Impact of traditional Samoan lifestyle (fa’aSamoa) on cancer screening practices

Background: The Samoan way of life, or the fa’aSamoa, is a collection of practices and rituals by which Samoans conduct their lives. The purpose of this study was to explore the possible influence of the fa’aSamoa on cancer prevention practices. Methods: The investigators conducted six focus groups; three in Carson, California and three in Pago Pago, American Samoa among 60 men from the communities, matai (chiefs), faifeau (pastors). Using a discussion guide, bilingual Samoan moderators asked questions about the fa’aSamoa, how traditional cultural practices might influence cancer prevention, and whether certain aspects of the fa’aSamoa could be incorporated into cancer screening programs to improve screening rates. Through qualitative content analysis, the investigators identified major themes and came to a consensus about them. Results: The mean age of the 60 participants was 61 years, all were married, 50 were born in American Samoa, and 10 were born in the Independent State of Samoa. Among the themes, three were particularly important. First, participants confirmed that the fa’aSamoa remains an important concept in Samoan life. Second, they believed that disease prevention was not an integral part of the fa’aSamoa. Indeed, traditionally modesty and reluctance to discuss personal issues may inhibit use of screening services. Despite these a beliefs, a third theme emerged. Because of the influence of the matai and faifeau in the fa’aSamoa, participants stressed that seeking input from these leaders could improve cancer prevention programs. Conclusion: The lack of emphasis on disease prevention in the fa’aSamoa may contribute to low cancer screening rates. However, other aspects of the culture, such as the respect for matai and faifeau could be incorporated into cancer prevention programs aimed at improving cancer control among Samoans.