Genetic counseling and testing for hereditary breast cancer have the potential benefit of early detection and early interventions in African American women. However, African American women have low use of these services compared to White women. We conducted two focus groups with African American women diagnosed with breast cancer (affected group, n=13) and women with at least one first-degree relative with breast/ovarian cancer (unaffected group, n= 8). A content analysis approach was employed to analyze interview data. Breast cancer survivors had more knowledge about genetic counseling and testing than participants who were unaffected with cancer. However, knowledge about genetic counseling was limited in both groups. Barriers to pursuing genetic counseling and testing included poor understanding of the genetic counseling and testing process, fear of carrying the mutation, concerns about discrimination, and cost. Motivators to participate in genetic counseling and testing included desire to help family members, insurance coverage, and potential of benefiting the larger African American community. Education efforts are needed to increase genetic counseling and testing awareness in the African American community.

Racial/ethnic minority women experience disparities in breast cancer. Studies suggest that this may be partly related to later stage of diagnosis. Adherence to breast cancer screening guidelines is frequently lower in racial/ethnic minority populations, which may contribute to this disparity. The purpose of this study was to examine the predictors of intentions to obtain breast cancer screening based on established guidelines using the information-motivation-behavioral skills model. Data for this study were obtained from the community-based Kin Keeper Cancer Prevention Intervention study and included 278 racial/ethnic minority women (Black = 138; Latina = 68; Arab = 80). Data were collected between 2009 and 2010 and analyzed in 2013. Structural equation models were tested to examining the effects of functional breast cancer literacy, motivation, and breast cancer screening behavior. Motivation was significantly associated with breast cancer screening. Breast cancer literacy (information) is positively associated with breast cancer screening. The findings indicate that the higher the level of breast cancer literacy and the more motivated patients are, the more likely they are to be screened. In addition, there was a significant association between the covariate race and other model constructs. Functional breast cancer literacy and motivation interventions are important factors to consider when designing breast cancer screening interventions in racial/ethnic minority women. These interventions should consider cultural and contextual factors that are associated with screening behavior.

This descriptive, exploratory study is part of a larger observational study of the quality of cancer care delivered to population-based cohorts of newly-diagnosed patients with lung and colorectal cancer. The current study explores the role of spiritual well-being in adjustment to life after the cancer diagnosis, utilizing the Functional Assessment of Chronic Illness Therapy – Spiritual Well-being – Expanded (FACIT-Sp-Ex) Scale. Survey data collected from 304 newly-diagnosed cancer survivors were analyzed to explore important aspects of spirituality, such as sense of meaning in one’s life, harmony, peacefulness, and a sense of strength and comfort from one’s faith. Spiritual well-being scores, particularly meaning/peace, were statistically significant for African Americans, women and colorectal cancer survivors. These findings amplify a need for oncology social workers and other practitioners to assess spiritual well-being in cancer survivors in an effort to strengthen psychosocial treatment plans. Implications for social work practice and research are discussed.

Racial disparities in ratings of healthcare quality were diminished across several domains after controlling for psychosocial and healthcare factors. Strategies aimed at improving self-efficacy in women with higher levels of mistrust may improve patient satisfaction.

Health literacy and the family can be used to promote cancer screenings. We examined the associations of socio-demographic factors, family communication, and cancer literacy in a diverse population. Baseline data from the Kin Keeper(SM) Cancer Prevention randomized controlled trial were analyzed for Black (n=216), Latino (n=65), and Arab (n=235) women. Key variables were based on the Family Adaptability and Cohesion Scale IV, and the Cancer Literacy Assessment Tool. Among Blacks, cervical cancer literacy was positively associated with family communication. Cancer literacy was associated with higher educational level, employment, and family self-rated health status among Black and Arab women. Among Latinas, who were the least educated and had the lowest literacy scores, family communication was inversely related to breast cancer literacy. Family-centered networks may be a viable resource for the transmission of health cancer literacy information, inform health care decision-making, and contribute to decreasing breast and cervical cancer mortality.