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The moderating effect of acculturation on intrinsic religiosity and previous receipt of a pap test. Note. Measures (respective ranges): Acculturation (26–64); Intrinsic Religiosity (17–45) (color figure available online).
Source publication
In this study the authors explore the relationship between intrinsic, personal extrinsic, and social extrinsic religiosity to breast and cervical cancer screening efficacy and behavior among Vietnamese women recruited from a Catholic Vietnamese church and a Buddhist temple in the Richmond, Virginia metropolitan area. The potential moderating effect...
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Background
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Citations
... The constructs of R/S Salience and Attendance were available variables in the ATP surveys. While these variables do not capture the totality of the constructs of religion and spirituality, they are commonly used in the literature on R/S and cancer screening (Allen et al., 2014;Benjamins et al., 2011;Katz et al., 2008;Nguyen et al., 2012;Padela et al., 2015). Our utilization of these variables adds to the current body of literature, which also employs similar measures to assess R/S. ...
We explored longitudinal associations between religion/spirituality (R/S) Salience and R/S Attendance, and colorectal cancer screening, among adults aged ≥ 50 years in Alberta, Canada. R/S Salience was not statistically significantly associated with colorectal cancer screening (adjusted odds ratio [aOR]: 1.06, 95% confidence interval [CI] 0.88–1.28). Conversely, R/S Attendance was statistically significantly associated with higher odds of colorectal cancer screening: the aOR was 1.28 (95% CI 1.02–1.59) for participants attending services at least once a month and 1.31 (95% CI 1.01–1.69) for participants attending between one and four times yearly, compared to participants who never attended. Researchers should explore the possibility of delivering colorectal cancer screening programs in R/S settings.
... We included several covariates in the regression models, chosen based on previously published literature (Allen et al., 2014;Azaiza et al., 2010;Benjamins and Brown, 2004;Benjamins et al., 2011;Husaini et al., 2002;Katz et al., 2008;Kinney et al., 2002;McFall and Davila, 2008;Melvin et al., 2016;Nguyen et al., 2012;O'Reilly et al., 2013;Ochoa-Frongia et al., 2012;Sen and Kumkale, 2016;Steele-Moses et al., 2009) and their availability in the HLQ: marital status, education, income, employment status, age, smoking status, self-rated health, presence of chronic diseases, and functional social support (Supplementary Material -Appendix A). ...
... Previously published literature (primarily cross-sectional studies) reported positive and statistically significant associations between R/S and breast cancer screening (Allen et al., 2014;Azaiza et al., 2010;Benjamins and Brown, 2004;Benjamins et al., 2011;Leyva et al., 2015;McFall and Davila, 2008;Melvin et al., 2016;Nguyen et al., 2012;O'Reilly et al., 2013;Ochoa-Frongia et al., 2012;Sen and Kumkale, 2016;Steele-Moses et al., 2009). For example, in a sample of 37,140 women, O' Reilly et al. (2013) reported that Irish women with no religious affiliation had 30% lower odds of being screened for breast cancer compared to Irish women with a Catholic background (aOR: 0.77, 95% CI: 0.71-0.83). ...
... Our analyses involved a population-based sample of mainly white women (n = 2,569), while most analyses in the published literature were conducted in smaller samples of women (n ~ 100 to 1000) who were recruited from specific cities and municipalities in the United States. Many studies also enrolled subsets of women from specific ethnic communities, including African American (Melvin et al., 2016;Ochoa-Frongia et al., 2012), Vietnamese (Nguyen et al., 2012), or Hispanic (Allen et al., 2014;Melvin et al., 2016). Smaller samples focusing on specific racial or ethnic minorities may capture behaviors or beliefs that are not evident in larger population samples incorporating women from multiple different backgrounds. ...
