Improving breast health in a refugee community: The Somali Women's Breast Cancer Project

Background: Minnesota has the largest concentration of Somali refugees in the United States, with population estimates ranging from 25,000 to 60,000. Prior to their arrival in the U.S., most Somali women were unlikely to be screened for breast cancer because such services were not widely available. Although specific data for Somalis are lacking, evidence shows that racial and ethnic minority groups in Minnesota experience significant cancer disparities.

Objectives: The Somali Women's Breast Cancer Project aims to increase basic knowledge and awareness of breast cancer, and increase breast cancer screening rates for Somali women who are 40 or older.

Methods: Focus groups were conducted with Somali women to better understand the knowledge and attitudes of breast cancer in the community. These data were used to develop a culturally appropriate program to address breast health disparities, including: a module on breast health for use in home visit sessions, community education forums, and Somali-language videos.

Results: Focus groups revealed intense fear and numerous myths about breast cancer, as well as little awareness of screening methods. Since September 2005, 12,000 Somalis were reached through video broadcast, and Somali community health workers (CHWs) reached nearly 300 women in the Minneapolis/St. Paul area through home visits. Pre- and post-tests administered to women showed significant gains in knowledge. Research is ongoing to determine long-term knowledge retention and changes in screening behaviors.

Conclusion: In a refugee community with high stigma attached to breast cancer, program success is greatly dependent upon small, private educational sessions led by CHWs.