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Colorectal cancer screening behaviors among South Asian immigrants in Canada: a qualitative study

Joanne Crawford (Department of Nursing, Brock University, St. Catharines, Canada and Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada)
Farah Ahmad (School of Health Policy and Management, Faculty of Health, York University, Toronto, Canada)
Dorcas E. Beaton (Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada and Measurement Stream, Institute for Work & Health, Toronto, Canada and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada)
Arlene S. Bierman (Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada and Lawrence S. Bloomberg Faculty of Nursing, Institute of Health Policy, Management and Evaluation, Medicine, and Public Health, University of Toronto, Toronto, Canada)

International Journal of Migration, Health and Social Care

ISSN: 1747-9894

Article publication date: 15 June 2015

172

Abstract

Purpose

The purpose of this paper is to gain an in-depth understanding of beliefs, attitudes, and reasons for decision making about colorectal cancer (CRC) screening among South Asian (SA) immigrants.

Design/methodology/approach

Six focus groups conducted in English, Punjabi, and Urdu were held with 42 SA immigrants, 50-74 years old and at average risk for CRC, from November 2012 to May 2013. All focus group discussions were audio-taped and transcribed verbatim. Data analysis used an inductive and systematic approach employing constant comparison techniques.

Findings

Three dominant themes emerged. Beliefs and attitudes towards cancer and screening represented SA immigrant’s perceptions that early detection was beneficial; screening was not necessary in the absence of symptoms; cancer was scary; and the loss of previously established bowel practices upon immigration as potential risks for CRC. Knowledge and awareness focused on unscreened participants’ cancer stories; screened participants’ knowledge of CRC, risk factors, and screening; experiential learning from focus groups; and screened participants’ strategies to promote screening. Support and accessibility concentrated on physician support and responsibility to provide information, explanation, and recommend screening to facilitate access.

Originality/value

Findings provide novel insights on socio-cultural context, beliefs, and barriers to CRC screening among SA immigrants. Culturally appropriate community-based strategies included story-telling, the use of social networks, and greater physician engagement. Enhancing collaborative partnerships with physicians and public health may minimize structural barriers and reduce health disparities. Future research could explore effectiveness of outreach strategies including these collaborations.

Keywords

Acknowledgements

Joanne Crawford would like to acknowledge the Population Health Improvement Research Network for the Ontario Doctoral Student in Population Health Award and the Canadian Association of Nurses in Oncology for the Novice Researcher Grant as they provided partial support of the doctoral research.

Citation

Crawford, J., Ahmad, F., Beaton, D.E. and Bierman, A.S. (2015), "Colorectal cancer screening behaviors among South Asian immigrants in Canada: a qualitative study", International Journal of Migration, Health and Social Care, Vol. 11 No. 2, pp. 130-146. https://doi.org/10.1108/IJMHSC-09-2014-0037

Publisher

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Emerald Group Publishing Limited

Copyright © 2015, Emerald Group Publishing Limited

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