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Provider Perspectives on Promoting Cervical Cancer Screening Among Refugee Women

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Abstract

Many refugees in the United States emigrated from countries where the incidence of cervical cancer is high. Refugee women are unlikely to have been screened for cervical cancer prior to resettlement in the U.S. National organizations recommend cervical cancer screening for refugee women soon after resettlement. We sought to identify health and social service providers’ perspectives on promoting cervical cancer screening in order to inform the development of effective programs to increase screening among recently resettled refugees. This study consisted of 21 in-depth key informant interviews with staff from voluntary refugee resettlement agencies, community based organizations, and healthcare clinics serving refugees in King County, Washington. Interview transcripts were analyzed to identify themes. We identified the following themes: (1) refugee women are unfamiliar with preventive care and cancer screening; (2) providers have concerns about the timing of cervical cancer education and screening; (3) linguistic and cultural barriers impact screening uptake; (4) provider factors and clinic systems facilitate promotion of screening; and (5) strategies for educating refugee women about screening. Our findings suggest that refugee women are in need of health education on cervical cancer screening during early resettlement. Frequent messaging about screening could help ensure that women receive screening within the early resettlement period. Health education videos may be effective for providing simple, low literacy messages in women’s native languages. Appointments with female clinicians and interpreters, as well as clinic systems that remind clinicians to offer screening at each appointment could increase screening among refugee women.

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Acknowledgements

We would like to acknowledge the contribution of the participants in our study. This work was supported by grant number R21CA187401 from the National Cancer Institute. Dr. Zhang was supported by a National Research Service Award from the National Institutes of Health (Grant Number T32HP10002), Dr. Ornelas was supported by the Institute of Translational Health Sciences KL2 Program at the University of Washington (Grant Number ULTR0000423).

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Authors and Affiliations

  1. Family Medicine, University of Washington, UW Box 359846, 325 Ninth Ave, Seattle, WA, 98104, USA

    Ying Zhang

  2. Health Services, University of Washington, UW Box 359455, Seattle, WA, 98105, USA

    India J. Ornelas

  3. Cancer Prevention, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA

    H. Hoai Do & Victoria M. Taylor

  4. School of Social Work, University of Washington, UW Box 354900, Seattle, WA, 98105, USA

    Maya Magarati

  5. General Internal Medicine, University of Washington, UW Box 359959, Seattle, WA, 98104, USA

    J. Carey Jackson

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  1. Ying Zhang
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Correspondence to Ying Zhang.

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Zhang, Y., Ornelas, I.J., Do, H.H. et al. Provider Perspectives on Promoting Cervical Cancer Screening Among Refugee Women. J Community Health 42, 583–590 (2017). https://doi.org/10.1007/s10900-016-0292-5

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  • DOI: https://doi.org/10.1007/s10900-016-0292-5

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