title: Provider Perspectives on Promoting Cervical Cancer Screening Among Refugee Women.
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.
authors.affiliation: Family Medicine, University of Washington, UW Box 359846, 325 Ninth Ave, Seattle, WA, 98104, USA. zhangy07@uw.edu.
authors.forename: Ying
authors.identifier: http://orcid.org/0000-0002-1846-962X
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Health Services, University of Washington, UW Box 359455, Seattle, WA, 98105, USA.
authors.forename: India J
authors.initials: IJ
authors.lastname: Ornelas
authors.affiliation: Cancer Prevention, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA.
authors.forename: H Hoai
authors.initials: HH
authors.lastname: Do
authors.affiliation: School of Social Work, University of Washington, UW Box 354900, Seattle, WA, 98105, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Magarati
authors.affiliation: General Internal Medicine, University of Washington, UW Box 359959, Seattle, WA, 98104, USA.
authors.forename: J Carey
authors.initials: JC
authors.lastname: Jackson
authors.affiliation: Cancer Prevention, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA.
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D054521:Cultural Competency; D055088:Early Detection of Cancer; D005260:Female; D006266:Health Education; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D012036:Refugees / Q000523:psychology*; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D016387:Women's Health
keywords: Cervical cancer; Health care providers; Refugee; Women’s health