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Latest News
Dr.Padela recently got published in the Chest. The manuscript uses a clinical case to work through Muslim controversies over brain death and withdrawing life support Here is the link
The recording for our Live Webinar on "Advancing equity for Muslim physicians in the healthcare workforce" and the policy report that stems from our research is available now at : click here

A Religiously-Tailored Mammography Intervention for American Muslims

Overview

Generally mistaken for a small homogenous group, American Muslims are many and diverse. Because of this diversity, and because national health care surveys and databases typically do not collect religious affiliation data, there is limited data on aggregate female American Muslim breast cancer incidence and outcomes; what is known is based on ethnic group data and community surveys. Ethnic group data suggest that Muslim women present with breast cancer at a younger age, with a more advanced stage, making breast cancer an important health challenge for the community. Despite the fact that adhering to regular mammography can overcome this challenge. Studies have shown poor mammography adherence rates among Muslim women in the USA.

While other factors impacted the women adherence to mammogram, religious beliefs have greatly impacted Muslim women’s attitude towards mammography screenings. Among Muslim women in the USA, the project initially began by seeking to understand how religion impacts screening behaviors and attitudes towards mammography in an ethnically and racially diverse group of Muslim women. Results from our research were used to create religiously-tailored, peer-led group educational workshops conducted in mosques.

Objectives

1

Filling in critical gaps in knowledge about how Islam influences cancer screening behaviors.

2

Providing a model for how to partner with mosque communities to conduct a religiously and culturally-tailored mammography promoting program.

3

Designing an intervention that increases mammogram screenings, knowledge and behavior among Muslim women

Background

Breast Cancer & Mammography

Breast cancer is the second leading cause of cancer death among American women, and screening mammography is a proven method to reduce mortality from this cancer.

Screenings Disparities Among Muslim Women

Our research in Chicago

  • 37% of women (n=254) in the Chicago area had not obtained a mammogram in the last 2 years.

Why mammogram screenings are low among Muslim women?

Islamic beliefs have significant impact on Muslim behaviors toward cancer screenings. Additionally, Muslim women in the USA face multiple layers of barriers to adhere to mammogram screening

Our research in Chicago

  • 37% of women (n=254) in the Chicago area had not obtained a mammogram in the last 2 years.

Why the need to create a religiously tailored intervention for American Muslim Women?

The need to create a religiously tailored intervention for American Muslim Women

Finding from our research showed that religious believes influence decision to pursue mammography across ethnic racial diversity of Muslim woman:
  • Modesty is a significant Islamic ethic impacted behavior which influenced Muslim women decisions to obtain mammograms.
  • Fatalism is the belief that health outcomes are inevitable and controlled by God delayed Muslims women from having breast cancer screening.
  • Using religious coping methods, for example reading Qur’an, to deal with life stressors decreased the likelihood of Muslim women to adher to mammogram screenings.
  • The notions about duty to God and the stewardship of one’s body, enhanced Muslim women intention to get mammography.
  • Perceived religious discrimination in healthcare sittings negatively affected Mulsim women adherence to mammogram.

Methodology

Process of Developing Religiously Tailored, Evidence-Based Health Education for Muslim American Women

Community Partnership
Building
  • Council of Islamic Organizations of Greater Chicago
  • Muslim Women Resource Center
  • Arab American Family Services
  • Compassionate Care Network
  • Orland Park Prayer Center (Arab)
  • Mosque Foundation (Predominantly Arab)
  • Muslim Education Center (South Asian)
  • Nigerian Islamic Assoc. of USA (Nigerian)
Evidence
Gathering

In this stage we explored factors effecting mammogram screening among Muslim women using conducted surveys, focus groups, and individual interviews.

Intervention
Design

We used evidence based and theory driven means to creating our intervention.

Employed 3R model was used to create workshops contents and dissemination materials.

Implementation
  • A “Caring for Body and Soul women’s health” one day workshop was held 2 times at MEC (Muslim Education Center) and OPPC (Orland Park Prayer Center).
  • Peer-educators and guest lecturers, including a religious scholar and female physician, delivered didactics and facilitated discussion sessions on: breast cancer, mammography screening guidelines, religion and health, accessing resources for breast cancer screening.
  • Three khutbas (sermons) in the Chicagoland area were performed at the two partnered mosques ( MEC and OPPC). After the informative khutbas, surveys were conducted and responses of the survey were analyzed.

Project Outcomes

  • Significant increase in the level of knowledge about breast cancer and mammogram among Muslim woman
  • 58 Muslim women completed the workshop. Among them 29 participants had never obtained a mammogram, and 29 participants had not received a mammogram within the last two years. Read More
  • One year after the intervention, 22 participants (38%) received a mammogram.
  • After intervention, women reported likelihood of obtaining a mammogram increased.

