Overall, Minnesotans enjoy a high quality of life and health status;however, not all Minnesota citizens benefit equally. Recent immigrants - particulariy recent African-born immigrants who are predominantly Somali, and recent Latino immigrants who are predominately Mexican-born - do not share the same level of health as other Minnesotans. These populations also have a higher prevalence of several lifestyle risk factors that are associated with negative health outcomes. For example, 40% of Latinos and 55% of African-born people meet none ofthe Healthy People 2010 recommended guidelines for nutrition and moderate exercise;64.6% of Latinos and 51.2% of African born have a BMI that makes them ovenweight or obese.(2) Even when these immigrant groups arrive at the US with low rates of some high risk health behaviors (e.g. low smoking prevalence among new African and Latino immigrants), over time, their health risk profiles approximates that in underserved populations in the US. Although from very different cultures, Somali women and Hispanic women share some similar concerns when receiving health care. Both groups need access to adequate interpreter services. Further, for many Somali and Hispanic women, patient-provider gender concordance is important, especially for gynecologic concerns. We will be targeting our COC intervention to immigrants in the Twin Cities Metropolitan area and in rural counties with significant concentrations of immigrants. It is important to target rural regions, because there is ample evidence of underutilization of preventive cancer screening in rural areas. For example, over a five-year period (2001-2005) the invasive cervical cancer incidence rate was significantly higher in several rural areas of Minnesota than in the rest of the state.(3) In addition, the cervical cancer mortality rate was significantly higher in rural southwestern Minnesota, including our target county of Kandiyohi. Combining data from all races, women residing in rural Minnesota were less likely to report having had a Pap smear test in the last three years than were women living in urban areas.(3) Mammography use, as well, was less prevalent among residents of rural areas than among women living in the metro area (71% vs. 80%).(3) These data suggest that health disparities are compounded for immigrants living in rural areas.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZCA1-PCRB-G)
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University of Minnesota Twin Cities
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Sewali, Barrett; Okuyemi, Kolawole S; Askhir, Asli et al. (2015) Cervical cancer screening with clinic-based Pap test versus home HPV test among Somali immigrant women in Minnesota: a pilot randomized controlled trial. Cancer Med 4:620-31
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Harcourt, Nonyelum; Ghebre, Rahel G; Whembolua, Guy-Lucien et al. (2014) Factors associated with breast and cervical cancer screening behavior among African immigrant women in Minnesota. J Immigr Minor Health 16:450-6
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