Intervention to increase the participation of immigrant women in cervical cancer screening MERH 2018, Edinburgh 18 March, 2018 Samera Azeem Qureshi MD, PhD Esperanza Diaz MD, PhD Bernadette Kumar MD, PhD Kathy Møen MD Abdi Gele PhD

Background Low uptake of cervical cancer screening among immigrant women Community oriented approach Target both users and health professionals I suggest to cut text even more. Here some suggestions but do what you feelcomfortable with Could you move the text a litle more to the right? (have some margins, generally in all slides)

Comparison of the effect measured by analyses of registry data To identify barriers that influence the interactions between immigrants and health care professionals To evaluate the effectiveness of two different community-based strategies to increase the participation Comparison of the effect measured by analyses of registry data Margins here too

How to increase participation Immigrant Women Health care professionals

Focusgroups health professionals in Oslo 26 GP’s, 3 gynecologists and 3 LHV’s, total 32 3 questions were asked: Experience of cervical cancer testing among immigrant women Strategy if any used by them during consultation Need for more awareness and knowledge

Main Issues Raised General factors Specific factors Routines Responsibility Gender of GP Language barrier Knowledge Cultural Organizational structure

Focus Groups (Pakistani & Somali women) Six FGDs in Oslo with 36 women (Feb.-April 2016) Main Issues Raised Genaral Practitioner Not by males Nature of the test No letters from Kreftregisteret Letters difficult to understand Time and place and obligatory Religious belief has become more of a taboo Title: Work with the women- explian that Kathy will tell about health prof Three in each group ?? What is this Write General practitioner (not all know what GP is). The same KRG

Recruitment Community-based recruitment Use of social media facebook etc. Local contacts through telephone Snow-ball method I suggest recruitmen goes before intervention…

Intervention Between Feb- October 2017 total 14 meetings Explanation about cervical cancer causes, risk factors Do you have an illustration that you could put here?

Intervention Description & benefits of screening Short video on cervical cancer test Do you have an illustration that you could put here?

Intervention Information on taking appointment for the test Questionnaire Do you have an illustration that you could put here?

Results Pakistani Total invited: 391 Attended: 94 Somali Explain that this is a community-based trial. Nobody expect tha all are reached, this is how this is different from a randomised controlled trial where the intervention-object is the person. Here is the community. We hope people talk to each other back home. This is why we will measure through registers. I know the numbers were somhow disappointing to you, but we do not know how this is going to work.Maybe only been invited to this (even for those not attending) is a reminder that helps to go and take the etst!! BE POSITIVE!!

Results Majority of women 26-45 years 81% of women were married 72% Pakistani & 45% Somali had ever taken the test Awareness about cervical cancer and the test was low

Conclusions Although we weere not able to mobilize women, but we have to keep in mind that it was a community-based Word of mouth effect Main effects evident when registry data analysed