Social, cultural, and system barriers to breast and cervical cancer screening for Hmong women in Oregon

Background: Hmong in the U.S. are screened for breast and cervical cancer (BCC) at remarkably low rates. Cultural and social factors, including those reflecting their unique history and experience, are thought to affect BCC screening behavior among Hmong women. The health care system may also pose barriers to screening that are particularly relevant for the Hmong given low levels of health literacy. Yet, research on how these factors may influence BCC screening for Hmong women is lacking. Objective: Our objective was to explore the social, cultural, and health care system factors that may influence BCC screening for Hmong women living in Oregon. Methods: We conducted 17 key informant interviews with Hmong community leaders and other community members interested in women's health. We are currently conducting approximately 80 in-depth interviews with Hmong women and men. A Community Advisory Committee helps to ensure that the project meets the needs and preferences of the Hmong community. Results: Key informant interviews identified lack of knowledge, medical mistrust, discrimination, language, the role of family in medical decisions and as a source of health information, and other factors as potential influences on BCC screening. Results from the in-depth interviews are forthcoming and will also be presented. Discussion: Learning what factors influence BCC screening in a state such as Oregon, which has a relatively small Hmong population (pop. ~3600) and where few culturally appropriate services are available, is important for understanding the barriers to screening that Hmong women face and for developing culturally appropriate programs and services.