Examining the Role of Knowledge and Cultural Values on Utilization of Mammograms among a Sample of Arab Women

Breast cancer is one of the commonest cancer types affecting women and causing mortality. Its treatment is more successful when it is diagnosed early enough. For early diagnosis, it is recommended that women undergo breast cancer screening annually or at least once every two years. From the literature available, many women in the US attend breast screen services. The numbers vary depending with ethnicities. The Arabic American women are the ones who attend to these services least frequently. It is also noted in the literature that the cultural and knowledge values influence how women respond to breast cancer screening tests. This study is therefore aimed at finding out the cultural and knowledge values that act as barriers to the Arabic American women to make them the women who participate in the least numbers in breast cancer screening when compared to the women from other ethnicities. This study will be conducted on Arabic American women from Miami through a mixed method approach that includes interviews, questionnaires, and focus groups. The women participating must be between the age of 40 and 60 years and in good health. From this study, it is expected that the knowledge obtained will be used to break these barriers and make the women participate more readily in the breast cancer screening services to possibly capture the signs early enough and potentially reduce the mortality from breast cancer among the Arabic American women.

Cancer incidences have been rising over time with different types of cancer being reported more frequently12. Some types of cancer affect both sexes while others are specific to one sex. For instance, Breast cancer occurs mostly in female patients with very few isolated cases affecting male patients5. The causes of cancer vary greatly among individuals, different groups of people and different cultures.The purpose of this proposal is to assess and evaluate how cultural values and knowledge factors impact utilization of preventive mammograms among Arab women living in Miami, FL.
To achieve this, the study proposes using a mixed methods approach. In doing so, this study aims at filling in the gaps in the literature regarding the relationship between cultural values, knowledge about mammography, and utilization patterns of preventive mammography for the prevention and early detection of breast cancer among Arab-American women living in Miami, Florida, USA. The results of the study will improve scientific understanding of the role of knowledge and cultural values in mammography screening among Arab women living in Miami, FL.
Breast cancer continues to be the main determinant of mortality and a cancer disparity amongst minority populations in the United States1. The number of affected Arab women for the three cases noted by Bergmans was still significantly higher with 159.5 per 100,000 in Detroit, 194.9 per 100,000 in California and 194.3 per 100,000 in New Jersey. Bergmans et al. also noted that Arab women often succumb to breast cancer as a result of lower socioeconomic status, knowledge, and cultural barriers.
Several studies regarding breast cancer in minority populations in the US have been carried out previously. These studies revealed certain aspects of breast cancer in Hispanics and African American women with limited literature on Arab women.One of the studies done on breast cancer in Arab women was done by Cohan and Azaiza3.This study identified various challenges that Arab women face when they get breast cancer. Cohan & Azaiza3 explained that cultural values play significant roles when women are making decisions n whether to utilize the mammography services or not. Moreover, Cohan and Azaiza3 noted that about white women, Arab American women seem to have a unique risk profile that may put them at higher risk for aggressive breast cancer at the time of diagnosis. These include distinctive hormonal receptors and age at the time of diagnosis both factors that are associated with stage of diagnosis of breast cancers as noted by Hasnain et al7. According to Cohan & Azaiza3 there is a dearth of knowledge regarding the utilization patterns of mammography amongst the population of Arab women living in the United States.The observations above as derived from the literature will govern this study so that the study evaluates how the cultural values and beliefs among the Arab women influence their decisions on using preventive mammograms.
The Specific aims are:
AIM1: Recruit a convenience sample of 300 Arab women 40-60, living in Miami, FL to participate in a mixed-methods study about mammography screening.
AIM 2: Assess knowledge and cultural values related to mammography screening among Arab women in Miami, FL. BRFSS survey will be administered to participants.
AIM 3: Conduct 4 focus groups including 8-10 Arab women each to, further explore barriers related to knowledge and cultural values of Arab women toward mammogram screening.



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