Cancer screening education: can it change knowledge and attitudes among culturally and linguistically diverse communities in Queensland, Australia?
Katherine Cullerton A D , Danielle Gallegos A , Ella Ashley B , Hong Do B , Anna Voloschenko B , MaryLou Fleming C , Rebecca Ramsey A and Trish Gould CA School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia.
B Ethnic Communities Council of Queensland, 253 Boundary Street, West End, Qld 4101, Australia.
C School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia.
D Corresponding author. Email: k.cullerton@qut.edu.au
Health Promotion Journal of Australia 27(2) 140-147 https://doi.org/10.1071/HE15116
Submitted: 16 September 2015 Accepted: 11 April 2016 Published: 29 June 2016
Abstract
Issue addressed: Screening for cancer of the cervix, breast and bowel can reduce morbidity and mortality. Low participation rates in cancer screening have been identified among migrant communities internationally. Attempting to improve low rates of cancer screening, the Ethnic Communities Council of Queensland developed a pilot Cancer Screening Education Program for breast, bowel and cervical cancer. This study determines the impact of education sessions on knowledge, attitudes and intentions to participate in screening for culturally and linguistically diverse (CALD) communities living in Brisbane, Queensland.
Methods: Seven CALD groups (Arabic-speaking, Bosnian, South Asian (including Indian and Bhutanese), Samoan and Pacific Island, Spanish-speaking, Sudanese and Vietnamese) participated in a culturally-tailored cancer screening education pilot program that was developed using the Health Belief Model. A pre- and post-education evaluation session measured changes in knowledge, attitudes and intention related to breast, bowel and cervical cancer and screening. The evaluation focussed on perceived susceptibility, perceived seriousness and the target population’s beliefs about reducing risk by cancer screening.
Results: There were 159 participants in the three cancer screening education sessions. Overall participants’ knowledge increased, some attitudes toward participation in cancer screening became more positive and intent to participate in future screening increased (n = 146).
Conclusion: These results indicate the importance of developing screening approaches that address the barriers to participation among CALD communities and that a culturally-tailored education program is effective in improving knowledge, attitudes about and intentions to participate in cancer screening.
So what?: It is important that culturally-tailored programs are developed in conjunction with communities to improve health outcomes.
Key words: breast cancer, cervical cancer, colorectal cancer, ethnicity, lifestyle intervention.
References
[1] Queensland Health. The health of Queenslanders 2010: third report of the Chief Health Officer Queensland. Brisbane: Queensland Health; 2010.[2] Burgess DJ, Powell AA, Griffin JM, Partin MR (2009) Race and the validity of self-reported cancer screening behaviors: development of a conceptual model. Prev Med 48, 99–107.
| Race and the validity of self-reported cancer screening behaviors: development of a conceptual model.Crossref | GoogleScholarGoogle Scholar | 19118570PubMed |
[3] Ogunsiji O, Wilkes L, Peters K, Jackson D (2013) Knowledge, attitudes and usage of cancer screening among West African migrant women. J Clin Nurs 22, 1026–33.
| Knowledge, attitudes and usage of cancer screening among West African migrant women.Crossref | GoogleScholarGoogle Scholar | 23336438PubMed |
[4] Purc-Stephenson RJ, Gorey KM (2008) Lower adherence to screening mammography guidelines among ethnic minority women in America: a meta-analytic review. Prev Med 46, 479–88.
| Lower adherence to screening mammography guidelines among ethnic minority women in America: a meta-analytic review.Crossref | GoogleScholarGoogle Scholar | 18295872PubMed |
[5] Kwok C, White K, Roydhouse J (2011) Chinese–Australian women’s knowledge, facilitators and barriers related to cervical cancer screening: a qualitative study. J Immigr Minor Health 13, 1076–83.
| Chinese–Australian women’s knowledge, facilitators and barriers related to cervical cancer screening: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 21667256PubMed |
[6] Siahpush M, Singh GK (2002) Sociodemographic predictors of pap test receipt, currency and knowledge among Australian women. Prev Med 35, 362–8.
| Sociodemographic predictors of pap test receipt, currency and knowledge among Australian women.Crossref | GoogleScholarGoogle Scholar | 12453713PubMed |
[7] Ward PR, Javanparast S, Wilson C (2011) Equity of colorectal cancer screening: which groups have inequitable participation and what can we do about it? Aust J Prim Health 17, 334–46.
| Equity of colorectal cancer screening: which groups have inequitable participation and what can we do about it?Crossref | GoogleScholarGoogle Scholar | 22112702PubMed |
[8] Weber MF, Banks E, Smith DP, O’Connell D, Sitas F (2009) Cancer screening among migrants in an Australian cohort; cross-sectional analyses from the 45 and Up Study. BMC Public Health 9, 144
| Cancer screening among migrants in an Australian cohort; cross-sectional analyses from the 45 and Up Study.Crossref | GoogleScholarGoogle Scholar | 19442312PubMed |
[9] Aminisani N, Armstrong BK, Canfell K (2012) Cervical cancer screening in Middle Eastern and Asian migrants to Australia: a record linkage study. Cancer Epidemiol 36, e394–e400.
| Cervical cancer screening in Middle Eastern and Asian migrants to Australia: a record linkage study.Crossref | GoogleScholarGoogle Scholar | 23017217PubMed |
[10] McCredie M, Williams S, Coates M (1999) Cancer mortality in East and Southeast Asian migrants to New South Wales, Australia, 1975–1995. Br J Cancer 79, 1277–82.
| Cancer mortality in East and Southeast Asian migrants to New South Wales, Australia, 1975–1995.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M7ps1Cjug%3D%3D&md5=8183ebd615b05835bea7b57d9321ae9fCAS | 10098772PubMed | [eng.]
