3.4-O6A qualitative intervention approach to increase the participation of Pakistani and Somali women in cervical cancer screening program in Norway

Abstract

Background: In Norway the attendance in cervical cancer screening is low among immigrants as compared to the mainstream community. To increase attendance, we first conducted several focus groups with different stakeholders that identified barriers and factors that influence the interactions between immigrants and health care professionals for screening of cervical cancer. Subsequently we developed two interventions; one targeting women with Pakistani and Somali origin and the other health professionals. Aim: To describe the strategy used to increase women's participation in screening and to report its implementation and reach. Methods: The intervention was carried out in four different geographical areas adjoining Oslo. The initial idea was to randomize areas in each district into intervention or control. Due to fear of contamination and the impossibility of recruitment from such ''unnaturally'' divided areas we adopted a pragmatic approach and recruited women from bigger areas through a variety of channels and institutions. A member of the research team sharing immigrant background with the women invited as many women as possible. In order to encourage participation, we offered two lottery prizes worth NOK 500, at every meeting. For those attending, an oral presentation lasting 20-25 mins was given, covering topics of cervical cancer and screening, followed by an opportunity to raise questions. Outcomes of the intervention will be measured through registered data from the national cancer register. Results: A total of 300 women attended the 14 meetings. Most were married and between 26-45 years. More Pakistani as compared to Somali women had ever taken a pap-smear. The overall attendance in all the four areas was lower than expected, especially among Pakistanis, although both the moderators were medical doctors and spoke the native language. Overall awareness and knowledge of the subject was poor. Conclusion: Recruitment of immigrant women for the intervention was quite challenging. We tried our best to overcome these challenges by mobilising all channels, social media, personal contacts etc. The sensitivity of the issue might also contribute to the low attendance to the intervention. 3.