Developing a Culturally and Linguistically Targeted Breast Cancer Educational Program for a Multicultural Population.

Breast cancer is the most commonly diagnosed cancer among women in the USA. Despite the availability of screening mammograms, significant disparities still exist in breast cancer outcomes of racial/ethnic and sexual/gender minorities. To address these disparities, the Mount Sinai Mobile Breast Health Program in New York City collaborated with local organizations to develop culturally and linguistically appropriate breast cancer education programs aimed at increasing screening mammogram utilization. Literature review of the barriers to mammography screening formed the basis to allow us to draft a narrative presentation for each targeted cultural group: African American, African-born, Chinese, Latina, and Muslim women, as well as LGBTQ individuals. The presentations were then tested with focus groups comprised of gatekeepers and members from local community and faith-based organizations which served the targeted populations. Feedback from focus groups and gatekeepers was incorporated into the presentations, and if necessary, the presentations were translated. Subsequently, the presentations were re-tested for appropriateness and reviewed for consistency in message, design, educational information, and slide sequencing. Our experience demonstrated the importance of collaborating with community organizations to provide educational content that is culturally and linguistically appropriate for minority groups facing barriers to uptake of screening mammography.

Identifying Factors Associated with Cancer Screening in Immigrant Populations Living in New York City.

New York City rates for cancer screening with colonoscopy, Papanicolaou smear and mammography are higher than the rest of the nation yet immigrant populations still have barriers accessing healthcare. With 38% of the city identifying as foreign born, there is a growing need to understand immigrant health and cancer screening behaviors to better assist them in accessing care. Through the Hepatitis Outreach Network (HONE), almost 1300 consenting participants completed a questionnaire on their demographics, hepatitis risk factors, and cancer screening behaviors as well as accessed Hepatitis B Virus screening from 2013 to 2015. Using the information gathered from the completed surveys and the data analysis in 2016, age and English language proficiency had significant association to accessing cancer screening using the three noted methods. Overall, cancer screening rates were lower for the African born (54%), Asian born (23.9%) and US born (22%) participants than those of the rest of New York. English language proficiency appeared to be a barrier for some screening methods such as colorectal cancer screening with colonoscopy, and cervical cancer with Papanicolaou smear but not mammography. Immigrant health is a fundamental part of the public health field and so further investigation into disparities associated with other cancer screening methods is a necessity. An increase in culturally sensitive, language and age-specific health education programs may also improve cancer screening rates for immigrant populations in the city.