Title of Work

Facilitators and Barriers of Cervical Cancer Screening and Human Papilloma Virus Vaccination Among Somali Refugee Women in the United States: A Qualitative Analysis

Document Type


Publication/Presentation Date

Winter 1-2019

City of Publication or Presentation

Newbury Park, CA

Journal Title

Journal of Transcultural Nursing

Journal ISSN






First Page


Last Page




Cervical cancer screening rates among immigrant and refugee women are substantially lower than among non-immigrants, particularly for Somali refugees. The purpose of this study was to explore the facilitators and barriers to cervical cancer screening and HPV vaccination among Somali refugee women and their children.


Focus group discussions were conducted with Somali refugee mothers who had at least one child between the ages of 9 and 17 and who resided in Minnesota. Facilitators used a focus group question guide to explore facilitators and barriers to cervical cancer screening for women and HPV vaccination for their children. Investigators performed a systematic, comparative, and thematic analysis by coding and grouping focus group transcripts thematically. Data were analyzed in four major themes: 1) knowledge, 2) facilitators, 3) decision making, and 4) intervention strategies.


A total of 31 women participated in three focus groups. All participants had heard of cervical cancer; fewer had heard of HPV and HPV vaccination (n=20). Doctor recommendation and support from family members, particularly husbands for those who were married, were important facilitators for the participants to obtain screening, though all participants reported themselves as the person making their own health decisions. Community education was the most popular strategy in promoting screening and vaccine uptake.


Somali refugee women are eager to learn more about cervical cancer, screening, and HPV. Targeted interventions should aim to increase knowledge with husbands as important figures in reducing cervical cancer morbidity in the Somali community.

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