College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, 43210, USA.
Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, 460 W. 10th Avenue, Columbus, OH, 43210, USA.
J Community Health. 2017 Dec;42(6):1079-1089. doi: 10.1007/s10900-017-0355-2.
Bhutanese-Nepali refugees are one of the largest refugee groups to be resettled in the U.S. in the past decade. Cervical cancer is a leading cause of cancer disparity in this population, yet screening rates are suboptimal. Nepali-speaking interviewers administered a community health needs questionnaire to a convenience sample of Bhutanese-Nepali refugees in a Midwestern city between July to October of 2015. Descriptive statistics were used to describe socio-demographic characteristics, Pap smear beliefs, post-migration living difficulties, and screening status. Differences in Pap test uptake between groups were tested using t test and Chi square statistics. Of the 97 female participants, 44.3% reported ever having had a Pap smear. Screening rates were lowest among women who did not know English at all. Most women had positive perceptions of Pap smears (80%) and 44.4% had received a Pap test recommendation from their healthcare provider, family, or friends. Pap testing was significantly higher among those who had positive perceptions (58.3 vs. 11.1% for women of negative perception, p = 0.01) and those who had received a recommendation (87.5 vs. 18.6% for women who had no recommendations, p < 0.001). Significant predictors of having a Pap smear were having a healthcare provider/family/friends recommendation (OR 65.3, 95% CI 11.4-373.3) and greater number of post-migration living difficulties (OR 1.18, 95% CI 1.02-1.37). The results of this study have important implications for the development of cervical cancer prevention programs targeting Bhutanese-Nepali refugees. Providing cancer prevention interventions early in the resettlement process could impact Pap test uptake in this population.
不丹-尼泊尔难民是过去十年中在美国重新安置的最大难民群体之一。在该人群中，宫颈癌是导致癌症差异的主要原因，但筛查率不理想。2015 年 7 月至 10 月，在中西部城市，尼泊尔语采访者对不丹-尼泊尔难民的便利样本进行了社区健康需求问卷调查。使用描述性统计来描述社会人口统计学特征、巴氏涂片信仰、移民后生活困难和筛查状况。使用 t 检验和卡方检验比较组间巴氏试验接受率的差异。在 97 名女性参与者中，44.3%报告曾进行过巴氏涂片检查。完全不会英语的女性的筛查率最低。大多数女性对巴氏涂片检查有积极的看法（80%），44.4%的人从医疗保健提供者、家人或朋友那里得到了巴氏涂片检查的建议。巴氏涂片检查在有积极看法的女性中明显更高（58.3%比消极看法的女性的 11.1%，p=0.01），在接受过建议的女性中也明显更高（87.5%比没有建议的女性的 18.6%，p<0.001）。有巴氏涂片检查的重要预测因素是有医疗保健提供者/家人/朋友的建议（OR 65.3，95%CI 11.4-373.3）和更多的移民后生活困难（OR 1.18，95%CI 1.02-1.37）。本研究的结果对制定针对不丹-尼泊尔难民的宫颈癌预防计划具有重要意义。在重新安置过程的早期提供癌症预防干预措施可能会影响该人群的巴氏试验接受率。
