Rationale and Importance of the Study
The study is based on the rationale that the migrant Chinese women, share common health patterns with their counterparts from Mainland China. Given that cervical cancer is significant health challenge in Mainland China and is further compounded by lower testing rates, Chinese women born in China are likely to have higher rates of cervical cancer compared to those born in North America. Thus, to this population can be used to evaluate predisposing, enabling and reinforcing factors that are associated with taking a Pap tests. The study aimed to determine the factors that contribute towards lower testing among these populations and help to develop the appropriate strategies to promote the Pap testing (Hislop, Deschamps, Teh, & Jackson, 2003).
Steps that Precede-Proceed Model Applied as Theoretical Background
The Precede-Proceed model that was adopted as the theoretical background for the study includes ten steps that can be grouped into two categories. The first category focuses on conducting an analysis of the phenomena under study, establish the areas that should be prioritized in the study and setting the objectives of the study. The second category of steps focuses on the implementation of the intervention program, follow-up of the participants and the evaluation of the effectiveness of the program.
The study carried out a social diagnosis where the major problems and needs were identified in relation to the target population. The study then carried out an epidemiological diagnosis where the researchers documented the results of the problems identified in the first step using epidemiological data. The study also identified the behavioral and lifestyle factors that have an impact on the health of the population, using the behavioral and environmental assessment procedures. The researchers also carried out educational and organizational diagnosis during which they investigated factors that need to be addressed to facilitate the process of behavior modification among the members of the target population. Finally, the study focuses on administrative and policy diagnosis where the researchers analyze the resources that can be used to influence the implementation of the interventional program. The researchers focused on the educational and organizational diagnosis with the aim of providing the changes that the Chinese women should make to improve their uptake of Pat tests (Hislop et al., 2003).
The study collected data among 512 Chinese women living in Greater Vancouver. The participants in the study were aged between 20 and 79 years (Hislop et al., 2003). The study employed the random selection method to recruit the participants. The researchers then visited the households where the participants lived and conducted interviews using the language of choice for each participant. The interviews were also conducted at the time preferred by the participants.
Before starting the process of collecting data, the researchers engaged a Community Advisory Committee whose role was to introduce the research objectives through various media such as radio announcements, newsletters to community organizations, and newspaper advertainments (Hislop et al., 2003). The data was collected using a survey method which employed a questionnaire that had been previously used among Asian-American populations. The researchers also included focus group discussions and open-ended interviews as part of their data collection approaches. The questionnaire used in the study covered areas such as Pap testing, general healthcare issues, women’s health, traditional approaches to healthcare, sociodemographic factors, and acculturation. The focus group discussions were used to evaluate culturally sensitive components in the research (Bowling, 2014). The collection of the data was carried out by female Chinese interviewers who met the research requirement of being fluent in Cantonese, Mandarin, and English.
Factors Associated with Screening
The researchers found that screening was associated with a factor such as the belief that Pap testing prevented cancer. The general knowledge about the role that Pap testing played in the prevention of cancer was also associated with the increased screening (Hislop et al., 2003). These factors can be classified under the health education level of the participants (Morema, Atieli, Onyango, Omondi, & Ouma, 2014). The factors can also be classified under the influence of healthcare providers as they pay a significant role in ensuring that patients are well informed about the importance of various tests (U.S. Department of Health and Human Services, 2005). It is also important to note that the factors associated with screening as outlined in the research also mirrored the findings from other studies.
Implications for Further Research
There is need to conduct further research to determine the difference between cervical cancer screening among Chinese women who were served by English speaking physicians or Chinese-speaking physicians. The study under review indicated that among the participants, the number of Chinese women attended by non-Chinese physicians was small and hence it was not possible to conclude the impact that such a factor had on the screening level. Other studies have indicated that Chinese women who had a female physician and were served in their own language were more influenced in their decision-making process and thus this could contribute towards the choice of healthcare services they utilized (Jin, Lipold, McKenzie, & Sikon, 2013). Therefore, the comparison of the level of screening among Chinese women served by physicians whose spoke their own language and those who spoke English would yield results that can be used to reinforce the uptake of Pap tests.
Bowling, A. (2014). Research methods in health: Investigating health and health services. London: McGraw-Hill Education.
Hislop, G., Deschamps, M., Teh, C., & Jackson, C. (2003). Facilitators and barriers to cervical cancer screening among Chinese Canadian women. Canadian Journal of Public Health, 94(1), 68-73.
Jin, X. W., Lipold, L., McKenzie, M., & Sikon, A. (2013). Cervical cancer screening: What’s new and what’s coming? Cleveland Clinic Journal of Medicine, 80(3), 153-160.
Morema, E. N., Atieli, H. E., Onyango, R. O., Omondi, J. H., & Ouma, C. (2014). Determinants of cervical screening services uptake among 18–49 year old women seeking services at the Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya. BMC Health Services Research, 14(1), 335.
U.S. Department of Health and Human Services. (2005). Theory at a glance: A guide for health promotion practice.