Older African American women's beliefs, attitudes, and behaviors about breast cancer

Breast cancer poses a greater risk for African American than Caucasian women due to persistent health disparities. To reduce mortality risk, culturally specific knowledge is needed to support and encourage regular breast cancer screening and risk-reduction behaviors in older African American women. The specific aims of this study were to identify social, cultural, and behavioral factors associated with regular participation in breast cancer screening and risk-reduction behaviors; examine health beliefs that may influence regular participation in breast cancer screening and risk-reduction behaviors; and identify perceived facilitators and barriers to regular breast cancer screening and risk-reduction behaviors. African American women older than 65 (N = 57) participated in six focus groups. Analysis of focus group data revealed six major themes: Being Blessed, Cancer as a Death Sentence, Fear/Fear of Disfigurement, Avoiding Finding Out, Beliefs About Breast Cancer, and Tending to One's Family. These themes could be used by health care providers to develop culturally relevant educational initiatives to promote breast health practices and risk-reduction behaviors in this vulnerable population, thus helping reduce breast cancer disparities.     

African American women's beliefs about mental illness,stigma, and preferred coping behaviors

We examined African American women's representations/beliefs about mental illness, preferred coping behaviors if faced with mental illness, whether perceived stigma was associated with treatment‐seeking, and if so, whether it was related to beliefs and coping preference, and whether these variables differed by age group. Participants were 185 community‐dwelling African American women 25 to 85 years of age. Results indicated the women believed that mental illness is caused by several factors, including family‐related stress and social stress due to racism, is cyclical, and has serious consequences but can be controlled by treatment. Participants endorsed low perceptions of stigma. Major preferred coping strategies included praying and seeking medical and mental health care. Age differences were found in all variables except stigma. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32:480–492, 2009     

Measuring breast cancer and mammography screening beliefs among Chinese American immigrants

Disparities in breast cancer outcomes persist among Asian American women. Breast cancer is the most commonly diagnosed cancer among Chinese American women. This article describes the psychometric evaluation of an instrument measuring knowledge and beliefs related to breast cancer and screening among Chinese American women aged 40 or older. A sample of 100 foreign-born Chinese American women were recruited from an Asian community. Guided by the health belief model, a questionnaire was adapted from three existing questionnaires. Principal axis factoring analyses yielded a three-factor solution that accounted for 53% of the variance in the breast cancer items and a four-factor solution that accounted for 69% of the variance in the cultural items (Cronbach's alphas = .71-.89). Whereas these findings contribute to the understanding of the psychometric properties of an instrument targeted for Chinese American women, additional research is needed to evaluate its utility and efficacy for other Asian Americans.     

Cancer fatalism and breast cancer screening in African American women.

Despite significant advances in science, medicine, and technology African American women are more likely to die from breast cancer than Caucasian women. There is a growing body of literature that describes strategies to improve breast cancer screening among African American women. However, data suggest that African American women, compared to Caucasian women, are less likely to participate in regular breast cancer screening. The belief that a diagnosis of cancer will result in death has been identified as a potential barrier to cancer screening in African American population groups. However, research examining the degree to which perceptions of fatalism influence breast cancer screening in culturally and ethnically diverse population groups is scant. This repot describes the outcomes of a study undertaken to examine relationships between perceptions of cancer fatalism and breast cancer screening in African American women. Findings support the postulation that fatalism negatively influences health promoting practices such as breast cancer screening. However, contrary to prior research findings age was observed to be inversely associated with cancer fatalism.     

Health beliefs and high-risk sexual behaviors among HIV-infected African American men.

The purpose of this study was to describe whether the health beliefs of HIV-infected African American heterosexual men and men who have sex with men predict condom use during anal, vaginal, and oral sex. The sample consisted of 130 HIV-infected African American men with a mean age of 46 years. Multiple logistic regression analysis showed that the odds of noncondom use during anal sex was highest among heterosexual men and those with perceived barriers to condoms. Furthermore, participants without a relationship and those not discussing safe sex with their partners were more likely not to use condoms during vaginal sex.     

