Patricia Gonzalez

Diagnostic and therapeutic delays among a multiethnic sample of breast and cervical cancer survivors

Several publications reporting on health disparities document that ethnic minorities disproportionately experience delays in healthcare access, delivery, and treatment. However, few studies examine factors underlying access and receipt of healthcare among cancer survivors from the patient perspective. This study explores diagnostic and therapeutic care delays among a multiethnic sample of breast and cervical cancer survivors and examines contextual factors influencing diagnostic and therapeutic care delays.

Understanding the cultural health belief model influencing health behaviors and health-related quality of life between Latina and Asian-American breast cancer survivors.

PurposeThe purpose of this study was to (1) describe health behaviors and health-related quality of life (HRQOL) of Latina and Asian-American breast cancer survivors (BCS), (2) estimate possible culturally driven predictors of health behaviors and HRQOL, and (3) compare pathways for predicting health behaviors and HRQOL between the two groups.Materials and methodsSecondary data were used to investigate health behaviors and HRQOL among 183 Latina and 206 Asian Americans diagnosed with breast cancer. The study methodology was guided by the health belief model and the contextual model of HRQOL. Structural equation modeling was used to test cultural predictors on health behaviors of BCS.ResultsAsian Americans reported higher emotional and physical well-being scores than Latina-Americans. Confirmatory factor analyses demonstrated the adequacy of the two-factor model (“powerful others” and “sociocultural factors”) in the cultural health belief construct for Latina and Asian-American BCS. In the structural model, Latinas and Asian Americans showed different pathways in the predicted relationships among the variables. For Latina-Americans, doctor–patient relationship was positively related to exercise, and in turn, influenced physical and emotional well-being. For Asian Americans, treatment decisions and the “sociocultural factor” were significantly related to stress management.ConclusionThis study adds to the existing literature in that no study has focused on cultural health beliefs and health behaviors between Latina and Asian-American BCS. Evidence that Latinas and Asian Americans varied in the patterns of cultural factors influencing health behaviors and HRQOL might lead to the development of culturally sensitive breast cancer interventions for promoting positive health behavior and ultimately increasing HRQOL.

The Latina Breast Cancer Screening Sacle Beliefs about breast cancer and breast cancer screening

The Latina Breast Cancer Screening (LBCS) was developed to measure Latinas’ culturally-shared health beliefs about breast cancer and breast cancer screening. A 60-item LBCS scale was tested with 288 participants and reduced to 35 items using principal components analyses. The 35-item LBCS scale and other measures were administered to a second sample of 147 participants to establish the scale’s validity and reliability. A six-factor solution suggested six LBCS sub-scales. The LBCS in its entirety displayed strong internal consistency (α =.93) with adequate estimates of convergent, discriminant, and predictive validity. The LBCS scale appears to be a valid and reliable measure.

Coping with breast cancer: Reflections from Chinese American, Korean American, and Mexican American women.

OBJECTIVE The present study identified and compared the coping strategies of Chinese American, Korean American, and Mexican American breast cancer survivors (BCS). METHODS Six focus groups were conducted with Chinese American (n = 21), Korean American (n = 11), and Mexican American (n = 9) BCS. Interviews were audio-recorded, transcribed, and translated for thematic content analysis of coping experiences and strategies. RESULTS Women reported the use of 8 coping strategies (religious/spiritual, benefit finding, fatalism, optimism, fighting spirit, information seeking, denial, and self-distraction). Among Chinese American BCS, benefit finding was the most referenced coping strategy, whereas religious/spiritual coping was most frequently reported among Korean American and Mexican American BCS. Denial and self-distraction were the least cited strategies. CONCLUSIONS Survivors draw upon new found inner strength to successfully integrate their cancer experience into their lives. Coping models must consider the diversity of cancer survivors and the variability in coping strategies among cultural ethnic minority BCS.