Community collaboration to increase foreign-born women’s participation in a cervical cancer screening program in Sweden: a quality improvement project
Journal article, 2014
Introduction: The prevailing inequities in healthcare have been well addressed in previous research, especially
screening program participation, but less attention has been paid to how to overcome these inequities. This paper
explores a key factor of a successful improvement project: collaboration with local doulas to raise cervical cancer
screening participation by more than 40 percent in an area with a large number of foreign-born residents.
Methods: Data was collected through two focus group discussions with the doulas in order to design
interventions and debrief after interventions had been carried out in the community. Various tools were used to
analyze the verbal data and monitor the progress of the project.
Results: Three major themes emerged from the focus group discussions: barriers that prevent women from
participating in the cervical cancer screening program, interventions to increase participation, and the role of the
doulas in the interventions.
Conclusions: This paper suggests that several barriers make participation in cervical cancer screening program
more difficult for foreign-born women in Sweden. Specifically, these barriers include lack of knowledge concerning
cancer and the importance of preventive healthcare services and practical obstacles such as unavailable child care
and language skills. The overarching approach to surmount these barriers was to engage persons with a shared
cultural background and mother tongue as the target audience to verbally communicate information. The doulas
who helped to identify barriers and plan and execute interventions gained increased confidence and a sense of
pride in assisting to bridge the gap between healthcare providers and users.
Cervical cancer screening