Understanding strategies for promoting breast health among African immigrant women

Ebun O Ebunlomo, The University of Texas School of Public Health


Given recent global trends indicating breast cancer as the leading cause of cancer deaths among women in both developing and developed countries, the drastic increase in African immigration rate in the United States, and the current confounding categorization of African-born women as "African-American", we sought to explore factors contributing to breast health practices among African immigrant women in the United States. Three separate studies were conducted to: (1) describe determinants of breast cancer practices such as knowledge, beliefs and risk perception among Nigerian-born women in Houston, Texas; (2) develop recommendations for a comprehensive breast health promotion program for African immigrant women using Intervention Mapping; and (3) investigate the experience of surviving breast cancer among African immigrant women. This dissertation research project involved conducting semi-structured interviews with Nigerian immigrant women with no current or previous breast cancer diagnosis (n=20) to understand how breast cancer is perceived and factors contributing to breast health practices. Interviews were transcribed verbatim and analyzed using ATLAS.ti (Version 7.0). Respondents expanded the scope of the study's intended focus on breast cancer prevention to promotion of women's health in general. They expressed broader beliefs associated with health promotion and disease prevention, described their overburdened lives as African immigrant women in the U.S. and identified unique problems related to breast health. In addition, we found only one intervention on women's health promotion targeting African immigrants; however, this intervention was not systematically developed, and it was not grounded in any behavioral theory of change. Hence, Intervention Mapping was employed to develop recommendations for a comprehensive, multi-level breast health promotion program based on literature review and qualitative inquiry findings. Four (4) program planning matrices were developed containing twenty (20) performance objectives across six (6) behavioral and environmental determinants. We also provide preliminary results from a pilot test of selected program components, and recommendations for outcome and process evaluation plans. Finally, the last phase of this dissertation endeavor involved key informant interviews with ten (10) African-born breast cancer survivors about their experience post-diagnosis. Participants were from Nigeria, Uganda and Kenya. The four major themes that emerged for the ten narratives are: Sub-minority status (Africans versus African-Americans), Exposure, Womanhood / Sexuality, and Linguistic Gap / Lost in Translation. To our knowledge, this study represents the first formative research endeavor exploring the experience of African breast cancer survivors, and it shows a unique perspective on how these women conceptualize their experience with breast cancer. It also provides great insights into how African immigrant women see themselves in relation to other breast cancer survivors living in the United States.

Subject Area

Black studies|Behavioral psychology|Womens studies|Public health|Health education|Oncology

Recommended Citation

Ebunlomo, Ebun O, "Understanding strategies for promoting breast health among African immigrant women" (2014). Texas Medical Center Dissertations (via ProQuest). AAI3665083.