Overcoming cultural barriers for better preventive health

Photo of women in a march supporting the Pink Sari projects — Women marching in support of the Pink Sari projects (photo supplied)

In NSW, free breast screening (mammogram) is a key preventive health service for women aged 50–74. But, while uptake rates among the general population are high, prior to 2014 the program was struggling to gain traction in Indian and Sri Lankan communities.

Poster for the Pink Sari ‘Melodies’ concert (supplied)

Enter the Pink Sari project, a community-led public health program designed to increase breast screening rates among Indian and Sri Lankan women in NSW. A collaboration between researchers in the UTS School of Communication and the NSW Multicultural Health Communication Service (MHCS), the program targeted women over the age of 50 who had arrived in Australia in the last three years.

The research team started with a simple question: why were only one in five women in the target community accessing breast screening services? A series of surveys and research focus groups revealed a surprisingly complex series of barriers to access.

“Among these women, we found that there were superstitions, cultural issues, modesty concerns, and there was also a belief that cancer is a death sentence, so if you’ve got it, what’s the point of finding out,” says project lead, UTS Distinguished Professor of Public Communication Jim Macnamara.

 “There was also a concern that if disease was found in a family, the marriage prospects of daughters would diminish.”

Poster for the Pink Sari ‘Portraits in Pink’ project (supplied)

The researchers found that most of these women looked to their local GP, other women in their community, or their daughters if they needed health advice, rather than relying on television advertising or translated government health information.

In response, the researchers and campaign organisers devised a community-led research strategy that brought together Sri Lankan and Indian women and women’s groups, migrant associations and health care organisations, including more than 100 GPs, to transmit positive information about breast screening within the community.

Together, the Pink Sari team rolled out more than 55 events, including a fashion show, a community march and a photography exhibition, which were attended by more than 10,000 women from Indian, Sri Lankan and other Asian backgrounds. A Facebook page and website were launched to support the outreach initiatives.

And it worked. Within two years, breast screening rates within the community had increased by a whopping 25 per cent – an unprecedented result. Today, Pink Sari is an incorporated organisation run and funded by the NSW Indian and Sri Lankan community.

The challenge of a project like this is the diversities within those communities. We overcame that by getting genuine participation from community members who were passionate about the addressing the problem and understood the audience.

— Michael Camit, acting director MHCS and current UTS PhD student

“I think the research team were open to the idea that we need to look at who’s speaking for the community. The community knows what they need to do.”