Developing a Culturally Competent Faith-Based Framework to Promote Breast Cancer Screening Among Afghan Immigrant Women


For the tens of thousands of Afghan immigrant women currently living in the USA, religious and cultural beliefs can act as a barrier to health care access. Islamic frameworks and men’s gatekeeping roles often control women’s decision-making power about their health care needs. Gatekeepers, however, can be reconceived as facilitators empowered to protect the well-being of the family, and positive messages within Islam can foster collaborative investment in women’s health. Drawing upon a pilot study utilizing community-based participatory research involving the largest Afghan community in the USA, this paper documents the need for culturally sensitive faith-based education to promote breast cancer screening among this growing population.

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  1. Allied Media Corp (2000). Muslim American demographic facts. Retrieved from

  2. Alrawi, S., Fetters, M. D., Killawi, A., Hammad, A., & Padela, A. (2011). Traditional healing practices among American Muslims: Perceptions of community leaders in Southeast Michigan. Journal of Immigrant and Minority Health, 14(3), 489–496.

    Article  Google Scholar 

  3. Anderson, B. O., Shyyan, R., Eniu, A., Smith, R. A., Yip, C. H., Bese, N. S., et al. (2006). Breast cancer in limited-resource countries: An overview of the Breast Health Global Initiative 2005 guidelines. The Breast Journal, 12(S1), S3–S15.

    PubMed  Article  Google Scholar 

  4. Carroll, J., Epstein, R., Fiscella, K., Volpe, E., Diaz, K., & Omar, S. (2007). Knowledge and beliefs about health promotion and preventive health care among Somali women in the United States. Health Care for Women International, 28(4), 360–380.

    PubMed  Article  Google Scholar 

  5. DeShaw, P. (2006). Use of the emergency department by Somali immigrants and refugee. Minnesota Medicine, 89(8), 42–45.

    PubMed  Google Scholar 

  6. Gunes Murat, T., & Azadarmaki, T. (2008). Religiosity and Islamic rule in Iran. Journal for the Scientific Study of Religion, 47(2), 211–224.

    Article  Google Scholar 

  7. Israel, B. A., Eng, E., Schulz, A. J., Parker, E. A., & Satcher, D. (2005). Methods in community-based participatory research for health. San Francisco, CA: Jossey Bass.

    Google Scholar 

  8. Israel, B. A., Lichtenstein, R., Lantz, P., McGranaghan, R., Allen, A., Guzman, R. J., et al. (2001). The Detroit community-academic urban research center: Development, implementation, and evaluation. Journal of Pulbic Health Management and Practice, 7(5), 1–19.

    CAS  Article  Google Scholar 

  9. Israel, B. A., Schulz, A. J., Parker, E. A., & Becker, A. B. (1998). Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health, 19, 173–202.

    CAS  PubMed  Article  Google Scholar 

  10. Johnson, J. L., Bottorff, J. L., Balneaves, L. G., Grewal, S., Bhagat, R., Hilton, B., et al. (1999). South Asian womens’ views on the causes of breast cancer: Images and explanations. Patient Education and Counseling, 37(3), 243–254.

    CAS  PubMed  Article  Google Scholar 

  11. Kettani, H. (2010). 2010 World Muslim Population. Unpublished paper presented at the Eighth Annual Hawaii International Conference on Arts & Humanities, Honolulu, HI.

  12. Khan, S. M., Gillani, J., Nasreen, S., & Zai, S. (1997). Cancer in north west Pakistan and Afghan refugees. Journal of the Pakistan Medical Association, 47(4), 122–124.

    CAS  PubMed  Google Scholar 

  13. Lipson, J. G., Hosseini, M. A., Kabir, S., & Edmonston, F. (1996). Health Issues among Afghan Women in California. Health Care for Women International, 16, 279–286.

    Article  Google Scholar 

  14. Lipson, J. G., & Omidan, P. A. (1997). Afghan refugee issues in the U.S. social environment. Western Journal of Nursing Research, 19(1), 110–126.

    CAS  PubMed  Article  Google Scholar 

  15. Morioka-Douglas, N., Sacks, T., & Yeo, G. (2004). Issues in caring for Afghan American elders: Insights from literature and a focus group. Journal of Cross-Cultural Gerontology, 19(1), 27–40.

    PubMed  Article  Google Scholar 

  16. Padela, A. I., Gunter, K., Killawi, A., & Heisler, M. (2012). Religious values and healthcare accommodations: Voices from the American Muslim Community. Journal of General Internal Medicine, 27(6), 708–715.

    PubMed Central  PubMed  Article  Google Scholar 

  17. Pew Forum on Religion & Public Life. (2011). The future of the global Muslim population. Retrieved from

  18. Poureslami, I. M., MacLean, D. R., Spiegel, J., & Yassi, A. (2004). Sociocultural, environmental, and health challenges facing women and children living near the borders between Afghanistan, Iran, and Pakistan (AIP Region). Medscape General Medicine, 6(3), 51.

    PubMed Central  PubMed  Google Scholar 

  19. Powe, B. D., & Finnie, R. (2003). Cancer fatalism: The state of the science [Review]. Cancer Nursing, 26(6), 454–465 (quiz 466–457).

    Google Scholar 

  20. Shah, S. M., Ayash, C., Pharaon, N. A., & Gany, F. M. (2008). Arab American immigrants in New York: Health care and cancer knowledge, attitudes, and beliefs. Journal of Immigrant and Minority Health, 10(5), 429–436.

    PubMed  Article  Google Scholar 

  21. Shirazi, M., Bloom, J., Shirazi, A., & Popal, R. (2013). Muslim Afghan immigrant women's knowledge and behaviors around breast cancer screening. Journal of Psycho-Oncology, 22(8), 1679–1917.

    Google Scholar 

  22. UNHCR. (2004). Background paper on refugees and asylum seekers from Afghanistan. Geneva: UNHCR Center for Documentation and Research Publications.

    Google Scholar 

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This research was funded by the California Breast Cancer Research Program

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Correspondence to Mehra Shirazi.

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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 54, 153–159 (2015).

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  • Faith-based
  • Community participatory research
  • Breast cancer screening
  • Afghan immigrant
  • Islam