Southeast Asian Women's Health Project Cervical cancer is a major cause of morbidity and mortality among women in the United States, with more than 12,000 new cases and 4,000 deaths each year. Southeast Asians (SEAs) experience the highest cervical cancer incidence of any racial/ethnic group, yet they are screened at remarkably low rates. The most common cervical cancer screening is a Papanicolaou (Pap) test. Familial aspects (e.g., relationship between mothers and daughters), intergenerational conflict (e.g., bicultural straddling), and communication patterns (e.g., what is communicated, manner of communication) about cancer and cancer prevention are factors that potentially play a role in cervical cancer beliefs and Pap test uptake. The purpose of this proposed study is to determine the factors that influence Pap test uptake among SEAs, specifically Cambodian and Lao, mother-daughter dyads.
The specific aims are to (1) describe the perceptions of cervical cancer, Pap tests, and cervical cancer screening behaviors among Cambodian and Lao women aged 18-65 and (2) examine, in terms of cervical cancer beliefs and Pap test uptake, the communication patterns among Cambodian and Lao mother-daughter dyads, aged 18-65, within the context of social and cultural factors (i.e., biculturalism, familialism), and how mothes and daughters influence one another. In this exploratory study, we will interview a purposeful sample of Cambodian and Lao women aged 18 to 65 living in Franklin County, Ohio. To examine communication patterns related to cervical cancer knowledge, beliefs, and Pap test uptake, we will conduct focus groups with each of the two ethnic groups (Cambodian and Lao): three focus groups with daughters only and three focus groups with mothers only. Those will inform in-depth interviews to be conducted in an additionally recruited set of mother-daughter dyads. Afterward, we will conduct four additional focus groups with separately recruited mother-daughter dyads from each ethnic group to clarify and validate themes that emerged from previous focus groups and in-depth interviews. This study is innovative with its unique focus on Cambodian and Lao mother-daughter relationships, a key source of social support and influence on health behaviors that may potentially have lasting impact on women across generations. In this study, we will not only define culturally based factors that influence Pap test completion, but also describe them in the context of SEA culture and intergenerational cultural dialogue, allowing future interventions to leverage these beliefs to optimize intervention effect. This study will inform our long-term plan to develop a culturally appropriate, targeted cervical cancer educational intervention for SEA women.

Public Health Relevance

Cambodian and Lao women experience some of the highest cervical cancer incidence and mortality rates in the United States, yet little research exists on ways to address and reduce this cancer health disparity in these two populations. The proposed exploratory study seeks to expand our understanding of Cambodian and Lao women's perceptions of cervical cancer and screening and examine the communication patterns between Cambodian and Lao mothers and daughters related to cervical cancer beliefs and Pap test uptake. The findings of this study will inform the development of a targeted, culturally appropriate educational intervention to increase cervical cancer screening among Southeast Asian women.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Small Research Grants (R03)
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Special Emphasis Panel (ZCA1-SRLB-B (O1))
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Chollette, Veronica
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Ohio State University
Schools of Nursing
United States
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Kue, Jennifer; Szalacha, Laura A; Happ, Mary Beth et al. (2018) Culturally Relevant Human Subjects Protection Training: A Case Study in Community-Engaged Research in the United States. J Immigr Minor Health 20:107-114