Perceptions of Cancer Causes, Prevention, and Treatment Among Navajo Cancer Survivors

Bea, Jennifer W.; Heer, Hendrik D. de; Kinslow, Brian; Valdez, Luis; Yazzie, Etta; Curley, Pearl; Dalgai, Shelby; Schwartz, Anna L.

doi:10.1007/s13187-019-01487-5

Cited by 11 publications

(18 citation statements)

References 18 publications

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“… 41 In a chart review of Navajo patients with breast cancer, 30% did not receive standard care, which was attributed to cultural, structural, and geographic challenges. 42 , 43 …”

Section: Discussionmentioning

confidence: 99%

Disparities in Breast-Conserving Therapy for Non-Hispanic American Indian/Alaska Native Women Compared with Non-Hispanic White Women

et al. 2021

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Background Little is known about the surgical patterns of American Indian/Alaska Native (AI/AN) breast cancer patients. The purpose of this study is to determine whether there are disparities in breast cancer surgery and radiation therapy between non-Hispanic AI/AN (NH-AI/AN) women and non-Hispanic White (NHW) women. Methods Data from the National Program of Cancer Registries of the Centers for Disease Control and Surveillance, Epidemiology, and End Results were used for this cross-sectional study. Female patients with invasive breast cancer diagnosed 2010–2015 were stratified by race/ethnicity, surgical procedure, radiation, and region. Percentage distributions of mastectomy and lumpectomy were compared overall and by region and stage. Results From 2010 to 2015 there were 3292 NH-AI/AN women and 165,225 NHW women diagnosed with breast cancer. For early stage (AJCC stage 1 and 2), NH-AI/AN women had overall significantly higher percentage of mastectomy (41% vs 34.4%, p < 0.001) and significantly lower percentage of lumpectomy (59% vs 65.6%) compared with NHW women, without significant differences in post-lumpectomy radiation (71% vs 70%). There were regional variations, notably in the Northern Plains, where the percentage of mastectomy for early-stage disease was 48.9% for NH-AI/AN women versus 35.9% for NHW women, and in Alaska with 47% for NH-AI/AN women versus 33.3% for NHW women (p < 0.001). There were no overall significant differences in type of surgery or radiation for late-stage disease between groups. Conclusion This is the first study to show disparities in surgical management of NH-AI/AN women with breast cancer. For early-stage disease, NH-AI/AN women undergo a higher percentage of mastectomy. Future clinical directions could focus on the factors that drive awareness, decision-making, and access to breast conservation.

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“… 41 In a chart review of Navajo patients with breast cancer, 30% did not receive standard care, which was attributed to cultural, structural, and geographic challenges. 42 , 43 …”

Section: Discussionmentioning

confidence: 99%

Disparities in Breast-Conserving Therapy for Non-Hispanic American Indian/Alaska Native Women Compared with Non-Hispanic White Women

et al. 2021

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“…They were uncertain about or had negative experiences with Western medicine, including a sense of cultural misalignment with the treatment environment. A full summary of methods and major themes from the qualitative phase, organized according to the PEN-3 and HBM constructs, may be found in Bea et al (2018Bea et al ( , 2019.…”

Section: Key Themesmentioning

confidence: 99%

“…Native Americans, including Navajo, are diagnosed with cancer at more advanced stages compared to non-Hispanic Whites (NEC, 2018;Siegel, Ma, Zou, & Jemal, 2014) and have the poorest five-year cancer survival rate of any group in the country (Clegg, Li, Hankey, Chu, & Edwards, 2002;Siegel et al, 2014). Although community-based resources and Native American cancer navigation trainings have been developed (Native American Cancer Research Corporation, n.d.), to date, the Navajo, like many other Native American tribes, have limited access to cancerrelated resources (Bea et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Development of a Culturally Relevant Physical Activity Intervention for Navajo Cancer Survivors

