Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study

Rebekah Pratt, Sharif Mohamed, Wali Dirie, Nimo Ahmed, Michael VanKeulen, Huda Ahmed, Nancy Raymond, Kola Okuyemi

Screening rates for breast and cervical cancer for Muslim women in the United States are low, particularly for first-generation immigrants. Interpretations of the Muslim faith represent some of the barriers for breast and cervical cancer screening. Working to understand how faith influences breast and cervical screening for Somali women, and working with the community to identify and utilize faith-based assets for promoting screening, may lead to life-saving changes in screening behaviors. We partnered with an Imam to develop faith-based messages addressing the concerns of modesty and predetermination and promoting cancer testing and screening. A total of five focus groups were convened, with 34 Somali women (three groups) and 20 Somali men (two groups). Each focus group first discussed participant views of breast and cervical cancer screening in general and then viewed and discussed video clips of the Imam delivering the faith-based messages. Both Somali women and men had an overwhelmingly positive response to the faith-based messages promoting breast and cervical cancer screening. The faith-based messages appeared to reinforce the views of those who were already inclined to see screening positively, with participants describing increased confidence to engage in screening. For those who had reservations about screening, there was feedback that the faith-based messages had meaningfully influenced their views. Somali immigrant women and men found faith-based messages addressing topics of predestination and modesty and encouraging the use of screening and treatment to be both acceptable and influential. Faith can play an important role as an asset to promote breast and cervical cancer screening, and there may be substantial benefits to adding faith-based messaging to other interventions that focus on improving screening uptake. This may help to address health disparities for Somali women in this area.