Minority ethnic women and cervical screening: a matter of action or research?

Abstract

Concerns over low uptake of cervical screening among minority ethnic women have spurred much research and practical activity to address the problem. Due to theoretical and methodological difficulties, research in this area has tended to focus on the communication deficit of women, without addressing the social context. This has not only hindered a wider theoretical understanding of the problem but, also, has perpetuated ineffective health promotion practice in this area. Using a participatory action research (PAR) approach, the project ‘Woman-to-woman: promoting cervical screening to minority ethnic women in primary care’, tackled the problem by involving both health professionals and women from the communities. Working in partnership, both professional and lay participants identified the problems from their own perspectives and generated solutions to resolve them. An intervention strategy was formulated in which bilingual women from the communities were recruited as community health educators to provide an informed link between their respective communities and the primary care sector. The outcomes of the intervention were evaluated by all participants. This paper aims to introduce PAR as an alternative approach by presenting an overview of the study. It begins by highlighting some of the common theoretical and methodological problems encountered by researchers; and then introduces the research framework of PAR and describes the research processes. A case observation is presented to illustrate the depth of understanding of the screening processes that can be obtained using this approach. The project has demonstrated that applying PAR cannot only lead to meaningful discoveries and insights into the problem of minority ethnic women and cervical screening, but also change in health promotion practice, which would have been difficult to achieve using a conventional research model. However, this study has also revealed major limitations of PAR, which need to be addressed if the approach is to be further developed.