Latina Breast Cancer Survivors...Our Experience
| Institution: | University of California, Los Angeles | ||
| Investigator(s): |
Diana Tisnado , M.P.A., Ph.D. -
Brian Montano , MPH -
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| Award Cycle: | 2008 (Cycle 14) | Grant #: 14AB-2000 | Award: $168,421 |
| Award Type: | CRC Pilot Award | ||
| Research Priorities | |||
| Sociocultural, Behavioral, and Psychological Issues>Sociocultural, Behavioral, and Psychological Issues: the human side | |||
Initial Award Abstract (2008)
“Survivorship” (the phase of care following primary treatment) is a distinct and important phase of the cancer experience, but it has been relatively neglected in education, clinical practice, and research. The Institute of Medicine report “From Cancer Patient to Cancer Survivor: Lost in Transition,” recommends that survivorship care should include: 1) prevention of recurrence, new cancer and late effects of cancer treatment; 2) monitoring or surveillance for cancer and medical, mood, and social issues; 3) interventions for the effects of cancer and its treatment; and 4) coordination among specialists and primary care providers to ensure all health needs are met.
Little is known about adherence to best practices in survivorship care. Research is urgently needed to understand the patterns of delivery of survivorship care and to identify areas in need of intervention, particularly for populations at risk of disparities in cancer treatment and outcomes such as Latinas. We now propose a Community Research Collaboration Pilot Project to examine issues of breast cancer survivorship care among Latinas in Los Angeles County.
The goal of the proposed project is to increase understanding of Latina breast cancer patient experiences and attitudes regarding medical care and other pertinent services following completion of primary breast cancer treatment. Specifically, we will address the following specific aims:
- I. To explore the ways in which Latinas in Los Angeles County conceptualize survivorship care and their knowledge, attitudes and beliefs regarding survivorship care for their breast cancer after completion of initial treatment;
- II. To explore the experiences with and major barriers to appropriate follow-up care faced by Latinas, and to learn the importance placed by Latina breast cancer survivors place on issues lying in the domains of:
- (a) Access to care, and the relative importance of financial (e.g., money, insurance status) versus non-financial (e.g., language, competing needs) barriers to access;
- (b) Provider communication (e.g., discussing and recommending services in an understandable way; communication regarding risks of recurrent or new cancers);
We propose to conduct focus groups with Latina breast cancer survivors to explore their knowledge, attitudes, beliefs, and experiences with breast cancer care after completion of primary treatment, perceived barriers and facilitators to receipt of care; personal characteristics such as demographics, financial, social, and cultural barriers or resources, health care system structure, and other issues of significance identified by the participating women. Focus groups will be comprised of Latina survivors who have completed primary breast cancer treatments. Women who have received their first breast cancer diagnosis between one and five years prior to the study period, who are English or Spanish-speaking, and who feel well enough to participate will be eligible.
Few studies have addressed the quality of medical care after completion of primary treatment of breast cancer. Despite documentation of disparities in screening rates, stage at diagnosis, treatments, and shorter survival time by race and ethnicity, no studies of which we are aware have specifically addressed Latina breast cancer survivors’ knowledge, attitudes, beliefs, or experiences and needs in terms of planning for and accessing medical care for surveillance, monitoring and management of cancer (morbid) and non-cancer (co-morbid) medical issues.
The Latino community will have strong representation through the Latina Task Force (LTF) membership, who will be involved throughout all phases of the project. These dedicated professionals represent a full spectrum of organizations involved in improving the health status of the local Latino community, including private and public advocacy, health education, primary and tertiary care, support groups, survivors. We plan to work with the LTF to disseminate results of the study through a number of mechanisms with excellent potential to reach different audiences of interest, including Latinas in Los Angeles County, health care providers, and community partners.
This research will lay the foundation for the next phase of work: to develop and assess the acceptability of an intervention to address needs of Latina breast cancer survivors to be implemented by Partnered for Progress and/or the Latina Task Force. We plan to build on this work with other racial/ethnic groups at risk for being underserved. This research will enhance our understanding of the issues that impact the quality of breast cancer care that women receive, and to inform strategies to improve the quality of breast cancer survivorship care available to all women.
