theses

Rationale for the study
Cancer screening disparities exist among immigrant groups in the United States, yet the cancer screening behaviors of ethnic Black immigrants remains relatively unknown. Low cancer screening rates among ethnic Black immigrant groups are associated with various structural, and sociocultural barriers. These barriers may be the same for all ethnic Black immigrants but evidence is lacking. The Garifuna, an Afro-Amerindian Central American group experience structural forces in their homelands and settling communities in urbanized spaces in the US with little known of their cancer screening practices. The purpose of this study was to examine breast, cervical, and colorectal cancer screening practices among Garifuna women residing in the boroughs of New York City, and to identify any disparities in their cancer screening practices. The study examined levels of adherence to the recommended breast, cervical, and colorectal cancer screening guidelines and their association with demographic factors, access to healthcare services, perceptions/barriers, acculturation, identity and level of guideline knowledge.
Method
This study used a mixed method approach of interviews with eight key informants knowledgeable on the health behaviors of Garifuna women and surveying of four hundred Garifuna women, age 50 years and older residing in the New York City area. Content analysis was performed on key informant interview transcripts which confirmed survey sociocultural variable choices. Univariate analysis was used to describe the survey study sample and bivariate analysis to measure level of association between variables. Logistic regression examined the predictive nature of variables in explaining cancer screening adherence.
Results
Four hundred two Garifuna women completed surveys over a twenty-two month period. The results show that disparities exist in cervical cancer screening and are suggested in colorectal cancer screening. Models for colorectal cancer screening by colonoscopy and fecal occult blood testing were the most predictive of the cancer screening types with knowledge and health belief models having the highest predictive variability.
Conclusion
Further studies on cervical and colorectal cancer screening among Garifuna women are recommended to identify additional barriers contributing to these cancer screening disparities, and to develop culturally appropriate interventions aimed to end disparities in this unique immigrant group.

Ph.D

Includes bibliographical references.

Text

doi:10.7282/t3-6gxh-ft50

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