Objective To understand the experiences and perceptions of having cervical cancer screening tests and to explore the extant barriers to having the tests among first-generation Chinese American women in the United States. Design Qualitative, descriptive, phenomenological research. Setting Los Angeles, California. Participants Snowball and purposive sampling of 12 Chinese American immigrant women ages 20 to 65 years. Methods Individual face-to-face, in-depth, semistructured interviews in which participants were asked about their experiences and perceptions about cervical cancer screening. Interviews were audiotaped, transcribed, and translated into English. Data analysis included comparing and distinguishing, collecting and counting, and presupposing and inferring. Results Through the analysis process, we identified four major themes that reflected the experiences, perceptions, and barriers to having cervical cancer screening among Chinese American women: Belief in a Healthy Lifestyle, Maintaining Privacy for Female Health Problems, Fear of Losing Control, and Feeling Vulnerable in an Unfamiliar Health Care System. These themes indicated that Chinese immigrant women in the United States face challenges to their cultural health beliefs and practices with regard to decision-making and health-seeking behaviors related to cervical cancer screening. They felt more vulnerable as immigrants because of systematic barriers to navigation of the unfamiliar health care system and limited resources. Conclusion Women's health care providers should be aware of and give consideration to cultural differences through the provision of more educational information and comfort to Chinese immigrant women who seek cervical cancer screening. Ultimately, the development of culturally appropriate and affordable cancer prevention programs with effective strategies is important to ease Chinese American women's senses of vulnerability. © 2018 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses

Cervical cancer screening Lived experience Asian people/cultures immigrants/migrants

Needs Assessment health promotion human middle aged early cancer diagnosis Aged Early Detection of Cancer ethnology procedures qualitative research Cross-Sectional Studies interview United States Young Adult cross-sectional study migrant Humans California Interviews as Topic Emigrants and Immigrants Asian Americans female Asian American cultural factor Health Knowledge, Attitudes, Practice women's health organization and management adult Uterine Cervical Neoplasms uterine cervix tumor Cultural Characteristics attitude to health