title: Antecedents and mediators of community connection in African American women with breast cancer.
abstract: OBJECTIVE
  To describe the theory of community connection defined as close relationships with women and men who are members of a neighborhood, a church, a work group, or an organization. Antecedent and mediator variables related to community connection are identified.
  
  
  METHODS
  A cross-sectional design was used to assess for relationships among theorized antecedents and mediators of community connection in a sample of 144 African American women aged 21 years and older (mean = 54.9) who had been diagnosed with invasive/infiltrating ductal carcinoma. MEASUREMENT AND ANALYSES: Community connection was measured with the relational health indices-community subscale. Mediator analysis was conducted to assess significance of the indirect effects of the mediator variables, which were fear, breast cancer knowledge, and isolation.
  
  
  RESULTS
  Community connection was found to be associated with three of the four antecedents, cancer stigma, stress, and spirituality, but not associated with fatalism. Effects were mediated primarily through fear and isolation with isolation as was more dominant of the two mediators. Surprisingly, breast cancer knowledge showed no significant mediator role.
  
  
  CONCLUSIONS
  The importance of isolation and fear as mediators of community connection is highlighted by this research. The study could serve as a model for other researchers seeking to understand connection in ethnic groups and communities.
authors.affiliation: Palmetto Health Cancer Centers, Columbia, South Carolina, USA. heineys@mailbox.sc.edu
authors.forename: Sue P
authors.initials: SP
authors.lastname: Heiney
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Hazlett
authors.forename: Sally P
authors.initials: SP
authors.lastname: Weinrich
authors.forename: Linda M
authors.initials: LM
authors.lastname: Wells
authors.forename: Swann Arp
authors.initials: SA
authors.lastname: Adams
authors.forename: Sandra Millon
authors.initials: SM
authors.lastname: Underwood
authors.forename: Rudolph S
authors.initials: RS
authors.lastname: Parrish
mesh_terms: D000328:Adult; D001741:Black or African American; D001943:Breast Neoplasms; D005260:Female; D006801:Humans; D008875:Middle Aged; D012944:Social Support