LOXO-101 lenging within rural communities which
lenging within rural communities which demonstrate lower levels of screening mammography attendance.27 This situation is typically associated with lower levels of education and literacy which pre-vent engagement with publicity and promotional materials which encourage attendance.27,28 Self-referral screening mammography
may also be challenging in terms of physical accessibility and finding time to attend.18,28 The actions of physician's in explaining the procedure of mammography screening and formally recom-mending attendance at mammography screening determines a positive attitude towards mammography screening.14
A belief in folk medicine and the concept of Islamic predesti-nation (fatalism) have been identified as having a significant negative impact on a decision to attend for mammography screening.12,13 Predestination refers to the concept that LOXO-101 personal health has a religious predetermination and pre-empting the ex-istence of disease is to be avoided.26 Myths and hearsay evidence of the cause of breast cancer being related to envy or ‘red-eye’ may also act as barriers to attending mammography screening.29
The current study aimed to explore women's knowledge of BC and MSS as well as potential barriers which may act in preventing Kuwaiti women from attending MS.
The aim of the research, in exploring knowledge, attitudes and experiences determined that a qualitative methodology most appropriate.30,31 A qualitative approach allows the researcher to gather a rich, in-depth and meaningful understanding of an in-dividual's beliefs and experiences.32 The data gathered in the cur-rent study was thus collated using focus groups and within a pragmatic qualitative methodology.33,34 Focus groups provide participants a safe environment and the opportunity to discuss and share thoughts and experiences of a subject.35
Focus group interviews
The focus group interviews were completed during July 2017 and lasted for 90 min for Focus Group 1 and 75 min for Focus Group
2. Both focus groups were conducted through the medium of Arabic and the entire audio content of focus group discussions were digitally recorded for later transcription. The first author supervised the focus groups alone and was unable to also record any non-verbal communications. A topic guide (Appendix B) was used to
provide a degree of content structure and comparability to the focus group discussions.12,13 The topic subjects were derived from a review of previous literature.12,13,36
The pilot study
Prior to conducting the focus group sessions, the topic guide was used to direct two pilot study focus groups.37 Two pilot focus group studies were conducted using a convenience sample and included participates from a range of socio-economic backgrounds.
Ethical approval for the study was provided by Cardiff University Ethics Committee (School of Healthcare Sciences) in June 2016. The two socials organisations provided permission for hosting the focus groups and allowing contact of their respective members. Informed consent was also obtained from women who took part in the study.
The process of transcription of the focus group discussions and subsequent thematic analysis was conducted through the medium of Arabic to ensure that any subtleties in language were captured. To maintain anonymity each focus group participant was assigned a unique identifier. Thematic analysis was conducted using an approach developed by Braun and Clarke in which data is processed through six stages of analysis.38 Thematic analysis involved the researcher reviewing the transcripts on multiple occasions in order to initiate the process of coding, followed by the creation of themes and sub-themes (Fig. 1).38