ArticleInternational journal for equity in health2026
Understanding cancer screening participation patterns among first-generation migrants in Germany: a typology based on the intersections of hindering and facilitating factors.
Article in International journal for equity in health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCancer screening (CS) is a core element of preventive care. While international studies highlight that individuals with migration backgrounds often show varied participation in CS, there is a lack of specific evidence regarding first-generation migrants from Middle Eastern countries in Germany. This study aims to bridge that gap by examining CS participation patterns within this group and exploring how individual, social, and structural factors influence these patterns. The focus on Middle Eastern migrants is particularly important due to recent shifts in migration trends, which have led to an increase in the number of individuals from this region relocating to Germany.
methodsWe conducted a qualitative, triangulated study with two datasets: interviews with laypersons (LPs; n = 18) who are first-generation migrants, and interviews with healthcare professionals (HCPs; n = 17) (first or second generation) across disciplines related to CS; all with ties to Middle East countries. LPs were recruited and interviewed by community researchers; HCPs via physician registries and by academic researchers. Interviews were carried out online or in person, recorded, translated, and transcribed. Analysis followed qualitative content analysis within a socioecological framework. A typology of participation patterns was developed from LP interviews and contextualised with HCP accounts.
resultsCS participation was shaped by interdependent influences across individual, social, and structural levels, including knowledge and perceptions of prevention, language skills and available interpretation services, family roles, network support, organisational procedures, and experiences in care encounters. Comparative analysis of LP and HCP material identified convergences and divergences in how conditions for participation are perceived and navigated. Based on these dynamics, we identified four participation patterns: prevention-oriented, situational, withdrawn/resigned, and marginalised.
conclusionsParticipation among first-generation migrants from Middle East countries is best understood as patterned engagement shaped by intersecting conditions. The typology makes these patterns visible and provides an analytic basis for context-sensitive health promotion. Practically, the study underscores the value of participatory, multilingual approaches in research and the importance of organisational health literacy and communicative and structural competence to support equitable access to preventive services.
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