Introduction
Health promotion is a behavioral social science that draws from the environmental, biological, physical, psychological, and medical sciences to promote the health of individuals and prevent diseases, premature death, and disability by educating the community. The main purpose of health promotion is to positively influence the health behavior of communities and individuals. There have been increased efforts for cervical cancer screening using PAP tests, which have led to the declining mortality rates, especially in the developed countries like the United States (Abboud et al., 2017). However, this has not been the case for middle eastern women. The screening rates for these women remain low even for those who are located in developed countries, which puts them at a higher risk of advanced cervical cancer and poor health outcomes. Considering that cervical cancer is almost entirely preventable or curable if it is detected early middle eastern women must begin undergoing PAP smears (Vahabi & Lofters, 2016; Ziaei, Farahmand Rad, Rezaei Aval, & Roshandel, 2017). This is the only way that they can detect the cancer early and undergo treatment if it is detected. The reasons leading to the women not undergoing the tests should be established and solutions developed to ensure that the health of these women is promoted and they too can have better health outcomes. This paper will cover the issues faced by middle eastern women in their attempt to access treatment and the reason why they do not undergo PAP smear tests. This will offer vital information that can be used to develop solutions that will be culturally sensitive and acceptable to the women. We will also analyze the goals of the intervention to create a plan that can be implemented to address the clinical issue.

Importance

Health promotion focuses on preventive measures to ensure that a disease does not occur and the health of the community is maintained (National Council of State Boards of Nursing, 2019). Regular preventive care has been recognized to be one of the most vital ways of maintaining a person's health over time. If one waits to see a doctor only when they notice a problem, then it might be too late. For the sexual health of women, cervical cancer screening is especially important. It is recommended that they should begin undergoing PAP smear tests every two years once they are 21 years old and decrease the frequency to three years once they attain 30 years and they have had three normal PAP smear results in a row (Abboud et al., 2017). PAP smears can detect any precancerous changes on the cervix and this allows one to undergo treatment early and prevent the spread of the condition. With early screening and detection, it is possible to treat the condition before it turns into cancer. Many women are at risk of cervical cancer ad are warned that they might not feel any symptoms even when they are infected with HPV. The only way that this can be screened for is by undergoing regular PAP smear tests. Therefore, to ensure that one is safe and avoids having to treat the cancer one needs to undergo the screening as required. To assist in reducing the rates of death caused by cervical cancer, women should be educated on the importance of undergoing the test and be advised on what to expect (Ziaei et al., 2017).

Patient Population

The patient population under focus is middle eastern women who reside in the United States. It has been established that these women are not aware of the PAP smear test and without the necessary education most of them have not and will never have one. It is estimated that the rates of cervical cancer amongst middle eastern women are set to double by 2035 and this is attributed to a lack of awareness and screening. According to Ali, Skirton, Clark, and Donaldson (2017) in 2018, over 20,000 women suffered from cervical cancer in the Middle East and this led to 11,870 deaths. Without screening, the mortality rates will continue to rise and more and more women will be falling sick from a disease that is preventable and curable. Some difficulties are faced by the women in accessing health care and this is further compounded when it comes to sexual health information (Vahabi & Lofters, 2016). Culturally, middle eastern women shun from the sexual talk and they perceive their private parts can only be seen by their husbands. This results in many of them avoiding visiting hospitals for vaginal screenings even when they are sick or expectant. Having male physicians makes it even hard for them to open up and speak openly regarding sexual healthcare. Another difficulty is the language barrier. Without translators, it becomes hard to explain to the women the importance of cervical cancer screening using PAP smear, which results in most of them not undergoing the test. However, this trend is changing even though at a slower pace than would be expected. Many young middle eastern women are aware of the importance of undergoing these tests and they are willing to go for screening. The issue lies in the women who have held on to the religious pedagogy and strict regulations regarding modesty....…education that is well structured and will be focused on their cultural requirements. Health educators are trained on how to handle different aspects of health promotion and they can liaise with the community leaders to prepare the material in an acceptable format. Having a trained educator will maintain focus on the training and the women can create bonds with the educator without it jeopardizing the proposed plan (Endeshaw et al., 2018). Public health officers can analyze a community and determine the prevalence of the disease. Being able to identify the needs of a community is vital for the success of the proposed plan. The public health officer will visit communities and interact with the members to determine their needs and the challenges the community faces. The women community leaders are vital for the plan since they are charged with discussing and translating the information to suit the community. Most of the women will listen to their community leaders since they are afraid. With the involvement of the community leaders, the women will embrace the training and the training can be formulated to suit their cultural needs with the guidance of the leaders. With guidance from the community leaders, the program can be scheduled to suit the women in terms of training hours and age. The older women would prefer to attend sessions that are not inclusive of the young women or girls and vice versa.

Conclusion

This paper covered the need to improve the sexual health care of middle eastern women by encouraging them to undertake PAP smear screening as required. It has been established that as much as other women have embraced screening, the screening rates of these women are still low and there is a need to uncover the underlying factors. Culture and religion play a huge role in being a barrier and to overcome these barriers there is a need to have sexual health education to impart knowledge on the women on the advantages of undergoing screening. Our plan focuses on educating the women on the advantages of screening and how this will benefit them. The unmarried women are also taught how safe the procedure is and it will not rapture their hymen. The screening will improve the health of the women and reduce the mortality rates caused by cervical cancer. Addressing this clinical problem is vital for the middle eastern women as it will ensure that they do not suffer from a disease that can be prevented and cured. The women will also benefit in terms of understanding their bodies and they can openly share sexual health information with each other.…