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Breast cancer screening programs offer the greatest promise for early detection but rates of participation in free screening programs have been disappointing for challenged populations. The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening. During Year 03, Phase 1 activities were completed, including contact attempts to all potentially eligible women in the population data base. All Phase 1 interviews have been transcribed and technically verified. All interviews except 10 have been inductively coded. Formal presentations of study results-to-date have been presented to three professional groups, including the Susan G. Komen Breast Cancer Foundation, Puget Sound Affiliate. Results from the coded interview data offer compelling reasons why NEW educational, outreach and training materials are needed in order to more successfully engage fiscally challenged African American women in breast cancer screening programs.
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 In a previously conducted unpublished larger study (Burke, Barrett, & Cherry, 2009), the perspectives of women from rural North Carolina about breast cancer and breast cancer screening were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.
Black women of low-socioeconomic status (SES) demonstrate a higher incidence of breast cancer mortality associated with late-stage diagnosis than White women. Breast cancer screening, including mammography, breast self-examination, and clinical breast examination, remains the most effective route to early detection. Studies indicate poor adherence to breast cancer screening regimens among low-income minority women. An overall objective of the study is the construction of a theoretical model that can explain screening practices in low-SES black women. This will be accomplished in two separate waves. In the first wave, facilitators and barriers to breast cancer-screening participation among low-SES women of African-American and Caribbean descent will be determined through qualitative interview. This approach allows a voice for the concerns and experiences guiding these women in their screening choices. The current study incorporates an approach-avoidance theoretical framework that considers preventive screening behaviors to be both desirable and aversive. Based on the factors provided by respondents on the first wave of the study, a culturally sensitive Q-Sort instrument will be designed that will allow participants to rank order these factors as facilitators or barriers to screening, and therefore, provide a powerful approach to testing the theoretical paradigm. Finally innovative modeling techniques will be applied to determine the strength of emergent models to explain breast health care practices among low-SES Black women, either as idiopathic to the general population or specific to African-American or Caribbean cultural groups.
In this special issue, top researchers from a diversity of disciplines provide an overview of and insights into the major social, cultural, and structural variables that play a role in Black women's poor health, and differential morbidity and mortality. The articles focus on the major threats to Black women's health such as diabetes, obesity, cancer, violence, and AIDS, and utilize a wide range of qualitative and quantitative methods from medicine, psychology, sociology, and feminist analysis. Among the articles are: * An examination of the role of Black women's cultural and ethnomedical beliefs in their use of cancer screening by Laurie Hoffman-Goetz and Sherry Mills of the National Cancer Institute; * An empirical analysis of Black women's utilization of health services entailing more than 18,000 women by Lonnie Snowden and his colleagues at the University of California-Berkeley Center for Mental Health Services Research; * A comprehensive review and empirical analysis of the role of violence in Black women's health by Nancy Felipe Russo (Arizona State University), Mary Koss (University of Arizona), and Gwen Keita (APA Office on Women); * An empirical investigation of the role of social and contextual variables in HIV risk among low-income Black women by Kathleen Sikkema, Timothy Heckman, and Jeffrey Kelly of the Center for AIDS Intervention Research, Medical College of Wisconsin. Other articles include comprehensive and critical analyses and reviews of diabetes, breast cancer risk perceptions, and obesity among Black women, as well as analyses of Black women's exclusion from research in medicine, women's health, health psychology, and behavioral medicine. The first issue of any psychology journal to be devoted to the health of Black women, this special issue is a step in the direction of redressing the long-overdue neglect of Black women's health. It provides a cogent overview of the state of Black women's health, numerous empirical investigations, and clear suggestions for future research.
Black women of low-socioeconomic status (SES) demonstrate a high incidence of breast cancer mortality associated with late. stage diagnosis. Breast cancer screening, including mammography, breast self-examination, and clinical breast examination, remains the most effective route to early cancer detection. Studies indicate poor adherence to breast cancer screening regimens among low-income minority women. An overall objective of the study is the construction of models that can explain screening practices in low-SES black women. This will be accomplished in two separate waves. In the first wave, facilitators and barriers to breast cancer screening participation among low-SES women of African-American and Caribbean descent will be determined through qualitative interview. This approach intends to provide a voice for the concerns and experiences guiding these women in their screening choices. The current study incorporates an approach-avoidance theoretical framework that considers preventive screening behaviors to be both desirable and aversive. Based on the factors provided by the respondents in the first wave of the study, culturally-sensitive Q-Sort instrumentation will be designed that will allow participants to rank order these factors as facilitators or barriers and therefore, provide a powerful approach to testing the theoretical paradigm. Finally, innovative modeling techniques will be applied to determine the strength of models to explain breast health care practices among low-SES Black women, either as idiopathic to the general population of low-SES Black women or specific to African-American or Caribbean cultural groups.
The purpose of this research was to identify factors influencing African-American women's (AAW) decisions to participate in breast cancer prevention research (BCPR). The theoretical basis included the Health Belief Model (HBM), Theory of Reasoned Action (TRA) and the Transtheoretical Model (stage of behavior change). A combined qualitative (focus groups) and quantitative (mail survey) approach - was used.
"Being poor is a health risk (Wells et al., 2019). When we wrote Poverty and Place, Cancer Prevention among Low Income Women of Color (2019), we demonstrated the potent forces of poverty and place and the prevalence of cancer among low-income women of color. That initial volume was the inspiration for this volume, entitled Cancer Navigation: Charting the Pathway Forward for Low Income Women of Color. In Poverty and Place, we had academics and researchers in mind. Our purpose was to examine how and why racial and class disparities have become potent forces in health and longevity rates in the United States. Conducting original research drawn from North City St. Louis, Missouri and the river city of East St. Louis, Illinois, we sought to understand the combination of factors that facilitate or pose a barrier to cancer treatment and adherence, for marginalized low- income women of color"--