chart

Publications

  1. Associations between religion-related factors and breast cancer screening among American Muslims J Immigr Minor Health. 2015
  2. Developing religiously-tailored health messages for behavioral change: Introducing the reframe, reprioritize, and reform (“3R”) model Soc Sci Med . 2018
  3. Changing Mammography-Related Beliefs Among American Muslim Women: Findings from a Religiously-Tailored Mosque-Based Intervention J Immigr Minor Health . 2019
  4. Reducing Muslim Mammography Disparities: Outcomes From a Religiously Tailored Mosque-Based Intervention Health Educ Behav . 2018
  5. Religious beliefs and mammography intention: findings from a qualitative study of a diverse group of American Muslim women Psychooncology . 2016
  6. Muslim women’s perspectives on designing mosque-based women’s health intervention—An exploratory qualitative study
    Women & Health . 2018
  7. Acceptability of Friday Sermons as a Modality for Health Promotion and Education
    J Immigr Minor Health . 2018
  8. Adapting a religious health fatalism measure for use in Muslim populations Plos One . 2018
  9. The Development and Validation of a Modesty Measure for Diverse Muslim Populations Journal of Religion and Health volume . 2019
  10. Muslim women’s perspectives on designing mosque-based women’s health interventions—An exploratory qualitative study
    Women & Health.2017
  11. Predictors of Delayed Healthcare Seeking Among American Muslim Women
    Journal of Women’s Health . 2016
  12. Associations between religion-related factors and cervical cancer screening among Muslims in greater chicago
    J Low Genit Tract Dis . 2014

Presentations

  1. addressing muslim mammography disparities through a religiously-tailored intervention
  2. Addressing Muslim Mammography Disparities Through A Religiously Tailored Intervention
  3. Identifying And Intervening Upon American Muslim Health Disparities
  4. Imams & Health Promotion
  5. Incorporating Religious Authorities And Scripture In Health Interventions
  6. Isna: Women’s Health Matters
  7. Leveraging Religious Networks To Promote Breast Cancer Screening Amongst American Muslim Women
  8. Leveraging Mosques To Promote Breast Cancer Screening Amongst American Muslim Women
  9. Developing A Religiously Tailored Intervention To Enhance Mammography In Mosque Communities
  10. Reducing Muslim Mammography Disparities: Outcomes From A Religiously Tailored Mosque-Based Group Education Intervention
  11. Religious Concepts & Breast Cancer Screening Practices In The Greater Chicago Muslim Community
  12. Religious Concepts & Breast Cancer Screening Practices In The Greater Chicago Muslim Community
  13. Religious Influences Onhealth Care Practices Among American Muslim Women
  14. 13. Religiously Tailoring Messages To Enhance Mammography Intention Among Muslims
  15. Exploring Associations Between Breast Cancer Screening Practices & Religious Concepts Among American Muslims
  16. Muslim Women’s Perspectives On Designing Mosque-Based Women’s Health Interventions
  17. A Religiously-Tailored Intervention To Enhance Mammography Uptake Among Muslims
  18. The Influence Of Religion Upon American Muslim Mammography Beliefs And Practices
  19. The Influence Of Modesty Concerns And Fatalistic Beliefs Upon Breast Cancer Screening Practices Amongst American Muslims
  20. Understand American Muslim Communities

Community Conferences

  1. Muslim Clinicians in the Medical Academy, Anesthesiology Grand Rounds DEI, Medical College of Wisconsin, Milwaukee, WI, 2/2022.
  2. Being Muslim in Academic Medicine, Nagamia Institute of Islamic Medicine and Sciences (NIIMS), Rolling Meadows, IL, 7/2022.
  3. Accommodating Muslim Values in Healthcare, Medical College of Wisconsin, Milwaukee, WI, 8/2022.

Posters

Media Highlights

Links to Resources

  1. Know Your Rights – A fact sheet describing religious rights in the workplace and what steps to take if your rights have been disregarded, Muslim Advocates.
  2. Filing a Conscience and Religious Freedom Complaint – File a complaint online about religious discrimination. Federal Conscience and Religious Freedom Laws help to protect you from coercion, discrimination on the basis of conscience or religion, and burdens on the free exercise of religion, Office of Civil Rights.
  3. Ḥijāb in the OR – A guide to ḥijāb in the operating room, written by Dr. Deena Kishawi.

Tool Kits

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    Meet The Project Team

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    Aasim I.Padela, MD,MSc
    (Medical College of Wisconsin & The Initiative on Islam and Medicine)
    Dr. Sarah Alkhaifi
    (Assistant professor at King Abdulaziz University)

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    Case and Reason

    The opinions expressed in this publication are those of the authors. They do not reflect the opinions or views of the grant funding organizations.

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    Mufti Nazim Khutbah

    Padela Khutbah

    Shkifah Khutbah

    Intervention Study

    Qualitative Study and Interviews

    Fifty Muslim multiethnicity women (40 years old and above) were interviewed (6 focused group) and 19 in individual interviews. We found religious beliefs did informed mammography intention, which includes (1) the perceived religious duty to care for one’s health, (2) religious practices as methods of disease prevention, (3) fatalistic notions about health, and (4) comfort with gender concordant health care.

    Quantitative Study and survey

    240, 40 years of age or older, were surveyed (72 respondents were Arab, 71 South Asian, 59 African American, and 38 from another ethnicity). We found that positive religious coping and perceived religious discrimination in health settings significantly (negatively) affected mammogram adherence among Muslim women in Chicago.

    American Cancer Society mammogram recommendations

    Mammogram recommendation for women at average risk or breast cancer

    • Women between 40 and 44 have a choice to have a mammography every year.
    • Women 45 to 54 should get mammograms every year.
    • Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms.

    3R model

    Reframing “switch train tracks”
    • Keep the barriers belief intact but change the way one thinks about it so it is consonant with the desired health behavior
    • Normalizes the barrier belief
    Reprioritize: “show them a better train”
    • Introduce a new belief and create higher valence for it than the barrier belief
    • Normalization of the barrier belief is optional
    Reform: “breakdown the train carriage”
    • Negate the barrier belief by demonstrating its faults by appealing to authority structures

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