title: A Systematic Review of the Factors Influencing Ethnic Minority Women's Cervical Cancer Screening Behavior: From Intrapersonal to Policy Level.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Author Affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Dorothy N S
authors.initials: DNS
authors.lastname: Chan
authors.forename: Winnie K W
authors.initials: WKW
authors.lastname: So
mesh_terms: D000328:Adult; D000368:Aged; D002755:Choice Behavior; D003144:Communication Barriers; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology; D065006:Papanicolaou Test / Q000523:psychology / Q000639:trends; D011787:Quality of Health Care; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology