3. Cancer Screening:
What Are Screening Behaviours Of Minority Immigrant (Hispanic) Women? Can a LHP Intervention Result In Changed Health Behaviours?
A main focus of this study was to document the actual self-reported cancer screening behaviours of Spanish speaking women in Ottawa-Carleton, and to assess whether, and how much, the lay health promotion intervention could lead to individual behavioural change, increasing the number of women who complied with current cancer screening guidelines.
Application of the Transtheoretical Model (TTM)
Qualitative in-depth interviews conducted with 32 Hispanic women prior to the health promotion intervention, were analysed to determine what stage women had reached in terms of their cancer screening behaviour, specifically mammography, BSE, and Pap tests. (Please note: At the time the interviews took place, the Canadian Medical Association had not yet issued the new guidelines for Breast Self-examination - BSE). Results from in-depth interviews indicated that with a few exceptions, respondents complied with recommended cancer screening guidelines.
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Findings from the Pre-intervention health survey with Hispanic women (HS I)
In total, 212 women were surveyed. The ‘average’ woman who participated in the survey, was born in Central or South America, had lived in Canada for about 12 years, was married with two children, worked outside the home, livied on a family income close to poverty levels, identified herself as being Catholic and attending church about once a month. She spoke some English, especially at work, but overall used more often Spanish at home and with friends.
Access to medical services
- The majority of the respondents (91%) indicated that they had a family doctor, only 8% (16 women) did not.
- The majority had an OHIP card (89%), while 9% (19 women) indicated that they did not have such a card.
- 58% went for check ups regularly whereas 41% said they did not.
- Only 12 women (6%) had not gone to a doctor in the past year. The other 94% women had gone between once and 92 times.
- Most had little difficulty actually getting to a doctor (84%), while 16% found it hard.
- More than half (53%) felt that they had to wait too long in the waiting room, whereas 44% did not have this experience.
- 22% found it hard to find childcare while going to the doctor, while 64% did not find it hard.
- 15% were using a CHC for their medical care.
- 47% were using routinely a walk in clinic.
- More than a third (38%) felt that there was too much paper work involved, while 60% did not think so.
Trust in doctors
- Three quarters (72%) indicated that they trusted doctors, whereas one quarter did not (24%).
- 20% avoided seeing a doctor even when they were sick, while 80% did not. Two thirds (65%) also believed that doctors made too many mistakes, while one third did not think so (32%).
- One quarter (24%) of the women thought that doctors ordered too many tests, whereas three quarters (74%) did not think so. More than half of the women (57%) felt that their doctors did not spend enough time with them during an appointment, whereas 42% felt satisfied with the amount of time spent.
- A quarter (27%) felt that doctors or nurses were treating them differently because of being a Latin American woman; whereas 3/4 did not (72%).
- One third (33%) found it hard to communicate with doctors and nurses, while the other two thirds (65%) did not.
Own health
- Two thirds of the women rated their own health as being excellent (14%) or good (52%); 29% as all right and 7 women (3%) as bad.
- 91% had not been diagnosed with cancer, while 8% (16 women) had been diagnosed with a form of cancer. Of those diagnosed with cancer, 3 had been diagnosed with breast cancer, 3 with cervical cancer and 1 with cancer of the uterus.
- Twenty-five (12%) of the respondents had had a hysterectomy
- A third (32%) of the women were menopausal, or in menopause.
- 106 women answered the question if they had ever taken hormonal supplements for menopausal symptoms. 14 women had taken HRT less than a year (7%); 10 (5%) between 1-5 years, and 8 (4%) more than five years.
- More than a third (38%) of the women had additional health insurance, mostly through their work, or the work coverage of their husbands.
Cancer beliefs
- Respondents were asked whether they believed that certain factors can cause cancer. More than half correctly identified that HRT (56%), birth control pills (55%), or heavy drinking (51%) might contribute to the development of cancer. More than half (51%) also mistakenly believed that bruising or hitting might cause cancer.
- More than one third (38%) believed that one could have cancer without knowing it, whereas 59% did not believe so. 85% of all respondents believed that cancer can be cured, while 14% (29 women) did not.
- 14% of the women were worried about cancer, 23% were not worried; and one third (33%) were unsure about this. More than half (54%) also indicated that the word “cancer” scared them. 19% of the respondents indicated that they had too many other problems to be worrying about cancer, whereas 80% did not feel that way. The majority of women would like to know if they had terminal cancer (88%), however twenty-one women (10%) would not like to know.
- Three quarters of the women (76%) would talk with their friends if they had cancer, whereas 22% would not. Almost all women (94%) said that they would feel comfortable being around someone with cancer, whereas eleven women (5%) thought that they would not. Two thirds (65%) of the women knew a person with breast or cervical cancer, one third did not (34%).
- About half of the women (45%) believed that life and death was out of their control, whereas 46% believed it was not. 8% held neither belief strongly. Almost one third of the women (28%) also believed that illness was due to luck and destiny, whereas two thirds (67%) did not. Eleven women (5%) felt that cancer was a punishment from God, whereas 94% did not think so.
