Original articleBosnian, Iraqi, and Somali Refugee Women Speak: A Comparative Qualitative Study of Refugee Health Beliefs on Preventive Health and Breast Cancer Screening
Section snippets
Methods
This qualitative, descriptive study used a semistructured interview guide (Figure 1) developed previously for in-depth, one-to-one patient interviews (Saadi et al., 2012). Participants represented a convenience sample from the MGH Chelsea refugee database, supplemented by snowball sampling. Inclusion criteria included women refugees, 18 to 75 years old, self-identifying as Bosnian, Somali, or Iraqi, and receiving care at MGH Chelsea. The interviewers invited these women to participate either in
Study Participants
Table 1 shows sociodemographic characteristics of the 57 interviewed women. The Bosnian women were older than the Somali and Iraqi women (Table 1). Iraqis had been in the United States for the shortest period of time (<1 year, compared with Bosnian and Somali women who had been in the United States for a mean of 10.1 and 6.8 years, respectively). Most Somali and Iraqi women did not speak English. We present the result of our thematic and content analyses separately.
Thematic Analysis
The key thematic categories
Discussion
This study revealed key differences and similarities in Bosnian, Somali, and Iraqi refugee women's knowledge and beliefs about preventive health, with consequent implications for public health-oriented programming. Despite identifying barriers to care and screening, women across groups indicated willingness to overcome systemic barriers and personal fears of pain or bad news. Women noted facilitators to obtaining care, including someone who spoke their language and could explain what was
Conclusion
The refugee women's perspectives on preventive health and perceived barriers to breast cancer screening reported in this qualitative study provide insights on intergroup differences in these three populations. If public health initiatives are to succeed in providing support to refugee women, with the ultimate goal of increasing equity in health care, a deep understanding of these intergroup differences needs to be incorporated in development of population-specific, cost-effective prevention
Acknowledgments
The authors acknowledge the significant contribution to this project of the MGH Chelsea Healthcare Center Community Health Team, especially Kaftun Ahmed and Jelena Katadzic, as well as their director Sarah Oo.
Funding: This work was funded by Susan G. Komen MA Affiliate foundation and MGH Center for Community Health Improvement. Dr. Percac-Lima is supported in part by Cancer Control Career Development Award for Primary Care Physicians, CCCDAA-14-012-01-CCCDA from the American Cancer Society and
Altaf Saadi, MD, is a resident physician in the Partners Neurology program at Massachusetts General Hospital and Brigham and Women's Hospital. Her area of research and clinical interest is health care needs of immigrant and refugee populations.
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Altaf Saadi, MD, is a resident physician in the Partners Neurology program at Massachusetts General Hospital and Brigham and Women's Hospital. Her area of research and clinical interest is health care needs of immigrant and refugee populations.
Barbara E. Bond, MSW, EdD, is Associate Professor of Social Work at Bridgewater State University. Her research interests include health disparities with a focus on cancer prevention and psychosocial oncology.
Sanja Percac-Lima, MD, PhD, is Assistant Professor of Medicine at Harvard Medical School. Her clinical and research activities focus on eliminating disparities in cancer care among vulnerable populations.