TY - JOUR
T1 - Empowered choices
T2 - African-American women’s breast reconstruction decisions
AU - Connors, Shahnjayla K.
AU - Leal, Isabel Martinez
AU - Nitturi, Vijay
AU - Iwundu, Chisom N.
AU - Maza, Valentina
AU - Reyes, Stacey
AU - Acquati, Chiara
AU - Reitzel, Lorraine R.
N1 - Funding Information:
This study was funded by the University of Houston Division of Research and University of Houston-Downtown Office of Research and Sponsored Programs Synergy Grant (MPIs: Connors, Reitzel). Additionally, the National Cancer Institute supported the efforts of some authors in the project execution phase (P20CA221696 and P20CA221697 for Iwundu) and in the manuscript writing phase (P20CA221697-04S1 for Acquati). The authors gratefully acknowledge the women who collaborated with us on this study through their contributions of time, shared experiences and dedicated community efforts to empower and further the development of culturally-relevant and equitable care of African-American breast cancer survivors. We would also like to thank the Duncan Family Institute through the Center for Community-Engaged Translational Research at the University of Texas MD Anderson Cancer Center for assistance with material preparation via the Community Scientist Program. We would like to thank MD Anderson’s Project CHURCH and The Rose of Houston for recruitment assistance. Additionally, we are grate- ful to the University of Houston’s HEALTH Research Institute for the support of Ms. Dixie Sasu, Program Manager; Mr. Imarogbe Stokes, Community Education/Outreach Coordinator; Ms. Iman Garrett-Price, former Community Education/ Outreach Coordinator; and Ms. Mirna Centeno, Senior Graphic Designer. We appreciate the many individuals who contributed to the execution of this project including Ms. Ashley Ramclam, PhD candidate, University of Houston; Dr. Shayan Izaddoost, plastic and reconstructive surgeon, Bay-lor College of Medicine; Mr. Yashwant Harkara, BS candidate, University of Houston; and Mr. Surya Chinamuthevi, BS candidate, University of Houston. The following authors’ affiliations have changed: Chisom N. Iwundu, Assistant Professor, Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, United States and Valentina Maza, Project Coordinator, Project HEART, Psycholgical Sciences Department, Rice University, Houston,TX, United States. Disclaimer: An abstract upon which this manuscript is based was accepted for presentation at the annual American Academy of Health Behavior conference that was subsequently canceled due to COVID-19; however, the abstract was published in the “2020 Annual Scientific Meeting” edition of Health Behavior Research.
Funding Information:
This study was funded by the University of Houston Division of Research and University of Houston-Downtown Office of Research and Sponsored Programs Synergy Grant (MPIs: Connors, Reitzel). Additionally, the National Cancer Institute supported the efforts of some authors in the project execution phase (P20CA221696 and P20CA221697 for Iwundu) and in the manuscript writing phase (P20CA221697-04S1 for Acquati). The authors gratefully acknowledge the women who collaborated with us on this study through their contributions of time, shared experiences and dedicated community efforts to empower and further the development of culturally-relevant and equitable care of African-American breast cancer survivors. We would also like to thank the Duncan Family Institute through the Center for Community-Engaged Translational Research at the University of Texas MD Anderson Cancer Center for assistance with material preparation via the Community Scientist Program. We would like to thank MD Anderson?s Project CHURCH and The Rose of Houston for recruitment assistance. Additionally, we are grateful to the University of Houston?s HEALTH Research Institute for the support of Ms. Dixie Sasu, Program Manager; Mr. Imarogbe Stokes, Community Education/Outreach Coordinator; Ms. Iman Garrett-Price, former Community Education/ Outreach Coordinator; and Ms. Mirna Centeno, Senior Graphic Designer. We appreciate the many individuals who contributed to the execution of this project including Ms. Ashley Ramclam, PhD candidate, University of Houston; Dr. Shayan Izaddoost, plastic and reconstructive surgeon, Baylor College of Medicine; Mr. Yashwant Harkara, BS candidate, University of Houston; and Mr. Surya Chinamuthevi, BS candidate, University of Houston. The following authors? affiliations have changed: Chisom N. Iwundu, Assistant Professor, Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, United States and Valentina Maza, Project Coordinator, Project HEART, Psycholgical Sciences Department, Rice University, Houston,TX, United States.
Publisher Copyright:
© 2021 PNG Publications. All rights reserved.
PY - 2021/4
Y1 - 2021/4
N2 - Objectives: Breast reconstruction (BR) potentially can improve quality of life in postmastectomy breast cancer survivors (BCS); however, African-American women are less likely to undergo BR than Caucasian women. This qualitative study was undertaken to explore individual, sociocultural, and contextual factors influencing African-American women’s BR decision-making processes and preferences. Methods: Postmastectomy African-American BCS with and without BR participated in semi-structured interviews. We adopted a grounded theory approach using the constant comparison method to understand the contexts and processes informing participants’ BR decision-making. Results: Twenty-three women participated, of whom 17 elected BR and 6 did not. Whereas women’s primary reasons for deciding for or against BR differed, our core category, “empowered choices,” describes both groups’ decision-making as a process focused on empowering themselves physically and/or psychologically, through self-advocacy, informed and shared decision-making, and giving back/receiving communal and spiritual support from church and African-American survivor groups. Socioeconomic factors influenced women’s access to BR. Women preferred autologous BR and expressed the need for greater culturally-matched resources and support to inform treatment and shared BR decision-making. Conclusions: Understanding and supporting African-American women’s BR preferences and empowerment is essential to ensuring equal access, and culturally-relevant, high-quality, and informed patient-centered care.
AB - Objectives: Breast reconstruction (BR) potentially can improve quality of life in postmastectomy breast cancer survivors (BCS); however, African-American women are less likely to undergo BR than Caucasian women. This qualitative study was undertaken to explore individual, sociocultural, and contextual factors influencing African-American women’s BR decision-making processes and preferences. Methods: Postmastectomy African-American BCS with and without BR participated in semi-structured interviews. We adopted a grounded theory approach using the constant comparison method to understand the contexts and processes informing participants’ BR decision-making. Results: Twenty-three women participated, of whom 17 elected BR and 6 did not. Whereas women’s primary reasons for deciding for or against BR differed, our core category, “empowered choices,” describes both groups’ decision-making as a process focused on empowering themselves physically and/or psychologically, through self-advocacy, informed and shared decision-making, and giving back/receiving communal and spiritual support from church and African-American survivor groups. Socioeconomic factors influenced women’s access to BR. Women preferred autologous BR and expressed the need for greater culturally-matched resources and support to inform treatment and shared BR decision-making. Conclusions: Understanding and supporting African-American women’s BR preferences and empowerment is essential to ensuring equal access, and culturally-relevant, high-quality, and informed patient-centered care.
KW - African Americans
KW - Breast cancer
KW - Breast reconstruction
KW - Cancer surgery
KW - Health disparities
KW - Mastectomy
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U2 - 10.5993/AJHB.45.2.14
DO - 10.5993/AJHB.45.2.14
M3 - Article
C2 - 33888195
AN - SCOPUS:85105642551
SN - 1087-3244
VL - 45
SP - 352
EP - 370
JO - American journal of health behavior
JF - American journal of health behavior
IS - 4
ER -