Layers of information: interacting constraints on breast cancer risk-management by high-risk African American women

Padamsee, Tasleem J.; Meadows, Rachel; Hils, Megan

doi:10.1080/13557858.2018.1562053

Cited by 14 publications

(17 citation statements)

References 55 publications

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“…Second, these data suggest that specific personal characteristics are associated with chemoprevention awareness. In general, we find that women who use more nuanced information gathering strategies are also more likely to know about chemoprevention, and that knowing basic prevention information enables women to ask more detailed questions that could lead to actually considering specific risk-reduction behaviors [43]. Future studies should explore access to and use of risk-management information in more detail, since these dynamics are critical to the ability of high-risk women to make healthprotective decisions.…”

Section: Concern Example Quotesmentioning

confidence: 88%

“…Interviews covered a range of topics, including perceived breast cancer risk; sources and content of risk information; understanding and consideration of prevention options; decision-making processes and networks; and psychosocial well-being. Other findings from the parent project have been published and are under review elsewhere [3,[43][44][45].…”

Section: Methodsmentioning

confidence: 99%

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Understanding low chemoprevention uptake by women at high risk of breast cancer: findings from a qualitative inductive study of women’s risk-reduction experiences

2021

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Background Chemoprevention is one of several methods that have been developed to help high-risk women reduce their risk of breast cancer. Reasons for the low uptake of chemoprevention are poorly understood. This paper seeks a deeper understanding of this phenomenon by drawing on women’s own narratives about their awareness of chemoprevention and their risk-related experiences. Methods This research is based on a parent project that included fifty in-depth, semi-structured interviews with a purposive sample of African American and White women at elevated risk of breast cancer. This specific study draws on the forty-seven interviews conducted with women at high or severe risk of breast cancer, all of whom are eligible to use chemoprevention for breast cancer risk-reduction. Interviews were analyzed using grounded theory methods. Results Forty-five percent of participants, and only 21% of African American participants, were aware of chemoprevention options. Women who had seen specialists were more likely to be aware, particularly if they had ongoing specialist access. Aware and unaware women relied on different types of sources for prevention-related information. Those whose main source of information was a healthcare provider were more likely to know about chemoprevention. Aware women used more nuanced information gathering strategies and worried more about cancer. Women simultaneously considered all risk-reduction options they knew about. Those who knew about chemoprevention but were reluctant to use it felt this way for multiple reasons, having to do with potential side effects, perceived extreme-ness of the intervention, similarity to chemotherapy, unknown information about chemoprevention, and reluctance to take medications in general. Conclusions Lack of chemoprevention awareness is a critical gap in women’s ability to make health-protective choices. Future research in this field must consider complexities in both women’s perspectives on chemoprevention and the reasons they are reluctant to use it.

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Section: Concern Example Quotesmentioning

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Understanding low chemoprevention uptake by women at high risk of breast cancer: findings from a qualitative inductive study of women’s risk-reduction experiences

2021

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“…Qualitative research with African American women with hereditary breast cancer risk found that decisions to engage in cancer risk management behaviors are associated with 3 accumulated layers of risk information: perceived risk at the foundational layer, general information about managing breast cancer risk at the middle layer, and specific information about risk-management options at the most proximal layer. 29 African American women experience distinct dynamics at each of these layers compared with non-Hispanic White women. The authors noted that information access is associated a Unadjusted bivariate analyses with generalized estimating equations were performed by combining all events (performance of a screening mammogram) occurring during the 18 months of usual care before BCRA with all events occurring over 18 months after participants underwent BCRA.…”

Section: Discussionmentioning

confidence: 99%

Association of Population Screening for Breast Cancer Risk With Use of Mammography Among Women in Medically Underserved Racial and Ethnic Minority Groups

et al. 2021

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IMPORTANCE Black women bear a disproportionate burden of breast cancer mortality in the US, in part due to inequities in the use of mammography. Population screening for breast cancer risk in primary care is a promising strategy for mitigating breast cancer disparities, but it is unknown whether this strategy would be associated with increased mammography rates in underserved women of racial and ethnic minority groups.OBJECTIVE To examine whether providing individualized breast cancer risk estimates is associated with an increase in the rate of screening mammography. DESIGN, SETTING, AND PARTICIPANTSA cohort study was conducted in women receiving individualized risk estimates as part of routine primary health care at federally qualified health centers in medically underserved communities in Chicago, Illinois. The study was conducted from

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“…These differences may stem from access inequities or other barriers to receiving desired care. In one qualitative study of women at high risk of breast cancer, Black American women had considerably less access to specialists and knowledge about risk reduction options and more pressing health concerns that warranted their immediate attention and resources than their White counterparts, 48 reflecting the broadly recognized pattern of systemic disadvantage and structural racism in health care faced by people of color in America. [49][50][51][52][53][54][55][56] Accordingly, it is not surprising that Black women with BRCA1/2 pathogenic variants in the United States have lower rates of uptake of and adherence to cancer risk-reducing interventions than women from other racial groups.…”

Section: Interacting Patient-level and Societal Factorsmentioning

confidence: 99%

Systemic Barriers to Risk-Reducing Interventions for Hereditary Cancer Syndromes: Implications for Health Care Inequities

Mittendorf

Knerr

Kauffman

et al. 2021

JCO Precision Oncology

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Layers of information: interacting constraints on breast cancer risk-management by high-risk African American women

Cited by 14 publications

References 55 publications

Understanding low chemoprevention uptake by women at high risk of breast cancer: findings from a qualitative inductive study of women’s risk-reduction experiences

Understanding low chemoprevention uptake by women at high risk of breast cancer: findings from a qualitative inductive study of women’s risk-reduction experiences

Association of Population Screening for Breast Cancer Risk With Use of Mammography Among Women in Medically Underserved Racial and Ethnic Minority Groups

Systemic Barriers to Risk-Reducing Interventions for Hereditary Cancer Syndromes: Implications for Health Care Inequities

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