[11] Anikeeva O, Bi P, Hiller JE, Ryan P, Roder D, Han GS (2012) Trends in cancer mortality rates among migrants in Australia: 1981–2007. [eng.] Cancer Epidemiol 36, e74–82.
| Trends in cancer mortality rates among migrants in Australia: 1981–2007. [eng.]Crossref | GoogleScholarGoogle Scholar | 22104630PubMed | Epub 2011/11/23.
[12] Aminisani N, Armstrong BK, Egger S, Canfell K (2012) Impact of organised cervical screening on cervical cancer incidence and mortality in migrant women in Australia. BMC Cancer 12, 491
| Impact of organised cervical screening on cervical cancer incidence and mortality in migrant women in Australia.Crossref | GoogleScholarGoogle Scholar | 23092207PubMed |
[13] Federation of Ethnic Communities’ Councils of Australia. Cancer and culturally and linguistically diverse communities. ACT 2010.
[14] Coughlin SS, Wilson KM (2002) Breast and cervical cancer screening among migrant and seasonal farmworkers: a review. Cancer Detect Prev 26, 203–9.
| Breast and cervical cancer screening among migrant and seasonal farmworkers: a review.Crossref | GoogleScholarGoogle Scholar | 12269767PubMed |
[15] Koo JH, Arasaratnam MM, Liu K, Redmond DM, Connor SJ, Sung JJY, et al (2010) Knowledge, perception and practices of colorectal cancer screening in an ethnically diverse population. Cancer Epidemiol 34, 604–10.
| Knowledge, perception and practices of colorectal cancer screening in an ethnically diverse population.Crossref | GoogleScholarGoogle Scholar | 20580631PubMed |
[16] Goris J, Komaric N, Guandalini A, Francis D, Hawes E (2013) Effectiveness of multicultural health workers in chronic disease prevention and self-management in culturally and linguistically diverse populations: a systematic literature review. Aust J Prim Health 19, 14–37.
| Effectiveness of multicultural health workers in chronic disease prevention and self-management in culturally and linguistically diverse populations: a systematic literature review.Crossref | GoogleScholarGoogle Scholar | 22951183PubMed |
[17] National Cancer Institute. Theory at a glance: a guide for health promotion practice. Washington DC: National Institutes of Health 2005.
[18] Department of Health and Ageing. Bowel cancer knowledge, perceptions and screening behaviours: knowledge, attitudes, and practices pre and post intervention surveys (2002 & 2004). In Ageing DoHa, editor. Canberra: Commonwealth of Australia; 2004.
[19] Steven D, Fitch M, Dhaliwal H, Kirk-Gardner R, Sevean P, Jamieson J, et al (2004) Knowledge, attitudes, beliefs, and practices regarding breast and cervical cancer screening in selected ethnocultural groups in Northwestern Ontario. Oncol Nurs Forum 31, 305–11.
| Knowledge, attitudes, beliefs, and practices regarding breast and cervical cancer screening in selected ethnocultural groups in Northwestern Ontario.Crossref | GoogleScholarGoogle Scholar | 15017446PubMed |
[20] Wolf MS, Fitzgibbon M, Rademaker A, Bennett CL, Ferreira MR, Dolan NC, et al (2005) Development of a brief survey on colon cancer screening knowledge and attitudes among veterans. Prev Chronic Dis 2, 1–10. http://www.cdc.gov/pcd/issues/2005/apr/pdf/04_0104.pdf
[21] Mutyaba T, Mmiro FA, Weiderpass E (2006) Knowledge, attitudes and practices on cervical cancer screening among the medical workers of Mulago Hospital, Uganda. BMC Med Educ 6, 13
| Knowledge, attitudes and practices on cervical cancer screening among the medical workers of Mulago Hospital, Uganda.Crossref | GoogleScholarGoogle Scholar | 16509979PubMed |
[22] Okobia MN, Bunker CH, Okonofua FE, Osime U (2006) Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study. World J Surg Oncol 4, 11
| Knowledge, attitude and practice of Nigerian women towards breast cancer: a cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 16504034PubMed |
[23] Pons-Vigués M, Puigpinos-Riera R, Serral G, Pasarin MI, Rodriguez D, Perez G, et al (2012) Knowledge, attitude and perceptions of breast cancer screening among native and immigrant women in Barcelona, Spain. Psychooncology 21, 618–29.
| Knowledge, attitude and perceptions of breast cancer screening among native and immigrant women in Barcelona, Spain.Crossref | GoogleScholarGoogle Scholar | 21384466PubMed |
[24] Cullerton K, Gallegos D, Fleming M. Ethnic Communities Council of Queensland: Evaluation of the Living Well Multicultural-Lifestyle Modification Program for Culturally and Linguistically Diverse Communities in Queensland (unpublished). 2013.
[25] Lofters A, Glazier RH, Agha MM, Creatore MI, Moineddin R (2007) Inadequacy of cervical cancer screening among urban recent immigrants: a population-based study of physician and laboratory claims in Toronto, Canada. Prev Med 44, 536–42.
| Inadequacy of cervical cancer screening among urban recent immigrants: a population-based study of physician and laboratory claims in Toronto, Canada.Crossref | GoogleScholarGoogle Scholar | 17467782PubMed |
[26] Witte K, Allen M (2000) A meta-analysis of fear appeals: implications for effective public health campaigns. Health Educ Behav 27, 591–615.
| A meta-analysis of fear appeals: implications for effective public health campaigns.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvlt1Onug%3D%3D&md5=3dde4de428f60e56ca59fd8b8155799dCAS | 11009129PubMed |