Peer-led, faith-based co-designed intervention to improve Muslim women's cancer screening: results from the IMCAN...

Cancer screening saves lives, but Muslim women are less likely to participate in screening than the general population. This makes them less likely to benefit from earlier diagnosis. Faith-based cancer communications provide an acceptable strategy for addressing screening barriers. Hence, we evaluated the impact of a faith-based intervention on knowledge, attitudes, and breast, cervical and colorectal (bowel) screening practices of Muslim women in the UK. Our intervention was a co-designed, peer-led, two-hour workshop informed by the Integrated Screening Action Model (I-SAM) and 3R religiously-tailored messaging model, included peer-led discussions about cancer screening, GP-led education on screening, testimonials from Muslim women, and a female religious-scholar led didactic on Islamic perspectives on screening.

In 2024, as part of a non-randomised feasibility and efficacy trial, the workshop was co-delivered 16 times, face-to-face or online, with 169 Muslim women in Glasgow and North-East England who were not up-to-date with at least one screening programme. Consistent with I-SAM, outcomes included screening knowledge, attitudes, intentions and self-reported uptake measured at baseline, post-intervention, and 6-and 12-months. Changes from baseline were evaluated with paired tests. Linear regression was used to assess associations with socio-demographic and attitudinal covariates.

Participants were aged 25-74 (mean 47), and 128 (76.6%) identified as South Asian. Mean cancer knowledge more than doubled from pre-intervention to 12-month follow-up (from 3.2/14 to 7.4/14; mean change = 4.2 [95% CI 3.6, 4.8]). Some attitudes changed significantly (e.g., risk perception), although others did not (e.g., worry about male providers). Intention to engage in screening increased significantly from pre-intervention to 12-months for breast (55 to 92%, change = 37% [22, 52%], n = 38), cervical (43 to 83%, change = 40% [29, 51%], n = 100), and colorectal (35 to 85%, change = 50% [28, 72%], n = 20). Among participants invited for screening during 12 months-follow-up, self-reported uptake was 70% (n = 14/22) for breast screening, 87% (n = 41/50) for cervical screening and 91% (n = 10/11) for colorectal screening.

This is the first evaluation of a peer-led, faith-based intervention for British Muslim women and suggests it may be effective in improving screening knowledge, attitudes and behaviour. Further research is needed to determine intervention effectiveness in larger and more robust studies.