Sage Starr K, Hawkins-Taylor Chamika, Crockett Rev Andre, Balls-Berry Joyce E
University of St. Thomas, Department of Health and Exercise Science, 2115 Summit Ave S., Mail #4004, St. Paul, MN 55105-1078, USA.
South Dakota State University, Pharmacy & Allied Health Professions, SAV 149, Box 2202C, Brookings, SD 57007, USA.
J Natl Med Assoc. 2020 Oct;112(5):454-467. doi: 10.1016/j.jnma.2019.02.006. Epub 2019 Mar 30.
Black women in Minnesota and beyond have a greater burden of death due to some cancers than their White counterparts. Delayed screening and treatment may explain these disparate statistics. The purpose of this study was to work in collaboration with a local Black faith-based organization to gain an updated understanding of Black women's knowledge, attitudes, and behaviors related to breast and cervical cancer, and determine to what extent known factors persist as barriers to accessing cancer screening among Black women in Rochester, MN. We also sought to identify unique barriers for Black women residing in a particularly health resource rich community.
Using a community-based participatory research approach, two academic institutes worked in collaboration with a local Black faith-based organization to conduct focus groups. Focus groups were utilized to identify factors that may limit Black women's access to cancer screening and health care.
Forty-five eligible participants attended one of eight focus group sessions. All participants self-identified as Black women and most were born in the United States. Content analysis of participant responses suggested that Black women's health-seeking behaviors related to breast and cervical cancer screening continue to be very much influenced by known factors that serve as barriers to screening services. Four primary themes pertaining to these influential factors emerged from participants' focus group discussions: 1) knowledge of cancer, risk factors, and screening options; and 2) socioeconomic factors, 3) psycho-social factors, including lack of trust of doctors specifically involved in clinical research, and 4) cultural factors, including reliance on religious practice in place of medical intervention.
Black women face real and perceived barriers to cancer screening even where health resources are abundant. Results reiterate an on going need for culturally appropriate interventions to improve Black women's breast and cervical cancer screening participation by minimizing barriers and engaging entire communities - including Black women, religious leaders, and health care providers.
明尼苏达州及其他地区的黑人女性相较于白人女性，因某些癌症导致的死亡负担更重。筛查和治疗的延迟可能是造成这些不同统计数据的原因。本研究的目的是与当地一个基于黑人信仰的组织合作，以更新对黑人女性与乳腺癌和宫颈癌相关的知识、态度及行为的理解，并确定在明尼苏达州罗切斯特市，已知因素在多大程度上仍然是黑人女性获得癌症筛查的障碍。我们还试图找出居住在一个健康资源特别丰富的社区的黑人女性所面临的独特障碍。
采用基于社区的参与性研究方法，两个学术机构与当地一个基于黑人信仰的组织合作开展焦点小组讨论。焦点小组讨论用于确定可能限制黑人女性获得癌症筛查和医疗保健的因素。
45名符合条件的参与者参加了8场焦点小组讨论中的一场。所有参与者都自认为是黑人女性，且大多数在美国出生。对参与者回答的内容分析表明，黑人女性与乳腺癌和宫颈癌筛查相关的就医行为仍然受到诸多已知因素的很大影响，这些因素成为了筛查服务的障碍。参与者在焦点小组讨论中出现了与这些影响因素相关的四个主要主题：1）对癌症、风险因素及筛查选项的了解；2）社会经济因素；3）心理社会因素，包括对专门参与临床研究的医生缺乏信任；4）文化因素，包括依赖宗教活动而非医疗干预。
即使在健康资源丰富的地方，黑人女性在癌症筛查方面也面临着实际的和感知到的障碍。研究结果再次强调，持续需要采取符合文化背景的干预措施，通过减少障碍并让整个社区（包括黑人女性、宗教领袖和医疗保健提供者）参与进来，以提高黑人女性乳腺癌和宫颈癌筛查的参与率。
