A Culturally Adapted Breast and Cervical Cancer Screening Intervention Among Muslim Women in New York City: Results from the MARHABA Trial.
Laura C Wyatt, Perla Chebli, Shilpa Patel, Gulnahar Alam, Areeg Naeem, Annette E Maxwell, Victoria H Raveis, Joseph Ravenell, Simona C Kwon, Nadia S Islam
Author Information
Laura C Wyatt: Department of Population Health, NYU Langone Health, New York, NY, 10016, USA. laura.wyatt@nyulangone.org. ORCID
Perla Chebli: Department of Population Health, NYU Langone Health, New York, NY, 10016, USA.
Shilpa Patel: Center for Health Care Strategies, Trenton, NJ, 08619, USA.
Gulnahar Alam: Department of Population Health, NYU Langone Health, New York, NY, 10016, USA.
Areeg Naeem: School of Dental Medicine, University at Buffalo, Buffalo, NY, 14214, USA.
Annette E Maxwell: School of Public Health, UCLA Fielding, Los Angeles, CA, 90095, USA.
Victoria H Raveis: NYU College of Dentistry, New York, NY, 10016, USA.
Joseph Ravenell: Department of Population Health, NYU Langone Health, New York, NY, 10016, USA.
Simona C Kwon: Department of Population Health, NYU Langone Health, New York, NY, 10016, USA.
Nadia S Islam: Department of Population Health, NYU Langone Health, New York, NY, 10016, USA.
We examine the efficacy of MARHABA, a social marketing-informed, lay health worker (LHW) intervention with patient navigation (PN), to increase Breast and Cervical Cancer screening among Muslim women in New York City. Muslim women were eligible if they were overdue for a mammogram and/or a Pap test. All participants attended a 1-h educational seminar with distribution of small media health education materials, after which randomization occurred. women in the Education + Media + PN arm received planned follow-ups from a LHW. women in the Education + Media arm received no further contact. A total of 428 women were randomized into the intervention (214 into each arm). Between baseline and 4-month follow-up, mammogram screening increased from 16.0 to 49.0% in the Education + Media + PN arm (p < 0.001), and from 14.7 to 44.6% in the Education + Media arm (p < 0.001). Pap test screening increased from 16.9 to 42.3% in the Education + Media + PN arm (p < 0.001) and from 17.3 to 37.1% in the Education + Media arm (p < 0.001). Cancer screening knowledge increased in both groups. Between group differences were not statistically significant for screening and knowledge outcomes. A longer follow-up period may have resulted in a greater proportion of up-to-date screenings, given that many women had not yet received their scheduled screenings. Findings suggest that the educational session and small media materials were perhaps sufficient to increase Breast and Cervical Cancer screening among Muslim American women. ClinicalTrials.gov NCT03081507.
Pew Research Center, U.S. Muslims concerned about their place in society, but continue to believe in the American dream.
New York Foundation (2020) New York’s diverse Muslim community. Available from: https://nyf.org/files/2019/08/NYF_Muslim_A.pdf .
Padela AI, Murrar S, Adviento B, Liao CH, Hosseinian Z, Peek M, Curlin F (2015) Associations between religion-related factors and breast cancer screening among American Muslims. J Immigr Minor Health 17(3):660–669
[DOI: 10.1007/s10903-014-0014-y]
Zorogastua K, Sriphanlop P, Reich A, Aly S, Cisse A, Jandorf L (2017) Breast and cervical cancer screening among US and non US born African American Muslim women in New York city. Aims Public Health 4(1):78–93
[DOI: 10.3934/publichealth.2017.1.78]
Padela AI, Gunter K, Killawi A, Heisler M (2012) Religious values and healthcare accommodations: voices from the American Muslim community. J Gen Intern Med 27(6):708–715
[DOI: 10.1007/s11606-011-1965-5]
Islam N, Patel S, Brooks-Griffin Q, Kemp P, Raveis V, Riley L, . . . Kwon S (2017) Understanding barriers and facilitators to breast and cervical cancer screening among Muslim women in New York city: perspectives from key informants. SM J Community Med 3(1)
Guimond ME, Salman K (2013) Modesty matters: cultural sensitivity and cervical cancer prevention in muslim women in the United States. Nurs Womens Health 17(3):210–217
[DOI: 10.1111/1751-486X.12034]
Shah SM, Ayash C, Pharaon NA, Gany FM (2008) Arab American immigrants in New York: health care and cancer knowledge, attitudes, and beliefs. J Immigr Minor Health 10(5):429–436
[DOI: 10.1007/s10903-007-9106-2]
Foundation CHC (2003) Allies for quality: lay health workers’ role in improving health care quality. Available from: https://www.chcf.org/wp-content/uploads/2017/12/PDF-AlliesForQualityBrief2.pdf .
