Department of Health Behavior and Policy, USA; VCU Massey Cancer Center Office of Health Equity and Disparities Research, 830 East Main Street, 9th Floor, Richmond, VA, 23219, USA.
Department of Health Behavior and Policy, USA; VCU Massey Cancer Center Office of Health Equity and Disparities Research, 830 East Main Street, 9th Floor, Richmond, VA, 23219, USA.
J Natl Med Assoc. 2020 Apr;112(2):167-175. doi: 10.1016/j.jnma.2020.02.006. Epub 2020 Mar 18.
Black breast cancer patients delay and underutilize adjuvant breast cancer therapies; yet, very few studies have specifically examined Black women's attitudes toward breast cancer therapy. This study observed the influence of self-reported interpersonal processes of care (e.g. self-efficacy) clinical and sociodemographic factors and sociocultural (e.g. religiosity), related to Black breast cancer patients' attitudes toward radiation and systemic therapies (chemotherapy and adjuvant endocrine therapy - "AET").
This was a secondary analysis of data from the Narrowing Gaps in Adjuvant Therapy Study (2006-2011). The analysis included 210 Black women who were newly diagnosed with breast cancer. Bivariate and multiple regression analyses were performed between independent variables (e.g., demographics) and three outcome variables (chemotherapy, AET, and radiation therapy) to asses women's perceptions of therapy type. The lasso method was used to select variables correlated with therapy attitudes.
Most women reported negative attitudes toward AET (56%) and radiation (54%); fewer negative attitudes were observed toward chemotherapy (47%). Higher education and greater perceived susceptibility of a recurrence were associated with more positive attitudes toward chemotherapy. Regarding radiation therapy, women with greater patient satisfaction were more likely to have more positive attitudes.
Our study findings may aid in the development of behavioral interventions targeted to mitigate Black women breast cancer treatment disparities. We found modifiable factors (e.g. communication, satisfaction ratings) that support opportunities for clinicians to better address Black women's needs regarding adjuvant treatment options. The development of tailored interventions for newly diagnosed Black breast cancer patients on patient related factors in health care are warranted for Black women with lower educational levels.
黑种人乳腺癌患者会延迟并较少选择辅助乳腺癌疗法；然而，很少有研究专门研究黑种女性对乳腺癌疗法的态度。本研究观察了自我报告的人际护理过程（例如自我效能感）、临床和社会人口学因素以及社会文化因素（例如宗教信仰）对黑种乳腺癌患者对放射治疗和系统治疗（化疗和辅助内分泌治疗——“AET”）态度的影响。
这是 Narrowing Gaps in Adjuvant Therapy Study（2006-2011）数据的二次分析。该分析包括 210 名新诊断为乳腺癌的黑种女性。在独立变量（例如人口统计学特征）和三个结果变量（化疗、AET 和放射治疗）之间进行了双变量和多变量回归分析，以评估女性对治疗类型的看法。使用套索法选择与治疗态度相关的变量。
大多数女性对 AET（56%）和放射治疗（54%）持负面态度；对化疗（47%）的负面态度较少。较高的教育程度和更高的复发易感性与对化疗的更积极态度相关。关于放射治疗，患者满意度较高的女性更有可能持有更积极的态度。
我们的研究结果可能有助于制定针对黑种女性乳腺癌治疗差异的行为干预措施。我们发现了一些可改变的因素（例如沟通、满意度评分），为临床医生提供了更好地满足黑种女性对辅助治疗选择的需求的机会。为了满足教育程度较低的黑种新诊断乳腺癌患者的需求，需要针对患者相关因素制定针对黑种女性的量身定制的干预措施。
