Rhoda Moise, Ph.D., an alumna of the Ph.D. in Prevention Science and Community Health program at the University of Miami Miller School of Medicine’s Department of Public Health Sciences, is the first author of a study published in the July edition of PLOS One focusing on cervical cancer prevention and control among Haitian women in South Florida.
Dr. Moise and the co-authors of the study conducted a statistical analysis to identify the barriers and facilitators to cervical cancer screening among Haitian women living in Miami-Dade County. The Miami metropolitan area has the largest community of Haitians living in the United States and although overall cervical cancer-related mortality has decreased in the U.S., women of African ancestry— including Haitian women in particular—experience a disproportionate burden of cervical cancer.
Study participants included Haitian women from 30 to 65 who live in South Florida and reported a lack of a Pap smear in the last three years.
“As a mixed methodologist, I see value in both quantitative and qualitative scientific inquiry," Dr. Moise said. "Results from this statistical analysis guided my qualitative research in Haiti, which was also published this year in the Journal of Health Education and Behavior."
A myriad of factors were evaluated in the study, including citizenship status, age, education, employment, access to care, marital status and insurance. Results of the study show that the predominant factor that predicted cervical cancer risk in Haitian women is citizenship status. Other significant variables included length of time in the U.S. and access to routine care.
Furthermore, perceived access to care proved to have a greater association than health insurance to a participant’s screening history. Education, employment and marital status served as facilitators and demonstrated a mild influence in predicting the women’s health and health behavior.
Women who are middle or older age were also more likely to report previous screening history compared to younger women.
“There is a Haitian proverb that says ‘A fish that dies in water did not drown,’ and I offer it as a metaphor inviting collective reflection on its mirror to our modern-day concerns of health,” Dr. Moise said.
Highlighting Targeted Interventions
Overall, the study highlights the need for targeted interventions to address the factors that influence HPV infection and related cancer among Haitian women. Findings from the study will inform public health planning and delivery of health care services to the population.
To improve health outcomes for Haitian women, future research should focus on HPV screening knowledge, attitudes, and behaviors as well as on access and barriers.
“We have to acknowledge our increasing globalization and connectivity alongside our moral imperative to address issues with a unified effort to promote wellness for all, systematically,” added Dr. Moise.
Co-authors of the study included Raymond Balise, Ph.D., M.A., assistant professor of biostatistics in the Department of Public Health Sciences, Camille Ragin, Ph.D., M.P.H., associate professor in the Cancer Prevention and Control Program at Fox Chase Cancer Center, and Erin Kobetz, Ph.D., M.P.H., professor and associate director of Population Science and Cancer Disparities at Sylvester Comprehensive Cancer Center.