Developing and testing lay literature about breast cancer screening for African American women

Written materials about breast cancer screening for African American women with low literacy skills are needed. Available materials were not at or below third-grade reading levels, were not culturally sensitive, and were not accurate in illustrating correct breast self-examination (BSE) techniques. Focus groups representing the target population helped the authors design a pamphlet describing how to perform BSE and a motivational picture book to help women overcome barriers to screening. The authors chose a food theme for the cover of the pamphlet written at a third-grade level and suggested a photographic version. In the motivational book, two women address barriers to screening and replace myths and fears with facts and actions. Data from 162 women showed that they learned from both the photographic and illustrated versions. Women in the photographic group found significantly more lumps in the silicone models, so the authors chose that version to use in final testing. Finally, nurses pretested a group of patients before they reviewed the materials and post-tested another group after they reviewed them. The group who had reviewed the materials had greater knowledge of and intent to follow the guidelines and received higher scores on BSE techniques.     

Korean women's attitudes toward breast cancer screening tests

The purpose of the study was to explore Korean women's attitudes toward breast cancer screening tests from a feminist perspective. Twenty Korean women working in Dong-Dae-Moon Market in Seoul, South Korea were recruited using a convenience sampling method. Semi-structured in-depth interviews were conducted using an interview guideline that was developed for the study. The data were analyzed using a thematic analysis. The themes emerged from the analysis process included: "importance of breasts to women", "fearful, but not related to me", "bad previous experience", and "no need for a breast exam." Based on the findings, implications for nursing practice are proposed.     

African American beliefs about diabetes

In this presentation, a diabetes explanatory model of rural, African American adults at high risk for diabetes is described. Kleinman's explanatory model of illness was used as the organizing framework. African American men and women (N=42), between the ages of 18 and 51, participated. Participants described their knowledge and beliefs about diabetes, preventing diabetes, and whether diabetes could be cured or controlled. A common explanatory model of diabetes was not shared among the participants, and gender and age differences were apparent. Common themes included diabetes "running in families", "eating too much sugar", and "not taking care of yourself" as causes of diabetes. Weight and physical activity or exercise were not seen as contributing to the development of diabetes. Participants were not sure if diabetes could be prevented. These results provide information to address primary prevention of diabetes in this at-risk group.     

Elderly African American women's knowledge and belief about colorectal cancer.

The purpose of this pilot study using focus groups was to 1) identify elderly African American women's knowledge and belief about colorectal cancer, 2) determine whether African American elderly women seek preventative measures for colorectal cancer, and 3) determine the educational needs to increase participation in colon cancer screening. The author used a convenience sample of 15 African-American women between the ages of 45-69 recruited from a moderately large church in a major urban city. Results of the study showed that there was a very low level of participation in colon cancer screening among the women in the group. Over 70 percent had a college degree or higher and 62 percent had no knowledge about colorectal cancer. 77 percent were employed with 69 percent having health insurance; 38 percent did not perceive themselves at any risk for colorectal cancer; and only 23 percent stated that they had been tested for colon cancer. Reasons for not getting screened were: fear; afraid of pain; doctor never recommended any tests; had no symptoms; competing health histories; embarrassment; and flaws in risk perception.     

Older women's breast screening behaviors: what nurses need to know.

A study was conducted to assess whether the screening behaviors of breast self-examination, mammography, and clinical breast examination differed among older women. Results have implications for nurses caring for older women.     

Colon cancer screening in African American women.

African American women are more likely to die of colorectal cancer than are women of any other racial or ethic group. Early diagnosis depends on routine examination and screening. However, studies have shown that African American women are not utilizing available screening tools. African American women age fifty or older were questioned about their risk factors and frequency of CRC screening. The conceptual framework used was the Health Belief Model. Women who perceived fewer barriers, more benefits, higher perceived susceptibility, and increased confidence in the accuracy of screening, were likely to undergo screening. Implications for nursing practice are discussed especially focused on the role of advanced practice nurses as primary care providers. Utilization of a faith-based approach to reaching this population was also suggested.     

Knowledge and beliefs related to cervical cancer and screening among Korean American women

The purpose of this article is to examine knowledge and health beliefs associated with cervical cancer screening among Korean American women. A telephone survey was conducted with 189 Korean American women in the Chicago area. Age, marital status, income, knowledge of early detection method for cervical cancer, and perceived beliefs about benefits of and barriers to receiving Pap tests were all related to outcomes of ever having a Pap test and having had one in the preceding 3 years. Variables uniquely related to ever having a Pap test were education, employment status, fluency in English, and proportion of life spent in the United States. Variables uniquely related to having had the test during the preceding 3 years were having a usual source of care and regular checkups. Different intervention components are suggested for the groups of Korean American women who have never had a Pap smear and for those who have not had one in the preceding 3 years, in addition to common intervention strategies that aim to increase knowledge and perceived benefit and to decrease perceived barriers to receiving Pap tests.