Reducing Racial Disparities in Breast Cancer Survivors' Ratings of Quality Cancer Care

Sheppard, Vanessa B.; Hurtado‐de‐Mendoza, Alejandra; Talley, Costellia H.; Zhang, Yihong; Cabling, Mark L.; Makambi, Kepher H.

doi:10.1097/jhq.0000000000000046

Cited by 19 publications

(9 citation statements)

References 61 publications

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“…45–47 Underlying this knowledge barrier may be concerns about genetic discrimination and a lack of trust in the medical system—a recurrent theme in the literature on African Americans. 48,49 A lack of provider referrals to genetic services as well as high costs and administrative barriers for these services have been shown to limit young African American breast cancer survivors’ participation in genetic counseling and testing. 50,51…”

Section: Discussionmentioning

confidence: 99%

Communicating with Daughters About Familial Risk of Breast Cancer: Individual, Family, and Provider Influences on Women's Knowledge of Cancer Risk

Peipins

Rodriguez

Hawkins

et al. 2018

Journal of Women's Health

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Section: Discussionmentioning

confidence: 99%

Communicating with Daughters About Familial Risk of Breast Cancer: Individual, Family, and Provider Influences on Women's Knowledge of Cancer Risk

Peipins

Rodriguez

Hawkins

et al. 2018

Journal of Women's Health

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“…Specifically, Blacks report higher mistrust towards the medical establishment than their White counterparts [5][6][7]. Feelings of medical mistrust are more prevalent in Black breast cancer patients than White breast cancer patients and may contribute to existing disparities in treatment utilization [6,8]. Studies have shown that individuals who report greater medical mistrust also tend to have poorer physical and emotional well-being and quality of life [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Medical Mistrust in Black Breast Cancer Patients: Acknowledging the Roles of the Trustor and the Trustee

Sutton

Edmonds

et al. 2018

J Canc Educ

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Studies indicate that Black patients report higher medical mistrust compared to their White counterparts. However, little is known about factors associated with higher medical mistrust among Black breast cancer patients. We examined predictors of medical mistrust and relationships between medical mistrust, subscales of mistrust, and process of care factors to identify opportunities to promote positive healthcare interactions between the trustees (e.g., providers) and Black breast cancer patients, or the trustors. A secondary analysis was conducted of survey data from 210 Black women with confirmed diagnosis of invasive breast cancer. Participants completed telephone surveys consisting of questions pertaining to sociodemographics, attitudes, and beliefs about medical care and breast cancer treatments. Multiple linear regression determined factors associated with medical mistrust and mistrust subscales. Most participants (61%) were over the age of 50 and currently single (64.8%). Women with greater medical mistrust reported less satisfaction with the trustee's technical ability (p < 0.0001) and greater satisfaction with their own propensity to access care (p < 0.05). Additionally, women with public insurance demonstrated greater mistrust (p < 0.01) and suspicion (p < 0.05) than women with private insurance, and women with less education reported greater perceived discrimination than women who have at least a bachelor's degree. Findings from this study may inform future endeavors to educate providers on ways to effectively interact with and treat Black breast cancer patients. Opportunities to develop interventions that address and tackle issues of mistrust as reported by Black patients may contribute to ongoing efforts to reduce health disparities.

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“…All three beliefs and attitudes have been found to predict less favorable patient perceptions of their physician because they relate to anticipation of bias (mistrust of physicians and past discrimination) and critical scrutiny (healthcare suspicion) (e.g., Hagiwara et al, 2013; Penner et al, 2009; Sheppard et al, 2016). We predicted that we would replicate these effects for mistrust and suspicion in oncology interactions on patient perceptions of the physician’s patient-centeredness during the interaction and trust for the physician.…”

Section: Introductionmentioning

confidence: 99%

The impact of Black cancer patients' race-related beliefs and attitudes on racially-discordant oncology interactions: A field study

Penner

Harper

Dovidio

et al. 2017

Social Science & Medicine

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Objective Both physician and patient race-related beliefs and attitudes are contributors to racial healthcare disparities, but only the former have received substantial research attention. Using data from a study conducted in the Midwestern US from 2012 to 2014, we investigated whether 114 Black cancer patients’ existing race-related beliefs and attitudes would predict how they and 18 non-Black physicians (medical oncologists) would respond in subsequent clinical interactions. Method At least two days before interacting with an oncologist for initial discussions of treatment options, patients completed measures of perceived past discrimination, general mistrust of physicians, and suspicion of healthcare systems; interactions were video-recorded. Measures from each interaction included patients’ verbal behavior (e.g., level of verbal activity), patients’ evaluations of physicians (e.g., trustworthiness), patients’ perceptions of recommended treatments (e.g., confidence in treatment), physicians’ evaluations of patient personal attributes (e.g., intelligence) and physicians’ expectations for patient treatment success (e.g., adherence). Results As predicted, patients’ race-related beliefs and attitudes differed in their associations with patient and physician responses to the interactions. Higher levels of perceived past discrimination predicted more patient verbal activity. Higher levels of mistrust also predicted less patient positive affect and more negative evaluations of physicians. Higher levels of suspicion predicted more negative evaluations of physicians and recommended treatments. Stronger patient race-related attitudes were directly or indirectly associated with lower physician perceptions of patient attributes and treatment expectations. Conclusion Results provide new evidence for the role of Black patients’ race-related beliefs and attitudes in racial healthcare disparities and suggest the need to measure multiple beliefs and attitudes to identify these effects.

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Reducing Racial Disparities in Breast Cancer Survivors' Ratings of Quality Cancer Care

Abstract: Racial disparities in ratings of healthcare quality were diminished across several domains after controlling for psychosocial and healthcare factors. Strategies aimed at improving self-efficacy in women with higher levels of mistrust may improve patient satisfaction.

Cited by 19 publications

References 61 publications

Communicating with Daughters About Familial Risk of Breast Cancer: Individual, Family, and Provider Influences on Women's Knowledge of Cancer Risk

Communicating with Daughters About Familial Risk of Breast Cancer: Individual, Family, and Provider Influences on Women's Knowledge of Cancer Risk

Medical Mistrust in Black Breast Cancer Patients: Acknowledging the Roles of the Trustor and the Trustee

The impact of Black cancer patients' race-related beliefs and attitudes on racially-discordant oncology interactions: A field study

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