Religiously Tailored Educational Intervention to Encourage Mammography in American Muslim Women

Key Points

  • A mosque-based intervention involving peer-led, group education classes was designed to address barriers to mammography for American Muslim women.
  • The intervention increased the women’s perceived likelihood of undergoing breast screening.
  • Within 6 months of taking the classes, 42% of women who participated obtained a mammogram.

Despite the U.S. Preventive Services Task Force recommendation that women between the ages of 50 and 74 undergo mammography every 2 years, only about 50% of American Muslim women do so, compared with 67% of all American women. A study by Padela et al investigating the mammography-related barrier beliefs of American Muslim women that are impeding their use of breast screening, and designing a mosque-based intervention involving religiously tailored messages that addressed these issues, has found the program increased the likelihood the women would undergo mammography. Within 6 months of receiving classes, 42% of the women had obtained a mammogram.

The study results (Abstract C03) were presented at the 10th American Association for Cancer Research Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, on September 25–28 in Atlanta.

Study Details

The researchers first conducted focus groups and interviews with an ethnically diverse group of women aged 40 and older from Muslim organizations to identify salient behavioral, normative, and control beliefs regarding mammography screening. They then conducted interviews with the women to elicit ideas about intervention design and developed a curriculum and messaging for a religiously tailored mosque-based intervention involving peer-led group health education classes. The classes involved facilitated discussions and guest-led didactics covering religion, health, and mammography. Survey data from group education participants were collected preintervention, postintervention, 6 months postintervention, and 1 year postintervention.

Using community-engaged research methods, including a multidisciplinary community advisory board, the researchers identified the barrier beliefs hindering mammography screening among American Muslim women. For example, according to the investigators many believed that God controls diseases and cures, so screening would not be beneficial.

The research team designed interventions to overcome those barriers that considered these religious ideas while still communicating the importance of mammography screening. For example, the peer educators told the women that while God may control disease, religious teachings also stress that women must be good “stewards” of their bodies, so it is important to obtain information about one’s health.

A total of 52 Muslim women, mean age 50 years, who had not had a mammogram in the past 2 years participated in the 2-session course.

Results

The pre– and post–self-reported likelihood of obtaining a mammogram increased significantly following the intervention (= .03), as did breast cancer–screening knowledge (= .0002). Greater resonance with facilitator beliefs significantly predicted positive likelihood changes (odds ratio [OR] = 1.31, = .003). Participants with higher negative religious coping (OR = 1.33, = .04) and greater resonance with facilitator beliefs (OR = 1.44, P = .00) had higher odds for having an intention to get a mammogram after the classes, whereas those with higher religiosity (DUREL [Duke University Religion Index], OR = 0.72, = .01) and more resonance with barrier beliefs (OR = 0.72, = .01) had significantly lower intentions. At 6-month follow-up, 42% (n = 20/47) of participants had obtained a mammogram, and 7.7 % (n = 4) were lost to follow-up.

“It’s a challenge to frame healthy behaviors within the context of religious beliefs and cultural values,” said Aasim I. Padela, MD, MSc, Director of the Initiative on Islam and Medicine, Associate Professor of Medicine in the Section of Emergency Medicine at The University of Chicago, and lead author of this study, in a statement. “But we believe that by engaging with such deeply held aspects of identity, we can meet people where they are and encourage them to uphold their beliefs in a way that also benefits their health.” 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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