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Breast-Health Screening Perceptions of Chinese Canadian Immigrant Women Immigrant & Racialized Women’s Health Conference February 21, 2014 Heidi Sin RN,

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Presentation on theme: "Breast-Health Screening Perceptions of Chinese Canadian Immigrant Women Immigrant & Racialized Women’s Health Conference February 21, 2014 Heidi Sin RN,"— Presentation transcript:

1 Breast-Health Screening Perceptions of Chinese Canadian Immigrant Women Immigrant & Racialized Women’s Health Conference February 21, 2014 Heidi Sin RN, PhD 1

2 Outline Problem and purpose of the study Approach Research questions Study participants Data collection Results and Interpretation Recommendations Implications for Practices 2

3 Problem Breast cancer is a prominent type of cancer in women. Breast cancer accounted for 458,000 deaths globally. In Canada, 22,700 individuals diagnosed with breast cancer along with 5,100 cancer-related deaths in Regular breast-health screening could reduce mortality from breast cancer. Screening rate was low within ethno-cultural groups. Result in high mortality and morbidity. 3

4 Purpose To explore the perceptions of breast-health screening among Chinese Canadian immigrant women, aged 30 to 69 and barriers that prevented them from having breast- health screening. 4

5 Research Method and Design Qualitative case study Demographic survey Semistructured interview Focus group 5

6 Research Question What are the perceptions of breast-health screening among Chinese Canadian immigrant women aged 30 to 69? 6

7 Research Subquestions Types of preventive health measures Perceived benefits of breast-health screening Obstacles to breast-health screening Females’ perceptions of condition, situations, or contexts that influence their lived experiences with breast-health screening Perceived role of breast-health screening 7

8 Characteristics of population Chinese women aged 30 to 69. Born and received education in mainland China. First language is Mandarin. Have immigrated to Canada for 5 years or less. Residents in the Greater Toronto Area. Acquired no history of breast cancer. Approached Welcome Centre Immigrant Services- Markham South or The Cross-Cultural Community Services Association. 8

9 Data Collection Pilot study Fifteen semistructured interviews Two focus groups 9

10 Results and Interpretations Subquestion 1: What types of preventive health measures used by Chinese Canadian immigrant women? Theme: Influence of Chinese cultural beliefs and practices to maintain health Healthy eating Physical activities Positive attitude Regular daily activities 10

11 Results and Interpretations Subquestion 2: What are the perceived benefits of breast- health screening for Chinese Canadian immigrant women? Theme: Important role of a female caregiver in a family Early detection of breast cancer Prevention of illness Beneficial to individuals and family members 11

12 Results and Interpretations Subquestion 3: What are the obstacles to breast-health screening for Chinese Canadian immigrant women? Theme: Accessibility to and utilization of screening services Lack of knowledge Inconvenience Language proficiency Embarrassment Perceived illness Radiation Cost 12

13 Results and Interpretations Subquestion 4: What are the females’ perceptions of condition, situations, or contexts that influence their lived experiences with breast-health screening? Two themes: Lack of preventive health concept and experiences affect participation Lack of preventive health concept Perceived illnesses Awareness of breast cancer impact 13

14 Results and Interpretations Subquestion 4: What are the females’ perceptions of condition, situations, or contexts that influence their lived experiences with breast-health screening? Theme: Experiences affect participation Positive / negative perceptions of screening Someone with breast cancer Screening experiences Screening instructions Positive / negative emotional responses 14

15 Results and Interpretations Subquestion 5: What perceived role does breast-health screening play in Chinese Canadian immigrant women’s health? Theme: Lack of information about breast-health screening program Benefits of screening Importance of screening Individual responsibility Breast-health screening program Current health status 15

16 Recommendations Develop culturally-sensitive linguistic programs and educational materials in consideration of Chinese health beliefs. Establish better communication between health care providers and clients and recommendation by physicians. Include breast-health screening as a standard item within annual check-up. Promotion of breast-health screening through ethnic media. 16

17 Recommendations Expand the operating hours for screening clinic and initiation of mobile women’s clinic. Provide translation services, comfortable and supportive environment at the breast-health screening clinics. Provide linguistic culturally educational program to include preventive health concept. Provide community-based outreach educational programs and a lay health educator program. 17

18 Implications for Practices To increase participation in breast-health screening: Increase knowledge. Reduce perceived barriers, facilitate perceived benefits, minimize negative experiences. Promote self care message. Involve physicians. Send reminders through a systematic approach. Remove embarrassment by given options. Review health organizations role. Conduct further longitudinal studies. 18

19 19

20 20 Thank you!!

