Abstract
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
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