title: How a cancer education group serves the underserved: 'family' ties and battling cancer.
abstract: OBJECTIVE
  Socially disadvantaged cancer patients have unmet educational needs, but we know little about how educational groups might help. This exploratory study examines how a group education program met underserved patients' needs.
  
  
  METHODS
  We examined a program for US patients in a safety-net hospital that featured English and Spanish language groups. We collected data from 54 group sessions over 28 months, including information on participant demographics, attendance, and satisfaction. Qualitative field notes collected by trained observers were analyzed via a grounded-theory approach to examine group dynamics.
  
  
  RESULTS
  Participants were underserved, had diverse disease sites and race/ethnicity, and reported that groups met their needs. Emergent analysis identified two themes related to group dynamics. First, members identified with each other as a fictive family, although the meaning of "family" differed in the groups. Second, groups focused on battling cancer not adjusting to life as a survivor-a focus that impaired participants' ability to discuss coping strategies for managing negative feelings.
  
  
  CONCLUSIONS
  Fictive 'family' engages participants. The emphasis on 'family' and resistance to coping strategies may reflect participants' social disadvantages.
  
  
  CONCLUSIONS
  Groups for the underserved should strive to create a 'family' and may have difficulty helping participants cope with their illness.
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, UC San Francisco, San Francisco, CA 94118, USA. daniel.dohan@ucsf.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Dohan
authors.forename: Robertina
authors.initials: R
authors.lastname: Szolarova
authors.forename: Blue
authors.initials: B
authors.lastname: Walcer
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D006126:Group Processes; D006266:Health Education / Q000379:methods*; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011203:Poverty; D016730:Program Development; D036301:Qualitative Research; D012657:Self-Help Groups; D012944:Social Support; D017741:Survivors; D014481:United States