title: Breast cancer survivorship program: testing for cross-cultural relevance.
abstract: Taking CHARGE, a theory-based self-management program, was developed to assist women with survivorship concerns that arise after breast cancer treatment. Few such programs have been evaluated for cultural relevance with diverse groups. This study determined the utility and cultural relevance of the program for African American (AA) breast cancer survivors. Two focus groups were held with AA women (n = 13), aged 41 to 72 years, who had completed primary treatment. Focus group participants assessed the program content, format, materials, and the self-regulation process. Content analysis of audiotapes was conducted using an open, focused coding process to identify emergent themes regarding program relevance and topics requiring enhancement and/or further emphasis. Although findings indicated that the program's content was relevant to participants' experiences, AA women identified need for cultural enhancements in spirituality, self-preservation, and positive valuations of body image. Content areas requiring more emphasis included persistent fatigue, competing demands, disclosure, anticipatory guidance, and age-specific concerns about body image/sexuality. Suggested improvements to program materials included portable observation logs, additional resources, more photographs of younger AA women, vivid colors, and images depicting strength. These findings provide the basis for program enhancements to increase the utility and cultural relevance of Taking CHARGE for AA survivors and underscore the importance of evaluating interventions for racially/ethnically diverse groups.
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 109 Observatory St, Ann Arbor, MI 48109-2029, USA. lchung@umich.edu
authors.forename: Lynna K
authors.initials: LK
authors.lastname: Chung
authors.forename: Bernadine
authors.initials: B
authors.lastname: Cimprich
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Janz
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Mills-Wisneski
mesh_terms: D000328:Adult; D001741:Black or African American / Q000193:education / Q000208:ethnology*; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D001943:Breast Neoplasms / Q000208:ethnology*; D018864:Cultural Diversity; D005260:Female; D017144:Focus Groups; D006801:Humans; D008824:Michigan; D008875:Middle Aged; D020380:Needs Assessment; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology; D017741:Survivors / Q000523:psychology*