Devotta Kimberly, Lofters Aisha, Bender Jacqueline, O'Campo Patricia
University of Toronto, 155 College St Room 500, Toronto, ON, M5T 3M7, Canada.
Women's College Hospital, 76 Grenville St, Toronto, ON, M5S 1B2, Canada.
BMC Public Health. 2025 Jan 22;25(1):265. doi: 10.1186/s12889-025-21448-6.
Regular cervical screening can significantly reduce the onset and prevalence of cervical cancer. In Ontario, Canada, South Asian women have the lowest rates of cervical cancer screening among major ethnic groups in the province.
Using an innovative and participant-driven method called Concept Mapping (CM), we set out to understand how the lives and experiences of South Asian women living in Ontario shape their decisions around getting screened for cervical cancer. We engaged over 70 South Asian women and people who serve them in healthcare and community, to drive the CM process.
Participants brainstormed 45 unique and distinct statements. Through sorting and map interpretation, participants identified and interpreted 6 clusters amongst the statements: (1) Personal beliefs and misconceptions around cervical cancer; (2) Education and knowledge issues around cervical cancer; (3) Cultural beliefs and influences specific to sexual health; (4) Barriers to prioritizing uptake of cervical screening; (5) System/ infrastructure gaps or inadequacies; and (6) Lack of comfort and supportive relationships in healthcare. Additional analysis shows us the interrelationships between the ideas. Statements within the clusters about education and knowledge issues around cervical cancer, personal beliefs and misconceptions, as well as cultural beliefs and influences specific to sexual health are viewed as distinct beliefs with clear effects on the uptake of cervical screening. More complex interrelationships are seen with the cluster of statements about barriers to prioritizing uptake of cervical screening.
As Ontario and many other jurisdictions around the world seek to strengthen cervical screening efforts in line with national and international goals to eliminate cervical cancer by 2040, it is critical to address underscreening. This CM study recognizes the value of engaging those most impacted by an issue, to identify and prioritize how and where to intervene to address low rates of cervical screening. To address underscreening we need to design multi-level interventions that address the identified ideas and the interrelationships among them.
定期进行宫颈癌筛查可显著降低宫颈癌的发病率和患病率。在加拿大安大略省，南亚女性在该省主要种族群体中宫颈癌筛查率最低。
我们采用一种名为概念映射（CM）的创新且由参与者驱动的方法，旨在了解居住在安大略省的南亚女性的生活和经历如何影响她们进行宫颈癌筛查的决策。我们邀请了70多名南亚女性以及在医疗保健和社区中为她们服务的人员来推动CM过程。
参与者集思广益提出了45条独特且不同的陈述。通过分类和地图解读，参与者在这些陈述中识别并解读出6个类别：（1）关于宫颈癌的个人信念和误解；（2）关于宫颈癌的教育和知识问题；（3）针对性健康的文化信念和影响；（4）优先进行宫颈癌筛查的障碍；（5）系统/基础设施差距或不足；（6）在医疗保健中缺乏舒适感和支持性的关系。进一步分析向我们展示了这些想法之间的相互关系。关于宫颈癌教育和知识问题、个人信念和误解以及针对性健康的文化信念和影响的类别中的陈述被视为具有明确影响宫颈癌筛查接受度的不同信念。关于优先进行宫颈癌筛查的障碍这一类别中的陈述则呈现出更复杂的相互关系。
随着安大略省和世界上许多其他司法管辖区寻求根据到2040年消除宫颈癌的国家和国际目标加强宫颈癌筛查工作，解决筛查不足问题至关重要。这项CM研究认识到让受问题影响最大的人群参与进来的价值，以确定并优先考虑如何以及在何处进行干预以解决宫颈癌筛查率低的问题。为了解决筛查不足问题，我们需要设计多层次干预措施，以解决已确定的想法及其之间的相互关系。
