Immigrants are relatively less likely to take part in preventive screening programmes, such as cancer screening. This is partly due to the language barrier and a lack of knowledge, according to a doctoral thesis by Nora Hamdiui. Her conclusion is that more tailor-made and culturally sensitive information will help this group make decisions on taking part.
On 9 May 2022, Hamdiui obtained her doctoral degree from Radboud University with research among Turkish and Moroccan-Dutch immigrants into their decision-making on taking part in screening programmes. As examples, she looked into hepatitis B and cervical cancer screening. Her research was funded by RIVM and ZonM.
Lack of knowledge and skills
In addition to a lack of knowledge of the Dutch language, immigrants are also more likely to have limited skills when it comes to obtaining, understanding, assessing and using information to help them make decisions on their health. Moreover, there is often a taboo in the Turkish and Moroccan community to talk about diseases. Because such topics are hardly ever discussed, if at all, there is no exchange of information. This leads to a lack of knowledge.
According to Hamdiui, there is a need for information on the emotional, practical, cultural and religious aspects of screening, in addition to the factual medical information that is often provided. This is needed to give immigrants the best possible support when it comes to making an informed decision on taking part. The best way to provide this information is through audio-visual media, for example during information meetings in community centres and mosques.
Before deciding to take part in screening for disease, Turkish and Moroccan-Dutch immigrants consult their partner, close friends, daughters and GP. This suggests that one’s social network, rather than the individual, takes an important role in making screening decisions. Hamdiui believes that this should be taken into account when providing information on and inviting people to screening programmes.
Respondent-driven sampling, which has proven to be an effective tool to recruit immigrants to take part in research, shows potential when it comes to recruiting this group to take part in screening programmes.
Specific attention to hard-to-reach groups
RIVM is paying specific attention to providing people with a migration background with sufficient and high-quality information. As part of its efforts, RIVM is working together with Pharos to develop materials for immigrants as well as conducting other research into the information needs of hard-to-reach target audiences. All of its cancer screening leaflets have been translated into English, Turkish and Arabic. Partly as a result of this doctoral research, RIVM is now offering straightforward infographics and video animations translated into Turkish, Moroccan Arabic, Berber and English specifically for cervical cancer screening.