Abstract
Background: Canada’s growing ethnocultural diversity challenges health professionals to develop culturally sensitive cancer prevention strategies. Little is known about the ethnocultural specificity of cancer risk beliefs. This qualitative pilot study examined cancer risk beliefs, focusing on diet, among adults from Toronto’s Somali, Chinese, Russian, and Spanish-speaking communities.
Method: Group interviews (n=4) were conducted with convenience samples of adults (total n=45) from four ethnocultural communities (total 45 participants).
Results: The constant comparison method of data analysis identified three common themes: knowledge of cancer risk factors, concern about the food supply, and the roles of spiritual and emotional well-being. Two areas of contrasting belief concerning specific mediators of cancer risk were identified.
Interpretation: Findings support the investigation of cultural-specific health promotion strategies emphasizing both the maintenance of traditional cancer protective eating practices and the adoption of additional healthy eating practices among new Canadians. More research is needed to enhance our understanding of ethnoculturally specific cancer risk beliefs and practices to ensure the cultural relevance of programming.
Résumé
Contexte: La diversité ethnoculturelle croissante du Canada lance aux professionnels de la santé le défi d’élaborer des stratégies de prévention du cancer sensibles à la culture. On a peu de renseignements sur les croyances des risques de cancer chez certains groupes ethniques. Cette étude pilote qualitative a examiné ces croyances, surtout à l’égard du régime alimentaire, chez les adultes des communautés somalienne, chinoise, russe et hispanophone de Toronto.
Méthode: Nous avons mené des entrevues en groupe avec des échantillons de commodité composés d’adultes (N=45) de ces quatre communautés ethnoculturelles.
Résultats: Par comparaison continue, nous avons cerné trois thèmes communs (la connaissance des facteurs de risques, l’inquiétude au sujet des sources alimentaires et le rôle du bien-être spirituel et affectif), ainsi que deux domaines où les croyances à propos des médiateurs spécifiques des risques de cancer sont opposées.
Interprétation: Les conclusions de l’étude viennent étayer le besoin de trouver des stratégies de promotion de la santé propres à chaque culture et qui soulignent la continuation des pratiques d’alimentation traditionnelles qui protègent contre le cancer et l’adoption de nouvelles pratiques d’alimentation saine chez les néo-Canadiens. Des recherches supplémentaires sont nécessaires pour mieux comprendre les croyances et les pratiques des différents groupes ethnoculturels à l’égard des risques de cancer et pouvoir ainsi établir une programmation qui réponde aux besoins particuliers de ces groupes.
Footnotes
Acknowledgements: This project was initiated by the Dietary Risk Factors Working Group of the Toronto Cancer Prevention Coalition with funding from the Public Health Branch of the Ontario Ministry of Health and Long Term Care, Toronto Public Health and with the in-kind resources of community partners. The contributions of members of the Dietary Risk Factors Working Group are gratefully acknowledged. The four interview moderators are thanked for their invaluable contributions to this project.
References
- 1.Toronto District Health Council. Toronto Profile III. Part I. Facts on the Health of Residents of Toronto. 1999. [Google Scholar]
- 2.Reddy KS. Ethnic diversity: The new challenges of preventive cardiology. J Int Soc Fed Cardiol. 1998;1(1):6–8. [Google Scholar]
- 3.Devine C, Sobal J, Bisogni C, Connors M. Food choices in three ethnic groups: Interactions of ideals, identities and roles. J Nutr Educ. 1999;31:86–93. doi: 10.1016/S0022-3182(99)70400-0. [DOI] [Google Scholar]
- 4.Harnack L, Block G, Subar A, Lane S. Cancer prevention-related nutrition knowledge, Beliefs, and attitudes of US adults: NHIS Cancer Epidemiology Supplement. J Nutr Educ. 1998;30:131–38. doi: 10.1016/S0022-3182(98)70303-6. [DOI] [Google Scholar]
- 5.Lantz PM, Dupuis L, Reding D, Krauska M, Lappe K. Peer discussions of cancer among Hispanic migrant farm workers. Public Health Rep. 1994;109(4):512–20. [PMC free article] [PubMed] [Google Scholar]
- 6.Choudry UK, Srivastava R, Fitch MI. Breast cancer detection practices of South Asian women: Knowledge, attitudes and beliefs. Oncol Nurs Foundation. 1998;25(10):1693–701. [PubMed] [Google Scholar]
- 17.Bottorff JL, Johnson JL, Bhagat R, Grewal S, Balneaves LG, Clarke H, et al. Beliefs related to breast health practices: The perceptions of South Asian women living in Canada. Soc Sci Med. 1998;47(12):2075–85. doi: 10.1016/S0277-9536(98)00346-3. [DOI] [PubMed] [Google Scholar]
- 8.Hughes C, Lerman C, Lustbader E. Ethnic differences in risk perception among women at increased risk for breast cancer. Breast Cancer Research and Treatment. 1996;40:25–35. doi: 10.1007/BF01806000. [DOI] [PubMed] [Google Scholar]
- 9.Vernon SW, Vogel VG, Halabi S, Bondy ML. Factors associated with perceived risk of breast cancer among women attending a screening program. Breast Cancer Research and Treatment. 1993;28:137–44. doi: 10.1007/BF00666426. [DOI] [PubMed] [Google Scholar]
- 10.Powell D, Leiss W. Mad Cows and Mothers Milk: The Perils of Poor Risk Communication. Montreal: McGill-Queen’s University Press; 1997. [Google Scholar]
- 11.Fessenden-Raden J, Fitchen JM, Heath JS. Providing risk information in communities: Factors influencing what is heard and accepted. Sci Tech and Human Values. 1987;12(3–4):94–101. [Google Scholar]
- 12.Achterberg C. Qualitative methods in nutrition education evaluation research. J Nutr Educ. 1988;20(5):244–50. doi: 10.1016/S0022-3182(88)80065-7. [DOI] [Google Scholar]
- 13.Strauss AL, Corbin J. Basics of Qualitative Research: Grounded Theory Procedures and Research. California: Sage Publications; 1990. [Google Scholar]
- 14.Morse J. Introduction. In: Morse J, editor. Qualitative Health Research. California: Sage Publications; 1992. p. xi. [Google Scholar]
- 15.O’Loughlin J. Understanding ethnicity in the role of chronic disease: A challenge for the new millennium. CMAJ. 1999;161:152–53. [PMC free article] [PubMed] [Google Scholar]
- 16.Lu HC. Chinese System of Food Cures. Prevention and Remedies. New York: Sterling Publishing; 1986. [Google Scholar]
- 17.Rapport. 1997.
- 18.Keenan DP. In the face of diversity: Modifying education delivery to meet the needs of an increasingly multicultural consumer base. J Nutr Educ. 1996;28:86–91. doi: 10.1016/S0022-3182(96)70033-X. [DOI] [Google Scholar]
- 19.Airhihenbuwa CO. Health promotionthe discourse on culture: Implications for empowerment. Health Educ Q. 1994;21(3):45–53. doi: 10.1177/109019819402100306. [DOI] [PubMed] [Google Scholar]
- 20.Chen J, Ng E, Wilkins R. The health of Canada’s immigrants in 1994-5. Health Rep. 1996;7(4):33–45. [PubMed] [Google Scholar]