21 References Anagnostououlos, F., Dimitrakaki, C., Fitzsimmons, D., Potamianos, G., Niakas, D., & Tountas, Y. (2012). Health beliefs and illness perception as related to mammography uptake in randomly selected women in Greece. Journal of Clinical Psychology in Medical Settings, 19, doi: /s Ayala, G. X., Vaz, L., Earp, J. A., Elder, J. P., & Cherrington, A. (2010). Outcome effectiveness of the lay health advisor model among Latino in the United States: An examination by role. Health Education Research, 25(5), doi: /her/cyq035 Bloomberg, L., & Volpe, M. (2008). Completing your qualitative dissertation: A roadmap form beginning to end. Thousand Oaks, CA. Sage. 21

22 References Canadian Cancer Society, Public Health Agency of Canada, & Statistics Canada. (2012). Canadian cancer statistics Toronto, Canada: Canadian Cancer Society. Cancer Care Ontario. (2010). Ontario breast cancer screening program 20 th anniversary report Toronto, ON: Author. Chen, Y. L. D. (1996). Conformity with nature: A theory of Chinese American elders’ health promotion and illness prevention process. Advances in Nursing Science, 19(2), Christensen, L. B., Johnson, R. B., & Turner, L.A. (2011). Research methods, design, and analysis (11th ed.). Boston, MA: Allyn & Bacon. Finlay, L. (2009). Debating phenomenological research methods. Phenomenological and Practices, 3(1), Gay, L. R., Mills, G. E., & Airasian, P. (2006). Educational research. Competencies for analysis and applications. Upper Saddle River, NJ: Pearson. 22

23 References Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.). (2008). Health behavior and health education. Theory, research and practice (4th ed.). Hoboken, NJ: Jossey-Bass. Inoue, M., Pickard, G. J., Welch-Saleeby, P., & Johnson, S. (2009). African-American caregivers’ breast health behavior. Health Education Research, 24(5), doi: /her/cyp008 Kwok, C., Fethney, J., & White, K. (2012). Mammographic screening practices among Chinese-Australian women. Journal of Nursing Scholarship, 44 (1), doi: /j x Lee-Lin, F., Menon, U., Pett, M., Nail, L., Lee, S., & Mooney, K. (2007). Breast cancer beliefs and mammography screening practices among Chinese American immigrants. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 36, doi: /J x 23

24 References Lee-Lin, F., Menon, U., Nail, L., & Lutz, K. F. (2012). Findings from focus groups indicating what Chinese American immigrant women think about breast cancer and breast cancer screening. Journal of Obstetric Gynecologic & Neonatal Nursing, 00(00), doi: /j x Leedy, P. D., & Ormrod, J. E. (2010). Practical research: Planning and design (9th ed.). Upper Saddle River, NJ: Pearson. Liang, W., Wang, J. H., Chen, M. Y., Feng, S., Lee, M., Schwartz, M. D.,…Mandelblatt, J. S. (2008). Developing and validating a measure of Chinese cultural views of health and cancer. Health Education and Behavior, 35, doi: / Mapp, T. (2008). Understanding phenomenology: The lived experience. British Journal of Midwifery, 16,

25 References Morgan, D. L. (1997). Focus groups as qualitative research. Newbury Park, California: Sage. Moustakas, C. (1994). Phenomenological research methods. Thousand Oaks, CA: Sage. Shin, K., Kim, M., & Chung, S. (2009). Methods and strategies utilized in published qualitative research. Qualitative Health Research, 19, Sun, A., Zhang, J., Tsoh, J., Wong-Kim, E., & Chow, E. (2007). The effectiveness in utilizing Chinese media to promote breast health among Chinese women. Journal of Health Communication, 12, doi: /

26 References Tabar, L., Vitak, B., Yen, A. M., Cohen, A., Tot, T., Chui, S.Y.,…Duffy, S. W. (2011). Swedish two-country trial: Impact of mammography screening on breast cancer mortality during 3 decades. Radiology, 260, doi: /radiol Todd, L. Harvey, E., & Hoffman-Goetz, L. (2011). Predicting breast and colon screening among English-as-a- second-language older Chinese immigrant women to Canada. Journal of Cancer Education, 26, doi: /s World Health Organization. (2013). Breast cancer: Prevention and control. Retrieved from 26


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