Breast cancer is the leading cause of cancer-related mortality among women. Screening permits the early detection and treatment of malignancies, thereby reducing mortality. A woman’s religiosity and spirituality (R/S) may facilitate screening through encouragement of healthy behaviors. Population-level data from Alberta’s Tomorrow Project (ATP) were used to explore the cross-sectional association between R/S and breast cancer screening among women aged 50 to 69 years who did not have a history of breast cancer. Two variables were used to measure R/S: (1) R/S Salience was defined as the importance of religion and spirituality in one’s life; (2) R/S Attendance was defined as the frequency of attendance at religious or spiritual services. We regressed breast cancer screening (mammogram: yes/no) on each R/S variable in separate multivariable logistic regression models. At baseline (n = 2,569), 94% of women reported receiving a mammogram. Greater R/S Salience was not associated with receipt of mammogram: the adjusted odds ratio (aOR) was 1.04 (95% confidence interval [CI]: 0.71 to 1.51. R/S Attendance also showed no association with mammogram: attending at least once monthly versus never attending (aOR: 1.10; 95% CI: 0.71 to 1.69); attending one to four times yearly versus never attending (aOR: 0.95, 95% CI: 0.57 to 1.58). Further research could examine specific subgroups of the population, e.g., whether use of R/S to promote breast cancer screening may be more effective among females with strong pre-existing connections to faith.
... Previous studies document the role of religiosity as an enabling factor for preventive health behaviors such as cancer screenings among ethnically diverse populations. [23][24][25] These results are consistent with previous studies that demonstrate, for cancer prevention messages to be effective among Latinas, the messages must resonate among members of the group and must be culturally appropriate. 26 The messages were also sent by a credible and trustworthy source of information-a patient navigator from Nueva Vida, which increases the likelihood of building the rapport and trust needed to draw women to the messages. ...
... Church as a source of breast cancer information was very important as well, which is consistent with the literature. [23][24][25] On the other hand, health insurance status was not an important predictive factor. Free mammogram screenings may have impacted the statistical significance of health insurance status in the model. ...
Objective: To investigate the efficacy of mobile health (mHealth) intervention strategies that delivered either personalized, culturally, and linguistically tailored cell phone voice messages or text messages related to breast cancer and prevention, compared to the control group, to determine which strategy is more likely to increase breast cancer knowledge and screening mammography among low-income Latina immigrants.
Methods: This randomized controlled trial assigned 256 Latina immigrants 40 years of age or older to one of three groups: an automated cell phone voice message group, an automated text message group, or the control group (mail). The mHealth intervention employed a comprehensive approach that included breast cancer and prevention education and free mammography screening. Outcome measures included knowledge of breast cancer and breast cancer prevention, and adherence to screening mammography.
Results: There was a general increase in breast cancer knowledge after the educational intervention for all the groups [p = 0.01, t(199) = 3.996]. Knowledge increase and mammography adherence did not differ based on group.
Conclusion: More important than the actual method of communication is how breast cancer and prevention messages are constructed, who the messenger is, and the enabling factors that facilitate screening adherence. A breast cancer preventive intervention program that is personalized, culturally and linguistically tailored, and offers a free or low-cost mammogram holds promise to be an effective method in reaching an underserved Latina population with a high breast cancer burden.
... Thus, its post-Katrina experience can tell us much about how other refugee communities might fare after a major disaster, in particular with regard to healthcare access. Previous research has found that less acculturated Vietnamese refugees are less likely to uptake physical examinations due to traditional beliefs and limited language proficiency (Nguyen et al. 2012;Ma et al. 2013;Yi et al. 2013;Nguyen and Clark 2014). Katrina might have influenced not only healthcare utilization among Vietnamese Americans but also the characteristics of acculturation and the relationship between acculturation and healthcare utilization. ...
How disasters affect health care within refugee communities is not well understood. To assess how Hurricane Katrina affected healthcare utilization among Vietnamese New Orleanians we employ a representative survey that took place just before Hurricane Katrina; and at several subsequent rounds near the 1-year, 2-year, and 5-year anniversaries of this event. To assess how acculturation affected healthcare utilization during this period we use random and fixed effects models. Principal findings are 1) access to routine healthcare had yet to recover to baseline levels by the fifth anniversary of the disaster; and 2) acculturation changed over the course of the study, as did the influence of acculturation on health care access. Implications for future research and for facilitating post-disaster health care access for recently settled refugee populations are discussed.
