“For lack of knowledge, our people will perish”: Using focus group methodology to explore African-American communities' perceptions of breast cancer and the environment

Abstract

Among women living in the United States, breast cancer is the second leading cause of cancer death. Disproportionate racial disparities in breast cancer exist, with African American (AA) women consistently having the highest rates of breast cancer related mortality despite lower incidence. This study attends to the Institute of Medicine's (IOM) call to action recommending the identification of effective strategies for communicating accurate and reliable breast cancer risk information to diverse audiences. Using focus group methodology, this study explores how AAs perceive and decipher information related to breast cancer and its relationship to their environment. Six focus groups were conducted. The sample (n = 50) was African American, 98% female, with an average age of 50.1 years. The focus group protocol consisted of open-ended questions designed to elicit information about participants' perceptions of their environment and its link to breast cancer. Focus groups were audio recorded and professionally transcribed. Analysis of the focus group transcripts revealed themes pertaining to these categories: (1) general knowledge and beliefs about breast cancer, (2) perceived environmental risks factors for breast cancer, (3) importance of seeking knowledge about breast cancer and the environment, and (4) recommended communication strategies. The emergent themes reflect the knowledge participants possessed about breast cancer and environmental risk factors, in addition to concerns about the importance of possessing accurate information, and how culturally appropriate health communication strategies can be used to disseminate breast cancer knowledge in the community. Findings from this study can be used for culturally appropriate communication about breast cancer and the environment with AA communities.

“Talk About Cancer and Build Healthy Communities”: How Visuals Are Starting the Conversation About Breast Cancer Within African-American Communities

“…More detailed methodology as part of our larger qualitative study is published elsewhere. 13 This study was approved by the University’s institutional review board.…”

“…found significant racial disparities in chemical biomarker concentrations for a variety of environmental exposures including pesticides and personal care and consumer compounds, suggesting increased exposure to environmental breast cancer risks for minority populations. 10 While, there are several known environmental risks for breast cancer, the state of the science is constantly evolving and information regarding these risks can be confusing, especially where there is debate regarding the degree and timing of exposure for environmental risks for breast cancer, 2,3,10,12–23 which may result in misperception of risk within the general public. 7,11–13,24…”

“…28 In addition, qualitative exploration of AA perceptions of environmental risks for breast cancer and related health communication demonstrates community-held cultural mistrust in medical information messages. 11,13 Cancer messages co-developed with community members can improve comprehension, environmental health literacy, and cultural suitability, and promote trust between researchers and communities for the successful translation of scientific research and adoption of health messaging. 2,13,29,30…”

“…Focus group findings from our larger study revealed that participants desired printed, culturally sensitive, visual breast cancer materials that they could easily reference or display at community gatherings and events. 13 Research suggests that storytelling is an effective tool for health communication as it plays a role in education and modeling behavior. 31,32 Visual storytelling can help familiarize complex information, which may increase audience engagement and reduce message resistance.…”

Development of a Clinical-Academic-Community Collaboration to Improve Health Literacy

“…The research team presented information to the QAC on health literacy, patient-provider communication, steps for developing a pilot intervention, and the importance of determining an organization’s readiness prior to intervention implementation. Following this presentation, the researchers collaborated with QAC members, 2 readiness research experts 28 , 29 and an established community adult literacy center director 12 , 30 - 33 to develop both a clinic readiness assessment and a clinic-based pilot intervention.…”