of AmericaMinneapolisUSA
  3. 3.Department of Family Medicine and Community HealthUniversity of MinnesotaMinneapolisUSA
  4. 4.Open Path ResourcesMinneapolisUSA

Personalised recommendations