Background
On 29 August 2005, Hurricane Katrina struck the Gulf Coast and caused nearly 1000 deaths in the state of Louisiana alone (US Department of Commerce, National Oceanic and Atmospheric Administration 2006). Breaches in the Federal levee system flooded much of New Orleans. It is well established that disasters negatively impact the use of healthcare services (Lechat 1979; Do et al. 2009). Katrina affected healthcare utilization by destroying medical facilities and stressing health systems in New Orleans (World Health Organization 2013). New Orleans East, which has a large Vietnamese refugee population, was heavily flooded (Federal Emergency Management Agency 2006). Refugees are particularly vulnerable to disruptions in healthcare post-disaster because of language barriers, cultural beliefs, and lack of adequate financial resources (Ell and Castaneda 1998).
... Those people may seek assistance from religious leaders such as priests, Buddhist monks and traditional healers (LaBorde n.d.). Previous studies have shown that less acculturated Vietnamese immigrants are less likely to be screened for cancer due to traditional beliefs and limited language proficiency (Grace X. Yi et al. 2013;Nguyen et al. 2012;Nguyen & Clark 2014). ...
On August 29, 2005, Hurricane Katrina flooded much of New Orleans. Eastern New Orleans, which has a large Vietnamese American population, was heavily flooded. This paper aims to assess one principal trajectory of post-disaster recovery for this community, focusing on healthcare utilization in the Vietnamese immigrant enclave just before Katrina and after Katrina. The sample of Vietnamese respondents was selected from a population register of all Vietnamese-American households in the greater New Orleans area just before Katrina. The same individuals were assessed in 2005 (just before Katrina), 2006, 2007, and 2010. The finding demonstrates a significant declining pattern of obtaining routine physical exams. Even at the fifth anniversary of Katrina, access to routine physical exams had yet to fully recover to the level of access previously attained by Vietnamese immigrants. The result also reveals that the impact of Katrina significantly influenced effects of acculturation on obtaining a routine physical exam.
... Household income and a family history of cancer were factors only found in specific ethnic groups. Household income was only associated with test uptake among Asians in the United States in the pastyears 31,35 and was not observed in other ethnic groups. 22,28,31,37 One possible reason was that nearly 60% of Asian women's income was less than twice the Federal Poverty Level, a percentage significantly higher than those in other EM groups. ...
... Religion was mentioned as an important factor influencing the screening behavior of women in 2 quantitative studies focusing on Asian women in the United States. 32, 35 Ma et al revealed that women who did not think that God or a higher power could control cancer were 2 times more likely to have ever had a Papanicolaou test. Nguyen and Clark 35 used the validated Religious Orientation Scale to measure religiosity, 43 a 20-item measure that assessed 3 factors affecting religiosity: intrinsic, social, and personal extrinsic. ...
... The study revealed that there was no direct relationship between religiosity and Papanicolaou test uptake. 35 However, when the acculturation level of women was also considered, the study found that it was a significant moderator between the 3 types of religiosity and Papanicolaou test uptake. That is, less acculturated women with increased levels of intrinsic religiosity were significantly associated with a decrease in the likelihood of ever having had a Papanicolaou test. ...
Background:
Cervical cancer can be prevented by effective screening using Papanicolaou tests, but the utilization rate is lower among ethnic minorities than in the general population. Understanding the factors influencing minorities' use of such screening can aid the design of an appropriate intervention to increase their uptake rate.
Objective:
The aims of this study were to examine the factors that influence ethnic minority women in using cervical cancer screening and the similarities and differences in associated factors across different groups and to explore the interrelationships between the factors identified.
Methods:
A literature search was conducted using Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature Plus, Scopus, PsycINFO, and PubMed. Furthermore, 1390 articles were retrieved, of which 24 met the inclusion criteria. Critical appraisal was performed by means of a quality assessment tool. The findings were summarized in tabular and narrative forms.
Results:
The findings showed that certain factors commonly affected ethnic minority women's screening behavior, including knowledge, attitude and perceptions, physician's recommendation, quality of care and service, language, and acculturation. Culture-related factors, religion, and acculturation exhibited close interrelationships with the attitude and perceptions factor, resulting in behavioral change.
