Racine Louise, D'Souza Melba Sheila, Tinampay Cindy
College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada.
J Nurs Scholarsh. 2023 Jan;55(1):329-344. doi: 10.1111/jnu.12818. Epub 2022 Oct 5.
To systematically assess the effectiveness of breast cancer (BC) interventions in improving breast self-examination (BSE), clinical breast examination (CBE), mammogram screening rates, and preventive activities in Muslim refugee and immigrant women.
Guided by the Health Belief Model, a mixed method systematic review and meta-analysis was performed using a sequential design.
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA), the Critical Appraisal Skill Program Checklists, and the Joanna Briggs Institute (JBI) methodology for systematic review and meta-analysis. A systematic search of English-language peer-reviewed articles was undertaken in multiple health and social sciences databases from January 1, 2015, to March 31, 2022. Randomized clinical trials and quasi-experimental studies focused on the uptake of BSE, CBE, and mammograms were selected.
Fourteen articles were included in the review. Most of the studies relied on quasi-experimental designs and were carried out in the United States of America. The qualitative analysis of BC screening interventions generated three themes: (1) education, (2) access-focused, and (3) cultural and faith-based. The meta-analysis included three randomized control trials and two quasi-experimental studies. The meta-analysis demonstrates the effectiveness of community-led cultural and faith-based interventions in facilitating the completion of CBE and mammography screening. Education on BC and patient navigator interventions are more effectively used in conjunction than standalone interventions, yet community-based cultural and faith-based interventions are the most effective.
This systematic and meta-analysis review provides evidence on the effectiveness of access-focused and cultural and faith-based interventions in improving BC screening in Muslim refugee and immigrant women. Future research should focus on designing and measuring the effectiveness of cultural and faith-based interventions to increase Muslim refugee and immigrant women's BC screening knowledge and practices.
This systematic and meta-analysis review demonstrates the need to explore Muslim refugee and immigrant women's cultural contexts for developing culturally sensitive BC screening interventions. Knowledge and practice of BC and religiosity intersect with financial, geographic, and linguistic barriers to decrease participation in screening and preventive activities in Muslim refugee and immigrant women.
系统评估乳腺癌（BC）干预措施在提高穆斯林难民和移民妇女的乳房自我检查（BSE）、临床乳房检查（CBE）、乳房X光筛查率及预防活动方面的有效性。
以健康信念模型为指导，采用序贯设计进行了混合方法的系统评价和荟萃分析。
本研究遵循系统评价和荟萃分析的首选报告项目声明（PRISMA）、批判性评价技能计划清单以及乔安娜·布里格斯研究所（JBI）的系统评价和荟萃分析方法。于2015年1月1日至2022年3月31日在多个健康和社会科学数据库中对英语同行评审文章进行了系统检索。选取了聚焦于BSE、CBE和乳房X光检查接受情况的随机临床试验和准实验研究。
该评价纳入了14篇文章。大多数研究采用准实验设计，且在美国开展。对BC筛查干预措施的定性分析产生了三个主题：（1）教育，（2）以获取为重点，（3）基于文化和信仰。荟萃分析纳入了三项随机对照试验和两项准实验研究。荟萃分析表明，社区主导的基于文化和信仰的干预措施在促进CBE和乳房X光检查筛查的完成方面具有有效性。关于BC的教育和患者导航干预措施联合使用比单独使用更有效，但基于社区的文化和信仰干预措施最为有效。
该系统评价和荟萃分析为以获取为重点以及基于文化和信仰的干预措施在改善穆斯林难民和移民妇女的BC筛查方面的有效性提供了证据。未来的研究应侧重于设计和衡量基于文化和信仰的干预措施的有效性，以增加穆斯林难民和移民妇女的BC筛查知识和实践。
该系统评价和荟萃分析表明，有必要探索穆斯林难民和移民妇女的文化背景，以制定具有文化敏感性的BC筛查干预措施。BC的知识和实践以及宗教信仰与经济、地理和语言障碍相互交织，降低了穆斯林难民和移民妇女参与筛查和预防活动的程度。
