Objective: Sexual minority women are at heightened risk for breast and cervical cancer and are less likely than heterosexual women to obtain timely screenings for breast and cervical cancer. This study tested hypotheses about potential factors that contribute to nonadherence to these screenings among sexual minority women. Method: Sexual minority women living in the United States aged 18 to 74 who met other eligibility criteria (n ϭ 1,115) were recruited to complete an online questionnaire. Screening utilization, demographic information, sexual orientation, and health care indicators were collected. Variables linked to minority stress were assessed: stigma consciousness, internalized homophobia, rejection sensitivity, fear of negative evaluation, and concealment of sexual orientation from one's health care provider. Logistic regression models tested whether these psychological variables were independently associated with nonadherence for Papanicolaou (Pap) test and breast cancer screening. Results: The variable of concealment had the strongest positive independent association with failure to obtain timely Pap tests. Among women who had a general physical in the last year, concealment, stigma consciousness, rejection sensitivity, and fear of negative evaluation were all positively associated with lower rates of timely Pap tests. Among all women, these psychological variables were positively associated with never obtaining a Pap test and concealment was also negatively associated with clinical breast exam adherence. Conclusions: Psychological barriers and concealment of sexual identity may hinder adherence to screening guidelines among some sexual minority women. Strategies facilitating positive experiences of disclosure to health care providers and addressing psychological factors related to minority stress could promote adherence.

Background Recruitment and attrition are inherently challenging issues in hospice research. We sought to describe strategies of recruitment, retention, and delivery of NOVELA (short for tele novela), an intervention for hospice family caregivers (HFCG). Methods Statistics were kept of every referral, consenting participant, visit session, and intervention activity. We used the Social Marketing Mix Framework to describe recruiting strategies employed and lessons learned. Results Two hospices in the U.S. Mid-Atlantic region referred 47 HFCG and N = 20 agreed to participate, out of which 50% (N = 10) completed all 4 sessions with an average of 2.8 sessions per person, each lasting an average duration of 13.5 minutes (range 8.0-25.7). The main reason for missing a session was a patient’s death (N = 8). Successful recruitment strategies employed in NOVELA included: (a) intensive start-up hospice engagement, (b) remote recruitment and delivery of NOVELA, and (c) scheduling flexibility to work around caregivers’ other demands. Conclusion The recruitment and intervention delivery had successes and challenges resulting in the identification of multiple opportunities to strengthen our strategy and inform future studies with HFCGs.

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Obesity following breast cancer diagnosis is associated with poor overall survival. Understanding weight trajectories will help inform breast cancer survivors at greater risk of weight gain, and those who would benefit from earlier anti-obesity interventions. We performed a retrospective chart review of women from the Breast Cancer Program Longitudinal Repository (BCPLR) at Johns Hopkins diagnosed with hormone receptor-positive Stage I-III breast cancer from 2010 to 2020. We investigated obesity (measured by body mass index [BMI]) over time, patient and tumor characteristics, as well as treatment and recurrence. We observed a significant ≥5% increase in BMI from diagnosis to most recent follow-up (p = 0.009), particularly among those who were overweight at diagnosis (p = 0.003). Additionally, among those up to 5 years since diagnosis, there was a significant association between experiencing a ≥0.1 kg/m2 increase per year since diagnosis and baseline BMI status (p = 0.009). A ≥0.6 kg/m2 decrease in BMI was observed for participants with obesity at diagnosis (p = 0.006). Our study highlights (i) the significant burden of obesity in women with a history of breast cancer and (ii) higher risks for increases in BMI and shifts in class of obesity among women who are overweight at diagnosis.