Conclusions:
The review sheds light on how common or unique are the factors across ethnic minorities and how these factors interact to influence behavior. Further studies are warranted to develop and test empirically a comprehensive model leading to a better understanding of the interrelationships between multiple factors.
Implications for practice:
The model should be useful in informing policy makers about appropriate resource allocation and in guiding the development of culturally relevant programs to increase screening uptake.
... [95][96][97][98] Frequency of church attendance was reported to have positive associations with breast cancer screenings. 99 The present study found significant positive associations only for those women who attended church every week in the poverty group, whereas women not in poverty had significantly higher odds of having annual mammography than non-church attendees regardless of the frequency of their church attendance. A further examination shows that mammography use rates of each frequency point among women in poverty were much lower than women not in poverty ( Figure 2). ...
Objectives: This study examines whether social networks have differential effects on mammography use depending on poverty status. Methods: Data were analyzed on US women (40+), employing logistic regression and simple slope analyses for a post hoc probing of moderating effects. Results: Among women not in poverty, living with a spouse/partner and attending church, regardless of frequency, were positively associated with mammography use; family size was negatively associated. Among women living in poverty, mammography showed a positive association only with weekly church attendance. Mammography was negatively associated with health-related social interactions occurring through the Internet. Post hoc probing showed significant moderating effects of poverty on the relationship between online health-related interactions and mammography use. Conclusions: To make the Internet a meaningful health empowerment tool for women in poverty, future research should identify how health-related interactions that occur online affect women in poverty's psychological and behavioral reactions that will contribute to our understanding of why they are discouraged from having mammograms. The mechanisms behind the differential effects of church attendance and poverty status on mammography also need further clarification.
... Those people may seek assistance from religious leaders such as priests, Buddhist monks and traditional healers (LaBorde n.d.). Previous studies have shown that less acculturated Vietnamese immigrants are less likely to be screened for cancer due to traditional beliefs and limited language proficiency (Grace X. Yi et al. 2013;Nguyen et al. 2012;Nguyen & Clark 2014). ...
... Esta situación hace necesario mejorar la información sobre el propósito del PAP, disminuyendo la ansiedad que este examen pueda producir. Respecto de la autoeficacia (46) definida como la convicción personal de poder realizar con éxito una conducta requerida que produzca resultados, también ha sido considerada una variable asociada a la adherencia al PAP (47)(48)(49)(50)(51). ...
Ganadora concurso Vicerectoría de Investigación de la Pontificia Universidad Católica de Chile, "Concurso de Investigación para Pregrado" en la versión verano 2015
... Esta situación hace necesario mejorar la información sobre el propósito del PAP, disminuyendo la ansiedad que este examen pueda producir. Respecto de la autoeficacia (46) definida como la convicción personal de poder realizar con éxito una conducta requerida que produzca resultados, también ha sido considerada una variable asociada a la adherencia al PAP (47)(48)(49)(50)(51). ...
Background: Social Determinants consider "characteristics of the social context that affect health, as well as the mechanisms by which social conditions translate into health impacts". Interventions aimed at reducing diseases will be successful only when properly considered the social determinants of health. Objective: Analyze, based on the existing literature, WHO's Social Determinants of health model and its application to cervical cancer (CC) screening adherence. Results: There are many studies that establish the relationship between structural and intermediate determinants and adherence to screening. Even though there are contradictory studies, it is important the positive association between structural determinants and greater adherence: a higher education, employment and the presence of increased house holding come determine a greater adherence to screening. As structural determinants, several factors are reported, including house hold characteristics, residence time, characteristics of the health system, availability and contact with health professionals, risk factors for cervical cancer, knowledge and beliefs of the disease, among others. Conclusion: It is necessary to consider CC prevention from a much wider perspective, with an approach that goes beyond the biomedical phenomena that the lack of screening adherence entails, but as a social problem that explains this health behavior. It is suggested that CC prevention campaigns should consider the Social Determinants approach.
