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Beyond Resettlement: Sociocultural Factors Influencing Breast and Colorectal Cancer Screening Among Afghan Refugee Women

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Abstract

Immigrants and refugees have an increased risk for developing chronic health conditions, such as breast and colorectal cancer, the longer they reside in the USA. Moreover, refugees are less even likely to use preventive health services like mammography and colonoscopy screening when compared with US-born counterparts. Focused ethnography was employed to examine sociocultural factors that influenced cancer screening behaviors among aging Afghan refugee women. We conducted 19 semi-structured interviews with Afghan women 50 and older and their family member/caregivers. Interview transcripts were inductively coded using Atlas.ti, where focused codes were sorted and reduced into categories, and we extracted meaning around groups of categories. Findings of this study revealed factors like fear of cancer, pre-migration experiences, family involvement, provider recommendation, and provider gender concordance influenced women’s cancer screening behaviors. This study also found that women who have had a recent mammogram or colonoscopy described empowerment factors that helped them withstand the stressful process of screening, through encouragement and reminders from providers, support from adult family members, and finding strength through duaas (prayers). As refugee women continue to age in the USA, clinicians should incorporate multi-level strategies, including family-centered and faith-based approaches to promote preventive screening behaviors in this population.

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Acknowledgments

The authors would like to acknowledge the participants who shared their stories with us.

Funding

This study was supported in part by the National Institute of Health (NIH)/Nursing Research (NINR) Ruth L. Kirschstein Institutional Research Training Grant: Health Disparities Research in Vulnerable Populations (Grant Number T32 NR007077), and the Sigma Theta Tau Gamma Chapter Research Award.

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Authors and Affiliations

  1. National Clinician Scholars Program, University of California, Los Angeles , Los Angeles, CA, USA

    Hafifa Siddiq

  2. UCLA Resource Center for Minority Aging Research Center for Health Improvement of Minority Elderly, Los Angeles, CA, USA

    Hafifa Siddiq

  3. School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA

    Carol Pavlish, Janet Mentes & Eunice Lee

  4. Loma Linda University School of Behavioral Health Sciences, Riverside, CA, USA

    Qais Alemi

Authors
  1. Hafifa Siddiq
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  2. Carol Pavlish
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  3. Qais Alemi
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  4. Janet Mentes
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  5. Eunice Lee
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Hafifa Siddiq and Carol Pavlish. The first draft of the manuscript was written by Hafifa Siddiq, and all authors commented on previous versions of the manuscript. As dissertation co-chair, Dr. Carol Pavlish provided qualitative and community-based methodological expertise. As dissertation co-chair, Dr. Eunice Lee provided expert mentorship on cancer screening among ethnic minority women. As a dissertation committee member, Dr. Qais Alemi provided expert mentorship in the population of interest, Afghan refugees. As a dissertation committee member, Dr. Janet Mentes provided expert mentorship in aging populations. All authors read and approved the final manuscript.

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Correspondence to Hafifa Siddiq.

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Siddiq, H., Pavlish, C., Alemi, Q. et al. Beyond Resettlement: Sociocultural Factors Influencing Breast and Colorectal Cancer Screening Among Afghan Refugee Women. J Canc Educ 37, 352–361 (2022). https://doi.org/10.1007/s13187-020-01822-1

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  • DOI: https://doi.org/10.1007/s13187-020-01822-1

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