Abstract
Introduction:
Significant racial disparities persist in cancer outcomes, particularly among Black women, who have lower 5-year survival rates for diseases such as endometrial cancer (EC). Delays in detection contribute to more advanced-stage diagnoses and poorer prognoses, yet little is known about the specific cultural and structural factors influencing these delays among Haitian women. Existing studies often overlook how cultural beliefs, family dynamics, healthcare mistrust, and limited awareness of EC symptoms, such as abnormal vaginal bleeding, shape healthcare-seeking behaviors. This study explores how cultural factors influence healthcare-seeking among Creole-speaking Haitian women.
Methods:
We conducted four focus groups with 19 Haitian women under 50 years old. Data were analyzed using a Thematic Analysis (TA) codebook approach, structured around the Andersen Model of Total Patient Delay. Two independent raters coded the transcripts using NVivo qualitative software.
Results:
Six major themes emerged: Awareness and Understanding of Menopause, Information Seeking and Appraisal, Social Influence on Decisions, Stigma and Taboos, Access and Organization, and Traditional Practices and Beliefs. Participants exhibited limited awareness of EC, often attributing abnormal bleeding to non-cancerous causes like hormonal imbalances or contraceptive use. Cultural beliefs, family influence, reliance on traditional remedies, and spiritual practices contributed to healthcare delays. Barriers included financial constraints, long appointment wait times, and mistrust in healthcare providers. Participants preferred culturally tailored education and community-based resources for health information.
Conclusions:
Culturally sensitive interventions are essential to improve EC awareness, build healthcare trust, and reduce systemic barriers. Addressing traditional practices, family dynamics, and spiritual beliefs is key to promoting early detection and improving cancer outcomes among Haitian women.