Heer¹,

Bea²,

Kinslow³

et al. 2019

Collaborations: A Journal of Community-Based Research and Practice

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Despite well-documented benefits of physical activity for cancer survivors, few interventions have been developed for Native American cancer survivors, the population with the poorest survival rates of any group. This paper describes the development and cultural adaptation of a physical activity intervention for Navajo cancer survivors using Intervention Mapping (IM). IM procedures were guided by the PEN-3 (Perceptions-Enablers-Nurturers) and Health Belief Models and informed by a qualitative study with 40 Navajo cancer survivors and family members. For each theoretical construct (perceived benefits, barriers, enablers of healthy behaviors, etc.), a measurable objective was identified. These objectives were then matched with intervention strategies. The IM process indicated the need for a highly culturally sensitive environment (site and providers), culturally acceptable measurements and materials, and integrating cultural and environmental activity preferences. Program objectives aligned directly with these areas. Intervention strategies included: (a) collaboration with providers sensitive to historical/cultural context and environmental barriers; (b) cultural adaptation of surveys, non-invasive physical measurements, no biospecimen storage; (c) materials, terminology and symbols embracing cultural values of return to harmony; (d) physical activities that are flexible and aligned with cultural preferences and environment/travel issues (e.g., outdoor walking; community and homebased options; portable, inexpensive resistance equipment; local resources; family/friends participation and more community cancer education); (e) clinical adaptations by site and symptoms. This study is the first to document the process of adaptation of a physical activity program for Navajo cancer survivors. Objectives and strategies incorporated via IM are expected to foster sustainability and enhance uptake, satisfaction, and adherence.

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“…Malignant neoplasm is the second leading cause of death in AI/AN [ 2 ]. For several cancers, there are still persistent disparities among AI/AN populations [ 3 ]. Within the USA, AI/AN have some of the lowest 5-year cancer survival rates [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…For several cancers, there are still persistent disparities among AI/AN populations [ 3 ]. Within the USA, AI/AN have some of the lowest 5-year cancer survival rates [ 3 ]. Cancer is a stigmatized disease in American Indian (AI) culture due to its association with death [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing Knowledge and Perceptions About Cancer Among American Indians of the Zuni Pueblo, NM

et al. 2021

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American Indians (AIs) in New Mexico have lower cancer screening rates compared to other populations and are more likely to be diagnosed with cancer at an advanced stage of the disease as reported by Li et al. (Archives of Internal Medicine 163(1):49–56, 2003). AIs also have the lowest 5-year cancer survival rates compared to any ethnic/racial group in the USA as reported by Clegg et al. (Arch Intern Med 162:1985–1993, 2002) and Edwards et al. (Cancer 97:1407–1427, 2005). Numerous barriers such as cultural beliefs, fear, fatalism, mistrust, stigma, and lack of culturally appropriate interventions could contribute to low cancer screening rates as reported by Daley et al. (J Health Dispar Res Pract 5(2), 2012); Filippi et al. (J Prim Care Community Health 4(3):160–166, 2013); James et al. (Prev Chronic Dis 10:E170, 2013); and Schumacher et al. (Cancer Causes Control 19(7):725–737, 2008). Trained Community Health Representatives (CHRs) from the Zuni Pueblo and native Zuni undergraduate students led six 1-h focus group sessions using a structured focus group guide with probes. The focus groups were conducted among 51 participants from different age groups (20–29 years, n = 19; 30–49 years, n = 17; and 50 years and older, n = 15) stratified by sex. Focus groups were conducted in both English and Shiwi (Zuni) languages. Sessions were audio recorded, and team members took notes. CHRs transcribed the notes and audio recordings, and created a codebook for qualitative data analysis. In the focus groups, participants provided Zuni-specific cultural context, opinion, and experience regarding (1) general knowledge about cancer, (2) cancer risk, (3) cancer risk reduction, (4) personal experiences with cancer, and (5) culturally competent delivery of cancer information and resources. Understanding the perceptions of cancer within the Zuni Pueblo is an essential component in the development of interventional/preventative measures and improvement of current care. Ultimately, this information will provide a basis for the next steps in culturally sensitive cancer care for the Zuni Pueblo.

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Perceptions of Cancer Causes, Prevention, and Treatment Among Navajo Cancer Survivors

Cited by 11 publications

References 18 publications

Disparities in Breast-Conserving Therapy for Non-Hispanic American Indian/Alaska Native Women Compared with Non-Hispanic White Women

Disparities in Breast-Conserving Therapy for Non-Hispanic American Indian/Alaska Native Women Compared with Non-Hispanic White Women

Development of a Culturally Relevant Physical Activity Intervention for Navajo Cancer Survivors

Assessing Knowledge and Perceptions About Cancer Among American Indians of the Zuni Pueblo, NM

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