Lu M, Moritz S, Lorenzetti D, Sykes L, Straus S, Quan H (2012) A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women. BMC Public Health 12:413
[DOI: 10.1186/1471-2458-12-413]
Hall CP, Wimberley PD, Hall JD, Pfriemer JT, Hubbard E, Stacy AS, Gilbert JD (2005) Teaching breast cancer screening to African American women in the Arkansas Mississippi river delta. Oncol Nurs Forum 32(4):857–863
[DOI: 10.1188/05.ONF.857-863]
Padela AI, Malik S, Ally SA, Quinn M, Hall S, Peek M (2018) Reducing Muslim mammography disparities: outcomes from a religiously tailored mosque-based intervention. Health Educ Behav 45(6):1025–1035
[DOI: 10.1177/1090198118769371]
Pratt R, Mohamed S, Dirie W, Ahmed N, Lee S, VanKeulen M, Carlson S (2020) Testing a religiously tailored intervention with Somali American Muslim women and Somali American Imams to increase participation in breast and cervical cancer screening. J Immigr Minor Health 22(1):87–95
[DOI: 10.1007/s10903-019-00881-x]
Islam N, Patel S (2018) Best practices for partnering with ethnic minority-serving religious organizations on health promotion and prevention. AMA J Ethics 20(7):E643-654
[DOI: 10.1001/amajethics.2018.643]
U.S. Preventive Services Task Force (2021) A & B recommendations. January 24, 2022. Available from: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-and-b-recommendations .
Noor S, Noor N, Haq M (2016) Breast cancer in Muslim countries: risk reduction strategies. J Adv Med Med Res :1–11
Lefebvre RC, Flora JA (1988) Social marketing and public health intervention. Health Educ Q 15(3):299–315
[DOI: 10.1177/109019818801500305]
Kwok J, Atencio J, Ullah J, Crupi R, Chen D, Roth AR, Brondolo E (2011) The perceived ethnic discrimination questionnaire–community version: validation in a multiethnic Asian sample. Cultur Divers Ethnic Minor Psychol 17(3):271–82
[DOI: 10.1037/a0024034]
Reeve BB, Willis G, Shariff-Marco SN, Breen N, Williams DR, Gee GC, Levin KY (2011) Comparing cognitive interviewing and psychometric methods to evaluate a racial/ethnic discrimination scale. Field Methods 23(4):397–419
[DOI: 10.1177/1525822X11416564]
Holt CL, Clark EM, Klem PR (2007) Expansion and validation of the spiritual health locus of control scale: factorial analysis and predictive validity. J Health Psychol 12(4):597–612
[DOI: 10.1177/1359105307078166]
Han HR, Song Y, Kim M, Hedlin HK, Kim K, Ben Lee H, Roter D (2017) Breast and cervical cancer screening literacy among Korean American women: a community health worker-led intervention. Am J Public Health 107(1):159–165
[DOI: 10.2105/AJPH.2016.303522]
Karliner LS, Kaplan C, Livaudais-Toman J, Kerlikowske K (2019) Mammography facilities serving vulnerable women have longer follow-up times. Health Serv Res 54(Suppl 1):226–233
[DOI: 10.1111/1475-6773.13083]
Ahmad F, Cameron JI, Stewart DE (2005) A tailored intervention to promote breast cancer screening among South Asian immigrant women. Soc Sci Med 60(3):575–586
[DOI: 10.1016/j.socscimed.2004.05.018]
Padela AI, Malik S, Din H, Hall S, Quinn M (2019) Changing mammography-related beliefs among American Muslim women: findings from a religiously-tailored mosque-based intervention. J Immigr Minor Health 21(6):1325–1333
[DOI: 10.1007/s10903-018-00851-9]
Marlow NM, Pavluckm AL, Bian J, Ward EM, Halpern MT (2009) The relationship between insurance coverage and cancer care: a literature synthesis. RTI Press
