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Gendered and racialized social expectations, barriers, and delayed breast cancer diagnosis
Author(s) -
Kim Sage J.,
Glassgow Anne Elizabeth,
Watson Karriem S.,
Molina Yamile,
Calhoun Elizabeth A.
Publication year - 2018
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31636
Subject(s) - medicine , poverty , breast cancer , distrust , intervention (counseling) , mammography , social support , affect (linguistics) , cancer screening , cancer , gerontology , family medicine , nursing , social psychology , psychology , economic growth , psychotherapist , communication , economics
Background Black women are more likely to be diagnosed at a later stage of breast cancer in part due to barriers to timely screening mammography, resulting in poorer mortality and survival outcomes. Patient navigation that helps to overcome barriers to the early detection of breast cancer is an effective intervention for reducing breast cancer disparity. However, the ability to recognize and seek help to overcome barriers may be affected by gendered and racialized social expectations of women. Methods Data from a randomized controlled trial, the Patient Navigation in Medically Underserved Areas study, were used. The likelihood of obtaining a follow‐up screening mammogram was compared between women who identified ≥1 barriers and those who did not. Results Of the 3754 women who received the Patient Navigation in Medically Underserved Areas navigation intervention, approximately 14% identified ≥ 1 barriers, which led to additional navigator contacts. Consequently, those women who reported barriers were more likely to obtain a subsequent screening mammogram. Black women, women living in poverty, and women with a higher level of distrust were less likely to report barriers. Conclusions Minority women living in poverty have always been the source of social support for others. However, gendered and racialized social expectations may affect the ways in which women seek help for their own health needs. A way to improve the effectiveness of navigation would be to recognize how minority women's gender images and expectations could shape how they seek help and support. A report of no barriers does not always translate into no problems. Proactive approaches to identify potential barriers may be beneficial.