Maghboeba Mosavel

“I Have Never Heard That One”: Young Girls' Knowledge and Perception of Cervical Cancer

With the advent of a vaccine for the human papillomavirus (HPV), many are claiming that cervical cancer may become a health worry of the past. While the vaccine certainly represents an important step forward in the fight against HPV and cervical cancer, it does not diminish the importance of health education or screening interventions particularly amongst adolescents. This study explores the existing state of cancer and cervical cancer knowledge of Latina and African American adolescent girls from low-income, urban neighborhoods. We found that the study participants expressed a range of attitudes toward cancer. Knowledge of cancer also was varied and somewhat anecdotal, showing no unified body of knowledge, but instead representing an assemblage of information culled from formal and informal sources. Participants were most familiar with breast and lung cancer and mentioned these types of cancer most frequently in the focus groups. Most participants had never heard of cervical cancer, while a few were familiar with several aspects of the disease. Cancer knowledge seemed to be gleaned mostly from personal stories, perhaps suggesting the pervasiveness of cancer incidence in their community. The predominant attitudes expressed toward cancer included fear, uncertainty, and anxiety. Our findings suggest that considerable continued health promotion efforts are needed to improve knowledge about cancer in general, and particularly about cervical cancer, to reduce fear and to highlight the effectiveness of prevention and screening.

Cervical cancer attitudes and beliefs-a Cape Town community responds on World Cancer Day.

Background. Attitudes and beliefs affect women’s cervical cancer screening behavior. Methods. We surveyed 228 women in Cape Town, South Africa about their screening history, knowledge, beliefs, and access barriers regarding Papanicolaou (Pap) smears and cervical cancer. Results. More than half of the participants had never had a Pap smear or had 1 more than 10 years ago. One third did not know what a Pap smear was. Lengthy wait times and fatalistic beliefs also affected screening behavior. Ethnicity was associated with differences in beliefs. Conclusions. Opportunistic cancer screening events are an effective way that women can obtain Pap smears and cancer education.

Community researchers conducting health disparities research: Ethical and other insights from fieldwork journaling

Lay persons who are trained to conduct research in their own communities form an essential part of many research projects. However, the effects of conducting research in their own communities have not been adequately explored. This paper examines the experiences, perceptions, and challenges faced by a group of community researchers during their involvement in a research project that examined if, and how, the relationships between mothers and their adolescent daughters could be harnessed to develop a daughter-initiated cervical cancer intervention. Seven community researchers interviewed 157 mother-daughter pairs in Cape Town, South Africa. We examine the use of journaling as a tool to document the experiences of community researchers, and we consider how journaling may help the community-based researcher grapple with the research process, and, more broadly, what such journal content illustrates with respect to the nature and challenges of community-engaged health research. An analysis of the content of the journals provides a strong indication of how personal and intimate the research process can be for community researchers by virtue of the background that they bring into the process as well as the additional weight of the research process itself. The complexities of navigating dual and somewhat oppositional roles - the role of impartial scientist or researcher and the role of invested community person - has been both underestimated and insufficiently researched.

Photovoice: a needs assessment of African American cancer survivors.

The goal of this research was to understand the barriers and challenges that African American cancer survivors experience after being diagnosed with cancer. The authors provided 20 cancer survivors and caregivers with cameras to take pictures of their needs right after they were diagnosed with cancer. Most importantly, a major theme that arose from the participants’ responses was the lack of culturally-specific support services located within their neighborhoods. Other needs included lack of social support, a lack of resources related to appearance, a lack of resources for continued care, and especially a lack of support services for children of survivors.

Perceptions of gender-based violence among South African youth: implications for health promotion interventions

Gender-based violence is a widespread problem in South Africa. Past structural inequities have created a climate conducive to violence against women. As an initial step toward developing a health promotion program, we conducted exploratory formative research to examine the barriers that affect the health and well-being of youth. Fourteen focus groups (nine with girls and five with boys) were conducted with 112 adolescents in a racially mixed community on the outskirts of Cape Town, South Africa. We utilized grounded theory and thematic analysis to examine the data. The impact of poverty, ubiquitous gendered violence, transactional sex and unsafe recreational spaces emerged as the major themes. The experiences of youth were consumed by issues of safety rather than the pursuit of other developmentally appropriate markers. Our findings suggest that health promotion programs should create safe spaces for youth and opportunities to critically question the assumptions and manifestations of a patriarchal society. Furthermore, the findings indicate that there is a strong need for multi-sectorial interventions directed at many levels to prevent gender-based violence.

