For Immediate Release: June 29, 2023; Houston, TX
While cervical cancer is highly preventable and treatable, it’s still a devastating killer for many African American women. In the U.S., African American women are 75 percent more likely to die from it, according to the American Cancer Society.
For HEALTH Research Institute’s Dr. Chakema Carmack, Ph.D., the grim statistics proved to be a call to action with the launch of a new research initiative. If cervical cancer is detected early, it has a 5-year survival rate of over 90 percent. While HPV is the leading cause of cervical cancer, there is an effective vaccine. Screenings, including HPV and Pap tests, can detect early changes in cervical cells which lead to cervical cancer risk.
“Science is what has guided this initiative,” Carmack said. “You mean to tell me that cervical cancer is 93% preventable and Black women are dying at nearly double the rate of other groups? That was the biggest “Aha!” moment. When I found out that cervical cancer is 93 % preventable, this was my Aha! moment that this was not right. Why are more Black and Latino women dying from it?”
Carmack launched a culturally-tailored pilot project entitled, “Proof of Concept and Feasibility in Podcasting Cervical Cancer Prevention for African American Women.” The initiative was funded for $49,801 by the NIHMD and HEALTH-RCMI [PI: Dr. Ezemenari Obasi]
In this novel study, approximately 40 participants are asked to evaluate and rate their perceptions and attitudes about cervical cancer. Interestingly, five categories emerged that were of particular importance to the group: cancer screenings, support system, cervical cancer 101 (knowledge), fatalism, and ease of prevention.
This process, called “concept mapping” helped create a socio-culturally responsive cervical cancer prevention podcast video, leveraged from the concept map findings. Specific socio-cultural findings were highlighted through this process.
“When it came to support system, health insurance was often the issue which gave me a good indication of public health information in these communities, because many women don’t know they can get free or low-cost Paps,” Carmack said. “Also, with social media—this came out in support system. In every map, most of the social media aspect was in support system, so this told me that social connection goes as deep as ‘support’ now. That is so interesting to me.”
After analyzing the insights from the initiative, Carmack realized how crucial it was to promote women’s health issues on social media sites since many of the women in the study reported not seeing or discussing HPV, Paps, or cervical cancer prevention in the social media spaces.
During the Concept Mapping phase, participants were given 63 index cards which contained statements that they rated in order of their individual importance, which ranged from, “I know that cervical cancer may run in the family,” to “health insurance would make it better to stay up to date on my pap smears.” and many other concepts.
“These statements had to do with attitudes about cervical cancer prevention, plus self-efficacy—are you able to do it?” Carmack said, “Also--what are the barriers that are preventing you from do it? And then norms and environment—like my mom’s telling me about the annual pap smears.”
In a review of the most profound findings of this phase, Carmack realized that one of the most significant factors for women’s comprehensive knowledge of cervical cancer was the impact of the mother.
“Another big Aha! moment of the study was actually the impact that mothers have on African American women,” Carmack said.“Some of the women talked about other things that mothers told them about—moms who did talk about sexual behavior and topics like that. However, when it came to actually going to the doctor and seeking preventative care, some don’t get that.”
Throughout the Concept Mapping phase, Carmack’s research team discovered that there is still so much that needs to be done in terms of educating the public about cervical cancer.
“A big part of my takeaway is that this information needs to be out there,” Carmack said. “We’re talking about a culture of health which must start at the household. What’s inside the household? Your mom and sisters are in the household. The idea of prevention really needs to be public knowledge.”
At this juncture of Carmack’s pilot project, the Concept Mapping phase has been completed, and a video was created from the findings. Carmack added that the video’s premise highlights a uniquely personal struggle between two sisters about the topic of cervical cancer and annual prevention checkups (i.e., Pap test).
“We came up with the idea of two sisters whose mom had a scare about cervical cancer. Then one older sister asks her little sister, ‘have you made your doctor’s appointment?’” Carmack said. “We had professional writers and theatre actors who collaborated on the video.”
The next phase for Carmack is the podcasting process, with her first podcast launching in late June. Carmack and her research assistant, Taylor Colman, M.A. have set up a few podcasting opportunities on platforms including Action One Media. The podcasting initiative is a way to convey the crucial message of cervical cancer prevention to the greater Houston community.
“We plan to talk about cervical cancer prevention as well as the video we created on the podcasting platforms,” Carmack said. “The plan is for the podcasting interviewers to watch the film, and then the interviewers to discuss it more--what was found, what does it mean, what are we doing in public health. The podcast phase is a deeper discussion with the community.”
For Carmack, advocating for cervical cancer ignites her passion in the arena of public health.
“It feels good to bring awareness. It feels responsible and responsive,” Carmack said. “At minimum, it’s 93 percent preventable. At maximum, we’re getting to 98 % preventable. This cancer shouldn’t exist. When it comes to social determinants of health, women of color have all those other things stacked against them. Let’s make sure cervical cancer is one less cancer to mess with.”
—Alison Medley
If you would like more information about this topic, please contact Alison Medley at 713.320.0933 or email aemedle2@central.uh.edu