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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): The elimination of cancer health disparities among minorities is a priority goal for Healthy People 2010 and the NCI. System-level healthcare discrimination and healthcare provider bias has received increased focus as possible contributory factors to overall health disparities and has prompted a call from NIH to further investigate the effects of racial/ethnic discrimination in healthcare. Little is known about racial/ethnic discrimination in cancer care delivery, particularly from perspectives of minority patients. The Aims of this R-03 exploratory proposal are (1) to investigate African American (AA) and Mexican American (MA) breast cancer patients perceptions of cancer care delivery, specifically perceived discrimination and (2) to analyze how ethnic/cultural group identification and Spanish-language preference affect perceptions of and experiences with cancer care delivery. A sequential triangulated qualitative design will be used to provide in-depth understanding of sociodemographic and ethnocultural aspects of cancer care from the perspectives of two minority groups. The total sample (N= 60 women) will include 20 AA patients, 20 MA predominately English- speaking patients, and 20 MA predominantly Spanish-speaking patients, diagnosed with breast cancer in the past 3 years, to explore issues related to potential language barriers and perceived racial/ethnic bias in breast cancer care delivery. These minority groups are chosen for study because of their history of discrimination in other contexts and because of their significant cancer disparities. For Aim 1, semi-structured interviews will be done with patients to analyze their perceptions and experiences of cancer care delivery using matrix analyses. For Aim 2, we will analyze how ethnic/cultural group identification affect perceptions of cancer care delivery and how these perceptions influence patients' healthcare utilization, treatment adherence, and willingness to remain engaged in continuous cancer care. Findings from this study will increase understanding of how ethnocultural factors affect minority patient experiences of cancer care and potential health-related consequences of perceived discrimination. The proposed study is a first step in a program of research to develop and test culturally responsive, evidence-based nursing and behavioral medical interventions to reduce cancer disparities among minority populations. This research project has the potential to improve the public health of minority cancer patients in the United States by highlighting perceived barriers in healthcare delivery systems. An in-depth understanding of how cultural factors affect patients' interactions with cancer physicians and other health care staff will help us to develop strategies to improve health care communication and cancer care delivery to minority populations.