Photovoice on Cervical Cancer Screening, Care, Barriers, and Healthcare Policy and Practice Implications among Hispanic Women in El Paso, TX
Introduction
Cervical cancer continues to be the fourth most common type of female cancer, with around 600,000 new diagnoses and 340,000 fatalities annually. Cervical cancer is primarily caused by the human papillomavirus (HPV), which is a sexually transmitted virus that can be prevented and detected early with vaccination and adequate screening. Despite high-income countries like the United States benefitting from national policies like Medicaid expansion and the Affordable Care Act, these more developed areas of the world still suffer from disparities within their own populations, with disproportionately low screening and vaccination rates among people of color, members of the LGBTQI+ community, and individuals with low income and who live in rural areas. HPV detection and vaccination are especially relevant and important for Hispanic women living in the U.S.-Mexico border region because this population tends to experience much higher cervical cancer incidence and mortality rates than white women. Several studies have explored factors affecting HPV prevention and cervical cancer screening among Hispanic women, but the experiences of Hispanic women who have had cervical cancer have rarely been studied.
Methods
This study used the Photovoice methodology, an evidence-based practice utilizing the Participatory Action Research (PAR) method, to gather personal narratives from ten Hispanic women in the El Paso, Texas area who have lived with cervical cancer and to advocate for political action on their behalf. Participants took photos of their daily lives and discussed their life, health, and social conditions to develop a call to action for community leaders and decision makers.
Results
Participants identified several themes that permeated the discussions: 1) education about and access to cancer prevention, vaccination, and detection; 2) strength, hope, and resilience to fight in the face of cancer; and 3) cultural, structural, and systemic barriers including low income, migrant status, lack of health insurance, and prescriptive gender stereotypes.
Conclusion
Sessions were concluded by forming a call to action with policy and practice recommendations and other implications for healthcare professionals and future researchers including increased education and awareness; greater free or low-cost access to screening, vaccination, and treatment; and greater cultural competence in terms of translation/bilingual service provision and practitioner empathy and sensitivity. An advisory committee made up of doctors, nurses, health workers, and other important community leaders convened to discuss the study's findings and disseminate them into political action.