Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Kathy Shadle James, DNSc., APRN, FAAN, Committee Chairperson; Jane M. Georges, PhD., RN, Committee Member; Bulaporn Natipagon-Shah, PhD., Committee Member


Cervical Cancer, Second-Generation, Second-Generation Thai American, Thai, Thai American


Background: Cervical cancer is one of the most preventable diseases in the United States (US) (Center for Disease Control and Prevention, 2015a). Despite advances in early detection and a vaccine available, it continues to affect Southeast Asian American (SEAA) women in high numbers. Multiple barriers to cervical cancer screening are seen among SEAA women, which include acculturation, age, marital status, apprehension, financial burden, access to healthcare, and knowledge about cervical cancer, screening, and preventative health (Ho & Dinh, 2010). Studies on SEAA women and cervical cancer screening primarily involve women who were born in Southeast Asia. These studies have not considered SEAA women born in the US (second-generation) who have very different lived experiences and influences than those of their mothers. There is only one study published on Thai American women and cervical cancer, and all participants were born in Thailand.

Aim: The specific aims of this study are to explore the perceptions of second-generation Thai American women towards cervical cancer screening, explore how second-generation Thai American women make decisions about seeking cervical cancer screening services, and to initiate development of a theory, grounded in the data, regarding second-generation Thai American women and cervical cancer screening.

Methods: This is a qualitative study and inspired by the constructivist approach to grounded theory. The researcher’s subjectivity and involvement with constructing and interpreting data are acknowledged in constructivist grounded theory. By using detailed reflexive memoing and constant comparison, the researcher’s stance and positionality is continuously integrated into the data (Charmaz, 2014).

Findings: Semi-structured interviews were conducted with 12 participants. Four themes emerged from the data: being proper, avoidance, realization, and feeling empowered. Participants described experiencing these themes over a period of time with influencing factors in each stage whether it be family, cultural values, society, healthcare providers, friends, the internet, or outreach programs.

Implications: Cervical cancer focused educational outreach programs for second-generation Thai American women should occur in college or sooner. Healthcare providers need to be sensitive to the generational differences of immigrant groups, and to be aware that their needs may be different.

Document Type

Dissertation: Open Access