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Factors Influence Breast Cancer Screening Practices Amongst Arabic Women Living in the State of Qatar. 2010-2013.
Granting Agency: Qatar National Research Fund, National Priority Research Program (NPRP). $1,010,317.00 USD.
Project Summary
Worldwide breast cancer is a major contributor to the women’s cancer morbidity and mortality. Breast cancer is the most frequent cancer diagnosed in women living in the State of Qatar. Al Amal Hospital in Doha, Qatar reported that 20% cancer cases receiving treatment in 2007 were breast cancer among women. Early detection and treatment can reduce breast cancer morbidity and mortality rates significantly. However, evidence shows that Arabic women are at significant risk due to the lack of early diagnosis and treatment for this disease. They are often diagnosed at advanced stages of breast cancer. At present, information on cancer preventive care needs and factors influence Arabic women’s participation in breast cancer screening activities that are specific to the State of Qatar health care context is very limited. Therefore, adopting the Multiple Intervention Program conceptual framework, we are planning to undertake a three-phase research program for which the goals are to
- understand the breast health issues as experienced by Arabic women living in the State of Qatar;
- identify and implement strategies that would assist women to participate in breast cancer screening activities thus reduce the morbidity and mortality rates of this disease; and
- evaluate, facilitate, and sustain Arabic women’s participation in breast cancer screening activities thus reducing breast cancer morbidity and mortality rates.
This project’s proposal addresses phase I of the research program for which the project’s specific goals are
- to address the identified knowledge gap and
- to formulate effective intervention strategies that will raise awareness of prevention and early detection of breast cancer and increase Arabic women living in the State of Qatar participation in breast cancer screening practices.
In phase I, we will conduct a mixed methods research project using both qualitative and quantitative approaches to:
- investigate the extent to which Arabic women participate in breast cancer screening activities (breast self examination, clinical breast examination, and mammography), their knowledge regarding breast cancer and its early detection, barriers and facilitators to participation in breast cancer screening practices, and their view on the appropriateness and availability of the current breast cancer screening activities,
- investigate how contextual factors such as social, cultural, historical, and economic influence Arabic women’s breast cancer screening practices and their decision to engage in breast cancer screening activities, and
- formulate effective intervention strategies that will increase women’s awareness and participation on breast cancer screening practices, thus reducing this disease’s morbidity and mortality rates.
Phase I research project will consist of two studies.
Study 1: This study is designed to be a quantitative cross-sectional survey which aims to investigate the Arabic women’s participation rate in breast cancer screening activities, their knowledge about breast cancer and its screening methods, barriers and facilitators to participation, and their view on the appropriateness and availability of the current breast cancer screening programs. Using a structured questionnaire, we will conduct face-to-face interviews with Arabic women aged 35 and over living in Doha, Al Wakrah, and Al Khor, Qatar. Convenient sampling will be used to recruit participants from different health care settings (hospitals and community health clinics). To get a representative sample size for 43,272 women aged 35 and over living in these three cities, with the margin of errors of 3.5%, we will conduct a survey using face-to-face interview technique with 753 women. Descriptive and inferential statistics will be performed. Descriptive statistical techniques (measures of central tendency and measures of variability) will be used for the examination of data. Correlation techniques will be employed to assess the extent to which interval variables are related. Chi-Square tests will be used for examining the relationships between categorical variables. Logistic regression models will be used to assess the effects of independent variables on dependent variables.
Study 2: Informed by the Ecological perspective and Kleinman’s Explanatory Model of Health and Illness, this study is designed to be an ethnography qualitative study which aims to:
- gain insight on how Arabic women view and participate in breast cancer screening practices from women, men, and health care providers,
- gain an understanding on how contextual factors such as social, cultural, historical, and economic influence Arabic women’s breast cancer screening practices, their access to these health care services, and social support networks from women, men, and health care providers’ perspectives, and
- gain insight on what intervention strategies will raise awareness of prevention and early detection of breast cancer and increase participation in breast screening practices among Arabic women living in the State of Qatar.
Purposive sampling will be used to recruit 50 Arabic women and 50 Arabic men age 35 and over, and 30 health care providers as research participants. Qualitative in-depth interviews will be individually conducted with each participant. Qualitative data analysis approach will be used for the examination of narrative data. To ensure gender appropriate, a bilingual (Arabic and English) male or female interviewer will conduct the interview in Arabic with the women and the men participants, and in the language that is preferred by the health care provider participants. The Arabic women and men participant will be interviewed twice for approximately one hour to one-and-a half hours. The health care provider participant will be interviewed twice for approximately 30 to 60 minutes. Informed consent will be obtained. The data analysis and data collection will occur concurrently. To ensure the study’s rigor and credibility as well as evaluate the emergent themes, ideas, and concepts, researchers will discuss the preliminary results with participants in the second interviews. Furthermore, this qualitative subjective data will then be triangulated and compared with findings from the survey. The information obtained from both the quantitative and qualitative studies will be used to develop culturally appropriate and effective intervention strategies and services to meet women’s cancer preventive care needs and decrease the seriousness and prevalence of breast cancer among Arabic women living in the State of Qatar.
Publications:
Donnelly, T. T. (Oct, 2013). Fighting breast cancer - Qatar research program: From secondary to primary prevention. Fourth International Symposium on Breast Cancer Prevention – International Breast Cancer and Nutrition Networks (IBCN). October 8-12, 2013. Saumur, France. PowerPoint presentation.
Donnelly, T.T ., & Hwang, J. (2013). "Breast Cancer Screening interventions for Arabic Women: A literature review." Journal of Immigrant and Minority Health. Online first.
Donnelly, T. T; Al-Khater, A.; Bujassoum Al-Bader, S.; Al-Kuwari, M.; Al-Meer, N.; Malik, M.; Singh, R.; Christie, F. (2013 In Press). “Arab Women’s Breast Cancer Screening Practices: A Literature Review.” Asian Pacific Journal of Cancer Prevention, 14 (8/9).
Donnelly, T.T; Al-Khater, A.; Al-Kuwari, M.; Singh, R.; Bujassoum Al-Bader, S.; Malik, M.; Al-Meer, N.; Chaudhry, S. (2012). Breast cancer screening amongst Arabic women living in the State of Qatar: Awareness, knowledge, and participation in screening activities. Avicenna. July 2012.
Donnelly, T. T; Al-Khater, A.; Al-Kuwari, M.; Al-Meer, N.; Bujassoum Al-Bader, S.; Malik, M.; Singh, R.; Christie, F. (2011). Study exploring breast cancer screening practices amongst Arabic women living in the State of Qatar. Avicenna. June 2, 2011.
Pamphlet -- Poster (Awareness, March 2013) -- Poster (Beliefs, Bali, April 2013) -- Proposal description -- Qatar Foundation news report (July 12, 2012) -- Presentation -- Calgary (2012) -- Presentation - Purdue (2012) -- Presentation - Mauritius (2011) -- Presentation - Yokahama (2010) -- Qatar Tribune report (September 5, 2011)
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