The "Area Down There:" An Exploration of Cervical Cancer Screening Attitudes and Behavior Among South Asian American Women Open Access

Mirza, Zunera (2011)

Permanent URL:


Abstract The "Area Down There:" An Exploration of Cervical Cancer Screening Attitudes and Behavior Among South Asian American Women By Zunera Mirza Background: Asian American women are less likely to seek a Pap test within the past three years compared to other racial and ethnic groups in the United States. Therefore, cervical cancer is a major cause of death for women among this fast growing population.The purpose of this study is to identify the perception of cervical cancer screening among young unmarried South Asian American women in the Atlanta area and to generate an understanding for approaching perceived barriers and benefits to seeking gynecological care. Methods: Qualitative data were collected through 20 in-depth interviews in Atlanta, Georgia. Interviews were coded and organized in NVIVO qualitative software. The Health Belief Model, social constructivist theory, and the decisional balance construct from the Transtheoretical Model provided a conceptual model for interpreting results. Results: The research found that the primary cue to action for cervical cancer screening was through a doctor's advice (to receive a Pap smear). Another cue to action involved participants engaging in sexual activity and/or experiencing pain, abnormal menstruation, etc. (feminine issues) that would cause the individual to seek general gynecological care and become influenced by the doctor to receive a Pap smear. Major barriers to seeking cervical cancer screening were limited understanding of what gynecological care was for, low perceived susceptibility, taboo of sexual topics, and stigmatizing cultural beliefs. Discussion: The findings from this study suggest that cervical cancer screening programs in the United States could be more effective if South Asians were targeted with dialogue and education around the preventive services provided by a gynecologist and the risk factors to cervical cancer. This study has several recommendations. One key recommendation is for healthcare providers to educate themselves and strategically address aspects of perceived susceptibility among young South Asian women (such as risk), since doctors are a trusted source of information and authority.

Table of Contents

Table of Contents Chapter I: Introduction...1 Background...2 Specific Aims...6 Research Questions...7 Chapter II: Literature Review...10 Biology of Cervical Cancer...12 Theoretical Orientation...17 Mammography and Cervical Cancer Screening Studies...22 Barriers & Facilitators to Screening...34 Public Health Implications...38 Chapter III: Methods...39 Procedures...42 Measures...45 Analytic Method...54 Chapter V: Results...59 Demographics...60 Qualitative Themes...61 Individual Perceptions...61 Modifying Factors...64 Likelihood of Action...68 Conceptual Framework...74 Chapter VI: Discussion...78 Implications...85 References...89 Appendices...96 Appendix A: Informed Consent...97 Appendix B: Interview Guide...99 Appendix C: Short Survey Instrument...104 Appendix D: Tables from Survey...108

About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
  • English
Research Field
Committee Chair / Thesis Advisor
Committee Members
Partnering Agencies
Last modified

Primary PDF

Supplemental Files