South African, urban youth narratives: resilience within community

South African youth in low-income, urbanised communities are exposed to high levels of daily stressors, which increase their risk to negative outcomes. Resiliency can provide avenues for youth to transcend adversity and may contribute to their positive development. To provide a deeper understanding of the pathways that adolescents use to overcome adversity, this paper examined future aspirations of South African youth and how these aspirations were connected to resiliency factors framed by their lived context. A phenomenological approach was used to explore the perceptions of high school students. Fourteen focus groups with girls and boys (N = 112) were conducted. Data were analysed using a thematic approach. Discussions of the harsh conditions undermining the communitys future highlighted opportunities for improvement. Community connectedness, hope and altruism were prevalent in youths responses and could be used to facilitate community and individual resiliency. Our overall findings have important implications for positive youth development efforts.

Needs of low-income african american cancer survivors: multifaceted and practical.

This study aimed to identify the needs of low-income, African American cancer survivors in an urban setting. Data were collected from semi-structured interviews conducted with cancer survivors (n = 12), caregivers (n = 10), professionals (n = 10), and surveys from town hall meetings (n = 80). The major needs identified, across all groups, included a diverse array of practical needs including transportation, financial and job assistance, childcare, self-care assistance, more education and lifestyle information when diagnosed as well as after diagnosis, better post treatment plan, and more need for social support. They identified the ideal resource center as being located within the survivors neighborhood and would provide a range of medically specific support as well as recreational services. Being of limited economic means has a host of implications for those diagnosed with cancer and for their family members. Participants suggested that needs for cancer survivors have to take into account a complexity of factors including culture, family, and especially economic implications.

Exploratory Health Disparities Research: The Need to Provide a Tangible Benefit to Vulnerable Respondents.

This article examines the responsibilities of researchers who conduct exploratory research to provide a service to vulnerable respondents. The term “service” is used to denote the provision of a tangible benefit in relation to the research question that is apart from the altruistic research benefits. This article explores what this “service” could look like, who might be responsible for providing it, and the challenges associated with such a service. The article argues that not providing a tangible benefit to vulnerable research participants is inconsistent with the principle of social justice that undergirds much of the rationale for conducting health disparities research.

Conducting community-engaged qualitative research in South Africa: memoirs of intersectional identities abroad

The influence of intersectional identities on social experiences is most often explored within research on minority populations (e.g. LGBT, African American women, etc.). However few, if any, studies have extended the subject of intersectionality to address the intersectional identities of researchers or their influence on the conduct of qualitative research in international settings. Through reflexive memoirs offered from student researchers that engaged in an international collaborative research project, this article highlights the challenges intersectional identities posed while conducting community-engaged qualitative research in Durban, South Africa. Within each memoir, particular attention is paid to (a) how the intersection of the student researchers’ perceived and actual racial, gendered, class, and national identities determined or obfuscated their statuses as ‘outsiders’ or ‘insiders’, (b) the influential nature of these mutually constitutive identities on the interview process, and (c) how the student researchers successfully or unsuccessfully negotiated the collective impact of their intersecting positions and identities in the field. By critically examining the complex and interdependent influence of race, ethnicity, gender, nationality, and class on researchers’ collection and interpretation of qualitative data, this article extends the application and relevance of the intersectionality framework to an international context and to the experiences of the interviewer/researcher.

The Use of a Telephone-Based Communication Tool by Low-Income Substance Abusers

The use of technology to access health information and support services has drastically proliferated. While many Americans have access to the Internet, several marginalized groups remain excluded from access to the information superhighway (Robinson, Patrick, Eng, & Gustafson, 1998). One of the critical questions is how health information can be made accessible to low-income groups who do not have the resources to comfortably access the Internet. It is precisely these marginalized groups who are the most likely to have health problems and are the least likely to have health insurance or access to the Internet (Eng et al., 1998). Telephone-based health education and support may provide an avenue to reach those least likely to have access to the Internet–because most people in the United States have access to a telephone. Telephone-based health interventions have enormous potential to provide disease-specific support (Rimer et al., 1999; Soet & Basch, 1997) and health information especially to low-income individuals including those who are homeless. The benefits of accessing telephone-based health information are amplified for low-income individuals with a substance abuse addiction. Very often these individuals are referred to outpatient treatment with minimal, if any, ancillary community-based support services. In general, individuals who have an addiction often need supplementary illness-related information or social support from peers or from providers (Reeves, 2000). This study evaluates how individuals from a low-income neighborhood who have been referred to substance abuse outpatient treatment used a telephone-based information system, Connect, to access substance abuse information and peer support.