Centering intersectional breast cancer screening experiences among black, Latina, and white women: a qualitative analysis

ObjectiveMammography screening guidelines in the United States highlight the importance of informing and involving women when making their breast cancer screening decisions. However, the complexity of interpreting and applying these population-level guidelines can contribute to patient burden. Patie...

Full description

Saved in:
Bibliographic Details
Main Authors: Sienna Ruiz, Kamilah Abdur-Rashid, Rachel L. Mintz, Maggie Britton, Ana A. Baumann, Graham A. Colditz, Ashley J. Housten
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1470032/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1846169104771186688
author Sienna Ruiz
Kamilah Abdur-Rashid
Rachel L. Mintz
Maggie Britton
Ana A. Baumann
Graham A. Colditz
Ashley J. Housten
author_facet Sienna Ruiz
Kamilah Abdur-Rashid
Rachel L. Mintz
Maggie Britton
Ana A. Baumann
Graham A. Colditz
Ashley J. Housten
author_sort Sienna Ruiz
collection DOAJ
description ObjectiveMammography screening guidelines in the United States highlight the importance of informing and involving women when making their breast cancer screening decisions. However, the complexity of interpreting and applying these population-level guidelines can contribute to patient burden. Patient-centered communication strategies can alleviate patient burden, but few consider perspectives from racially and ethnically marginalized populations. We examine diverse women’s perspectives on screening to characterize patient-centered experiences.MethodsWe conducted 28 focus groups with 134 non-Latina Black (n = 51), non-Latina White (n = 39), and Latina (n = 44) participants. We coded participants’ discussion of their screening influences. We used deductive and inductive qualitative methods to identify common themes.ResultsWe identified three themes: (1) personal relationships with primary care providers, (2) potential impacts of cancer on families, and (3) interactions with medical systems. Most White participants described trusting physician relationships in contrast to perfunctory, surface-level relationships experienced by many Black participants; high costs of care prevented many Latina participants from accessing care (Theme 1). Diagnosis was a concern for most Black participants as it could burden family and most Latina participants as it could prevent them from maintaining family well-being (Theme 2). While many White participants had general ease in accessing and navigating healthcare, Latina participants were often held back by embarrassment—and Black participants frequently described disrespectful providers, false negatives, and unnecessary pain (Theme 3).ConclusionCultural and structural factors appeared to influence participants’ approaches to breast cancer screening. Structural barriers may counteract culturally salient beliefs, especially among Black and Latina participants. We suggest patient-centered communication interventions be culturally adjusted and paired with structural changes (e.g., policy, insurance coverage, material resources) to reflect women’s nuanced values and intersectional social contexts.
format Article
id doaj-art-1e4dd415261c4427a3ef5a1132706b90
institution Kabale University
issn 2296-2565
language English
publishDate 2024-11-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Public Health
spelling doaj-art-1e4dd415261c4427a3ef5a1132706b902024-11-13T06:21:16ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-11-011210.3389/fpubh.2024.14700321470032Centering intersectional breast cancer screening experiences among black, Latina, and white women: a qualitative analysisSienna Ruiz0Kamilah Abdur-Rashid1Rachel L. Mintz2Maggie Britton3Ana A. Baumann4Graham A. Colditz5Ashley J. Housten6Washington University School of Medicine, St. Louis, MO, United StatesWashington University School of Medicine, St. Louis, MO, United StatesWashington University School of Medicine, St. Louis, MO, United StatesThe University of Texas, MD Anderson Cancer Center, Houston, TX, United StatesWashington University School of Medicine, St. Louis, MO, United StatesWashington University School of Medicine, St. Louis, MO, United StatesWashington University School of Medicine, St. Louis, MO, United StatesObjectiveMammography screening guidelines in the United States highlight the importance of informing and involving women when making their breast cancer screening decisions. However, the complexity of interpreting and applying these population-level guidelines can contribute to patient burden. Patient-centered communication strategies can alleviate patient burden, but few consider perspectives from racially and ethnically marginalized populations. We examine diverse women’s perspectives on screening to characterize patient-centered experiences.MethodsWe conducted 28 focus groups with 134 non-Latina Black (n = 51), non-Latina White (n = 39), and Latina (n = 44) participants. We coded participants’ discussion of their screening influences. We used deductive and inductive qualitative methods to identify common themes.ResultsWe identified three themes: (1) personal relationships with primary care providers, (2) potential impacts of cancer on families, and (3) interactions with medical systems. Most White participants described trusting physician relationships in contrast to perfunctory, surface-level relationships experienced by many Black participants; high costs of care prevented many Latina participants from accessing care (Theme 1). Diagnosis was a concern for most Black participants as it could burden family and most Latina participants as it could prevent them from maintaining family well-being (Theme 2). While many White participants had general ease in accessing and navigating healthcare, Latina participants were often held back by embarrassment—and Black participants frequently described disrespectful providers, false negatives, and unnecessary pain (Theme 3).ConclusionCultural and structural factors appeared to influence participants’ approaches to breast cancer screening. Structural barriers may counteract culturally salient beliefs, especially among Black and Latina participants. We suggest patient-centered communication interventions be culturally adjusted and paired with structural changes (e.g., policy, insurance coverage, material resources) to reflect women’s nuanced values and intersectional social contexts.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1470032/fullcancermammographypatient-centered communicationhealth equity (MeSH)screening
spellingShingle Sienna Ruiz
Kamilah Abdur-Rashid
Rachel L. Mintz
Maggie Britton
Ana A. Baumann
Graham A. Colditz
Ashley J. Housten
Centering intersectional breast cancer screening experiences among black, Latina, and white women: a qualitative analysis
Frontiers in Public Health
cancer
mammography
patient-centered communication
health equity (MeSH)
screening
title Centering intersectional breast cancer screening experiences among black, Latina, and white women: a qualitative analysis
title_full Centering intersectional breast cancer screening experiences among black, Latina, and white women: a qualitative analysis
title_fullStr Centering intersectional breast cancer screening experiences among black, Latina, and white women: a qualitative analysis
title_full_unstemmed Centering intersectional breast cancer screening experiences among black, Latina, and white women: a qualitative analysis
title_short Centering intersectional breast cancer screening experiences among black, Latina, and white women: a qualitative analysis
title_sort centering intersectional breast cancer screening experiences among black latina and white women a qualitative analysis
topic cancer
mammography
patient-centered communication
health equity (MeSH)
screening
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1470032/full
work_keys_str_mv AT siennaruiz centeringintersectionalbreastcancerscreeningexperiencesamongblacklatinaandwhitewomenaqualitativeanalysis
AT kamilahabdurrashid centeringintersectionalbreastcancerscreeningexperiencesamongblacklatinaandwhitewomenaqualitativeanalysis
AT rachellmintz centeringintersectionalbreastcancerscreeningexperiencesamongblacklatinaandwhitewomenaqualitativeanalysis
AT maggiebritton centeringintersectionalbreastcancerscreeningexperiencesamongblacklatinaandwhitewomenaqualitativeanalysis
AT anaabaumann centeringintersectionalbreastcancerscreeningexperiencesamongblacklatinaandwhitewomenaqualitativeanalysis
AT grahamacolditz centeringintersectionalbreastcancerscreeningexperiencesamongblacklatinaandwhitewomenaqualitativeanalysis
AT ashleyjhousten centeringintersectionalbreastcancerscreeningexperiencesamongblacklatinaandwhitewomenaqualitativeanalysis