美国黑人对黑色素瘤的认知的定性研究。
Qualitative exploration of melanoma awareness in black people in the USA.
机构信息
Program for Clinical Research and Technology, Stanford University School of Medicine, Stanford, California, USA.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
出版信息
BMJ Open. 2023 Jan 11;13(1):e066967. doi: 10.1136/bmjopen-2022-066967.
OBJECTIVE
Although black patients are more likely to have advanced melanomas at diagnosis, with a 5-year survival rate among black patients of 70% compared with 92% for white patients, black people are generally not the focus of melanoma public health campaigns. We sought to explore awareness and perspectives of melanoma among black people to inform the development of relevant and valued public health messages to promote early detection of melanoma.
DESIGN
Inductive thematic analysis of in-depth semistructured interviews.
SETTING
Interviews were conducted with participants via video software or telephone in the USA.
PARTICIPANTS
Participants were adults from the USA who self-identified as African American or black. Recruitment flyers were posted around the San Francisco Bay Area and shared on our team Facebook page, with further participants identified through snowball sampling.
RESULTS
We interviewed 26 participants from 10 different states. Overall, 12 were men and 14 were women, with a mean age of 43 years (range 18-85). We identified five key themes regarding melanoma awareness in black people: (1) lack of understanding of term 'melanoma' and features of skin cancer; (2) do not feel at risk of melanoma skin cancer; (3) surprise that melanoma can occur on palms, soles and nails; (4) skin cancer awareness messages do not apply to or include black people; and (5) Importance of relationship with healthcare and habits of utilisation.
CONCLUSIONS
Analysis of these in-depth semistructured interviews illuminate the pressing need for health information on melanoma designed specifically for black people. We highlight two key points for focused public health messaging: (1) melanoma skin cancer does occur in black people and (2) high-risk sites for melanoma in black people include the palms, soles and nail beds. Therefore, public health messages for black people and their healthcare providers may involve productively checking these body surface areas.
目的
尽管黑人患者在诊断时更有可能患有晚期黑色素瘤，其 5 年生存率为 70%，而白人患者为 92%，但黑人通常不是黑色素瘤公共卫生活动的重点。我们试图探讨黑人对黑色素瘤的认识和看法，为制定相关且有价值的公共卫生信息提供依据，以促进黑色素瘤的早期发现。
设计
对深度半结构化访谈进行归纳主题分析。
设置
在美国，通过视频软件或电话对参与者进行访谈。
参与者
参与者为自认为是非裔美国人或黑人的美国成年人。招聘传单张贴在旧金山湾区各地，并在我们的团队 Facebook 页面上分享，通过滚雪球抽样进一步确定参与者。
结果
我们采访了来自 10 个不同州的 26 名参与者。总体而言，12 名是男性，14 名是女性，平均年龄为 43 岁（范围 18-85 岁）。我们确定了黑人对黑色素瘤认识的五个关键主题：（1）缺乏对“黑色素瘤”一词和皮肤癌特征的了解；（2）不认为自己有患黑色素瘤皮肤癌的风险；（3）对黑色素瘤也可能发生在手掌、脚底和指甲感到惊讶；（4）皮肤癌意识信息不适用于或不包括黑人；（5）与医疗保健的关系和利用习惯很重要。
结论
对这些深度半结构化访谈的分析阐明了为黑人设计专门的黑色素瘤健康信息的迫切需要。我们强调了有针对性的公共卫生信息传递的两个关键点：（1）黑色素瘤皮肤癌确实发生在黑人中；（2）黑人中黑色素瘤的高危部位包括手掌、脚底和指甲床。因此，针对黑人及其医疗保健提供者的公共卫生信息可能涉及有效地检查这些身体表面区域。
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