I
n 2005, Nursing Professor Lucia Yiu and colleagues Dr. Uzo
Anucho (Social Work) and Dr. Nombuso Dlamini (Education)
undertook a project that examines promoting access to breast
health for ethno–cultural communities in the Windsor area.
The intent is to empower women with the education and skills to
better their own health. “We want to learn from the experiences of
women in Windsor-Essex County so that we can better work with our
community partners to make health services more optimal,” says Yiu.
“Windsor is the fourth-largest ethno-cultural community in
Canada. Windsor-Essex County has a high incidence of cancer rates
– not just breast cancer. Each week, 10-12 women are diagnosed
with breast cancer. Ethno-cultural women have more deaths because
they wait too long before having any screening done. Breast cancer
prevention is, therefore, a health priority.”
The project, which received about $200,000 in funding from the
Canadian Breast Cancer Foundation, focused on four groups: Middle
Eastern, South Asian (Indian), East Asian (China, Thailand, Japan),
and African.
“When we look at accessibility to health services, culture is a
determinant,” says Yiu. “And it’s not just language.” For example, an Asian
woman considers it taboo to expose her breast to someone else and may
be reluctant to have a clinical breast examination or a mammogram.
“Another reason I’ve seen is discrimination,” says Yiu.
Community partners include the Multicultural Council of Windsor-
Essex (a sponsoring agency), Ontario Breast Screening Program (OBSP),
Windsor-Essex County Health Unit, Windsor Women Working With
Immigrant Women (W5), YMCA, Sandwich Community Health Centre,
South Essex Community Council, and the New Canadian Centre.
The project mapped out available resources including teaching
materials in the necessary languages, and health service staff who
understand the clients.
A survey sent to physicians and community agencies determined
that some do have translated materials (54 percent) and that there is
some degree of translation services offered (39 percent). A common
theme was the need to promote cultural competence training for
service providers and to offer culturally sensitive programs by
trained members from the same communities with information and
material in their own languages.
Interviews with 20 women indicated that cultural factors,
comfort levels, and awareness of the health care system do impact
breast health. Many expressed a desire to have a female physician
and to see doctors who would take time to discuss things with them.
“We now hope to develop education and promotion strategies
for physicians and local agencies. That’s why we have community
forums. We want to empower the community to know what they
should do and when to ask what questions, and to tell them that it’s
okay to talk about breast health,” says Yiu.
Pre- and post-test evaluation of the 18 breast health workshops
(offered in five languages) showed positive intervention effects
for the women in all areas, including general breast cancer and
screening knowledge, perceived benefits to clinical breast exams and
to mammograms, as well as perceived barriers to both clinical breast
exams and mammograms.
The project shows health and newcomer organizations how
to deliver culturally competent health programs in breast health
promotion, says Yiu. The findings will also contribute to the
development of a comprehensive breast health promotion action
plan for a multicultural community for Windsor-Essex County.
“We will try to take the initiative beyond Windsor – our goal is
to create a template. Whatever we’ve found that works, we will share
with other communities. That’s the joy of doing research, you learn
from your experience and share with other people,” says Yiu.
❍
v
Barriers to
Breast Health
By Jennifer Barone
Immigrants to Canada often face cultural and language barriers.
What is their impact on women’s breast health?
view . spring 2008
5
Photograph by Kevin Kavanuagh
