SM Journal of Community Medicine

Archive Articles

Article Image 1

Understanding Barriers and Facilitators to Breast and Cervical Cancer Screening among Muslim Women in New York City: Perspectives from Key Informants

Background: Muslims are one of the fastest growing religious groups in the US. However, little is known about their health disparities, and how their unique cultural, religious, and social beliefs and practices affect health behaviors and outcomes. Studies demonstrate Muslim women may have lower rates of breast and cervical cancer screening compared to the overall population.

Methods: The purpose of this study was to: 1) conduct key-informant interviews with Muslim community leaders in New York City (NYC), to understand contextual factors that impact Muslim women’s beliefs and practices regarding breast and cervical cancer screening; and 2) inform the development and implementation of a research study on breast and cervical cancer screening among Muslims. Twelve key-informant interviews were conducted. The sample included imams, female religious leaders, physicians, community-based organization leaders, and social service representatives. The interview guide assessed: 1) unique healthcare barriers faced by Muslim women; 2) cultural and social considerations in conducting research; 3) potential strategies for increasing screening in this population; and 4) content and venues for culturally tailored programming and messaging.

Results: Key informants noted structure and culture as barriers and religion as a facilitator to breast and cervical cancer screening. Themes regarding the development of targeted health campaigns to increase screening included the importance of educational and in-language materials and messaging, and engaging mosques and religious leaders for dissemination.

Conclusion: Although Muslim women face a number of barriers to screening, religious beliefs and support structures can be leveraged to facilitate screening and enhance the dissemination and promotion of screening.

Nadia Islam¹, Shilpa Patel¹*, Quanza Brooks-Griffin², Patrice Kemp², Victoria Raveis³, Lindsey Riley¹, Sindhura Gummi⁴, Potrirankamanis Queano Nur⁵, Joseph Ravenell¹, Helen Cole¹, Simona Kwon¹


Article Image 1

Effect of Household Dysfunction and Community Violence on Mental Health in an Unrest Country

Objective: We set this study to estimate the relation of household dysfunction, community violence and family bonding to adults’ mental health in Baghdad city

Method: A multistage sampling technique resulted in a sample of 1000 adults (58% females, ages 18- 59). Adverse Childhood experiences and family bonding were measured via a modified version of the Adverse Childhood Experiences International Questionnaire (ACE-IQ). Depression and anxiety were measured by modified versions of the Center for Epidemiological Studies Depression Scale (CESD) and the Zung Self-Rating Anxiety Scale (SAS) respectively.

Findings: The results revealed that 37.1% of the participants reported depression. Depression score correlated positively with childhood household dysfunction and community violence, and negatively with childhood bonding to family. Regression analysis revealed that adverse experiences at home and exposure to community violence predicted higher levels of depression and anxiety. Family bonding, higher levels of education, and male gender were associated with less depression and anxiety.

Interpretation: These findings imply that efforts to increase bonding and effective functioning within families may contribute to better mental health among Iraqi adults

Riyadh K Lafta¹ and Ameel F Al-Shawi²*


Article Image 1

Hispanic Community Engagement (HCE): Pilot Study to Reduce Hypertension among Low-Income Mexican Americans

Background: Mexican American adults have a lower prevalence of hypertension and hypertension-related mortality rates compared to other ethnic groups. However, they are more likely to be unaware of their condition, lack access to care, and have uncontrolled blood pressure.

The Hispanic Community Engagement (HCE): Hypertension pilot study aimed to test the efficacy of a case management and educational intervention. The goal of the intervention was to improve adherence to recommended hypertension treatment plans and improve overall health status of Hispanic/Latinos with hypertension.

Methods: Hispanic/Latino patients with hypertension were randomly recruited from a federally qualified health center to participate in the 16-week intervention. Group health education focused on hypertension, healthy eating, physical activity, and living healthy. Case management phone calls were tailored to participant needs and topics included problem solving, review of goals and progress, and community resources. Data collection included fasting blood draws, anthropometric measurements, pre-post- intervention surveys, and post intervention focus groups. Pre-post surveys assessed changes in eating habits, physical activity, and adherence to treatment plans. Focus group questions focused on benefits from participating in the study as well as recommendations for modifications for future research.

Results: A total of 53 patients participated. Pre- post- data analysis demonstrated significant improvements in participant health status by improving total cholesterol, Low-density lipoprotein cholesterol, High-density lipoprotein cholesterol, and triglycerides levels (p ≤ .05). At post intervention, participants showed significant increases in adherence to their treatment plan of hypertension drugs and concern for their health status (p ≤ .05). Participants also demonstrated significant decreases in salt intake (p ≤ .05).

Conclusion: Results demonstrate the effectiveness of tailored interventions as well providing patients with guidance and support to carry out lifestyle changes. Further research is needed to determine the effectiveness of interventions aimed at producing long-term changes for Hispanic/Latino adults with hypertension.

Melawhy L Garcia¹*, Gregory A Talavera¹, Katherine B Keir², Adolph P Falcon³ and Sheila F Castañeda¹


Article Image 1

Ameliorating Negative Perceptions of Attention Deficit Hyperactivity Disorder (ADHD) Students

Attention deficit/hyperactivity disorder (ADHD) is a common mental health disease for children around the world. ADHD can cause negative perceptions of individuals and perceived need for additional interaction requirements among educators. These negative perceptions may result in poorer performance academically which will impact these ADHD children for the rest of their lives. We propose that simple behavioral training can lessen the negative perception of ADHD students and also lessen the stress experienced by educators. The recommended behavioral training is to modify ADHD behaviors so that these students will maintain eye contact longer and return to direct eye contact quicker, thus improving perceptions of interest and potential likeability.

Steven Walczak¹* and Robin Dawson Estrada²