BMJ Open
Volume 8, Issue 11, 2018

Barriers to and discourses about breast cancer prevention among immigrant women in Spain: A qualitative study (Article) (Open Access)

March S.* , Villalonga B. , Sanchez-Contador C. , Vidal C. , Mascaro A. , Bennasar M.D.L. , Esteva M.
  • a Research Unit, Primary Care Department, Balearic Islands Health Service, Balearic Islands Health Research Institute (IdISBa), Palma, Spain
  • b Arquitecto Bennassar Health Center, Majorca Primary Care Department, Balearic Islands Health Service, Palma, Spain
  • c Balearic Department of Health, Breast Cancer Early Detection Program, Palma, Spain
  • d Research Unit, Primary Care Department, Balearic Islands Health Service, Balearic Islands Health Research Institute (IdISBa), Palma, Spain
  • e Majorca Primary Care Department, Balearic Islands Health Service, Palma, Spain
  • f Research Unit, Primary Care Department, Balearic Islands Health Service, Balearic Islands Health Research Institute (IdISBa), Palma, Spain
  • g Research Unit, Primary Care Department, Balearic Islands Health Service, Balearic Islands Health Research Institute (IdISBa), Palma, Spain

Abstract

Objectives To identify knowledge, barriers and discourses about breast cancer screening in Spain among female immigrants from low-income countries and native Spanish women from a low socioeconomic class. Design Qualitative interview study with thematic analysis interpreted using cultural mediators. Setting Mallorca, Spain. Participants Thirty-six in-depth interviews, using cultural mediators, of immigrant women living in Mallorca who were 50-69 years old and were from Maghreb, Sub-Saharan Africa, Eastern Europe, Latin America, China or were native to Spain and from a low socioeconomic class. Results We analysed the interviews to assess breast cancer perceptions and beliefs, discourses about breast cancer prevention and barriers to accessing breast cancer prevention programmes. Although the women reported an association of breast cancer with death, they acknowledged the effectiveness of early detection. They also exhibited reluctance to talk about cancer. Discourses about cancer prevention tended to be proactive or fatalistic, depending on the woman's country of origin. For all women, fear of results and lack of time were barriers that limited participation in breast cancer prevention programmes. Language barriers, frequent changes of residence and fear due to status as an irregular (undocumented) immigrant were barriers specific to immigrant women. Conclusions The culture of origin affects whether an immigrant has a fatalistic or proactive approach toward breast cancer screening. Immigrants from low-income countries and Spanish natives from a low socioeconomic class experience barriers in access to breast cancer screening. Frequently changing homes is also a barrier for immigrant women. © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Author Keywords

mammography culture gender and health social position Immigration prevention

Index Keywords

education China immigrant South and Central America breast cancer Europe human middle aged Aged cancer prevention death gender identity qualitative research interview social status Mammography Spain female Article major clinical study thematic analysis adult social class
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85056701111&doi=10.1136%2fbmjopen-2017-021425&partnerID=40&md5=5de89b541d9c0ba501a27d6f729393f4
DOI: 10.1136/bmjopen-2017-021425
ISSN: 20446055
Original Language: English