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This qualitative study addressed the research question, what are the perspectives and experiences related to breast cancer and breast cancer screening of African American women residing in rural eastern North Carolina? A literature review indicated little research related to the perceptions and experiences of rural African American women about breast cancer and breast cancer screening. In a previously conducted unpublished larger study (Burke, Barrett, & Cherry, 2009), the perspectives of women from rural North Carolina about breast cancer and breast cancer screening were collected by means of focus group interviews. The researcher in the present study conducted a qualitative analysis of data from a sub-set of focus group interviews that involved African American women. A qualitative approach in this study afforded an opportunity to gain insight into African American women's experiences and views regarding breast cancer and breast cancer screening. The researcher analyzed transcripts from three focus group interviews that involved 17 African American women residing in rural eastern North Carolina. Five themes that emerged from the data were: knowledge and beliefs about breast cancer, influences on breast cancer screening behaviors, personal experience with screening, emotional reactions to discussing breast cancer and breast cancer screening, and promoting breast cancer screening. Key findings related to these emergent themes included a self-perceived low level of knowledge about breast cancer, cultural views about various causes of breast cancer, perspectives about mammograms, perceived barriers to breast cancer screening, the influence of faith on breast cancer and breast cancer screening, personal experiences with breast cancer screening, fear as a commonly shared reaction to breast cancer and breast cancer screening, and best practices for promoting breast cancer awareness and education. The researcher identified a need for future research on the topic of minority health in rural populations, specifically around breast cancer screenings and preventive health. An analysis of a sub-set of qualitative data provided by African American women and a comparison of findings with the research literature led the researcher to recommend that tailored health education be provided African American women on the topic of breast cancer and breast cancer screening.
Background and Purpose. Early detection of breast cancer has saved countless lives annually. Nationally, women of color experience higher rates of invasive breast cancer and mortality. The purpose of this study was to explore the perceptions of breast cancer screening among women of color (African American, Hispanic, and Pacific Islander) in order to promote preventive and supportive measures. Puget Sound Affiliates of Susan G. Komen explored breast cancer and breast cancer screening habits among 16 counties in Washington State through focus groups and semi-structured interviews in a community needs assessment in 2011. Findings from the community needs assessment identified counties with disproportionately high occurrence of newly invasive breast cancer diagnosis or invasive breast cancer, and worse outcomes among women of color. Methods. Using qualitative data provided by Puget Sound Affiliates of Susan G. Komen, this study explored the perceptions of 68 women of color ranging in age from 25 to 74. The data was analyzed using content analysis in Microsoft Excel and Nvivo 10. Evaluation. Finding contributed to a greater understanding of the perceptions of breast cancer among women of color to improve breast health outcomes within the community. Clinical Implication and Recommendation. The analysis of the qualitative data provided an informative guide to improve breast health care and implement new measures within communities among women of color through education and outreach.
African American women are more likely to have breast cancer diagnosed at a later stage than Caucasian women and have a five-year death rate 1.5 times greater than Caucasian women. To examine factors influencing early detection, a convenience sample of 39 African American women 50 years of age and older was selected from two local Baptist churches in eastern North Carolina. Eligibility criteria included ability to read and write in English and no prior or present diagnosis of breast cancer. Instruments used for the collection of data included Nola Pender's "Perceived Benefits and Barriers Scale" and a researcher-prepared tool to gather demographic data from the participants. Results: Benefits included knowing how often to receive a mammogram (89%), giving a sense of accomplishment (100%), health insurance pays for the mammogram (92%), breast cancer can be detected at an earlier stage by receiving regular mammograms (74%), and a belief that mammograms can detect cancer (80%). Barriers identified were that receiving a mammogram takes too much time (85%), it causes discomfort (90%), and it was not an enjoyable experience (95%). Although 74% indicated that breast cancer can be detected at an earlier stage by receiving regular mammograms, only 54% indicated they knew the purpose of a mammogram and 49% knew where to go for a mammogram. By incorporating knowledge of the perceived barriers and benefits to receiving a mammogram, health care professionals can better plan educational programs to encourage the use of mammogram screening, and better plan for mobile screening sites within the community.
Comparisons were made between African-American women with and without a family history of breast cancer with respect to mammography screening, attitudes towards mammography screening and perceptions of risk and concerns about breast cancer. Screening behavior was similar among both groups with compliance with recent screening exceeding 55%. Women with rather than without a family history expressed less positive and more negative attitudes towards mammography, although both had similarly positive global attitudes towards having mammograms. Attitudes were poor correlates of screening intentions and behaviors. Women with a family history reported higher perceived risk and were more concerned about getting breast cancer than women without a family history. While greater knowledge of breast cancer risk factors predicted heightened risk and concerns about getting breast cancer, overall knowledge was poor. Perceived risk was negatively related to being on schedule and with future intentions to have a mammogram. Women with a family history expressed a greater desire to be tested for breast cancer than women without a family history.
The purpose of this project is to develop methods to encourage earlier detection of breast cancer in rural African Americans. Our focus is on cultural and psychosocial beliefs that contribute to patient delay in seeking treatment of the symptoms of breast cancer. For the intervention phase, educational programs featuring a documentary video, public service announcements, and culturally sensitive brochures have been presented to over 1700 people in Pitt County. A separate component of the intervention involved distributing breast cancer educational packets to older female relatives of patients who visited their OB/GYN physicians and to women who were waiting for relatives in the emergency department. This older group is facing greater risk, yet may not be receiving regular breast screening. The next phase of the project will involve post-intervention surveys of women in both Pitt and Wilson Counties.
This program is aimed at the African American communities in five North Carolina counties, with the hopes that women over 50 will begin getting mammograms.