title: Are survivorship care plans responsive to African-American breast cancer survivors?: voices of survivors and advocates.
abstract: OBJECTIVE
  African-American breast cancer survivors (AABCS) suffer the greatest from cancer recurrence, morbidity, and mortality in part due to the lack of cancer follow-up care and surveillance. To improve survival and survivorship, the Institute of Medicine advises that cancer survivors be provided a survivorship care plan (SCP). The current study investigated AABCS' understanding of SCP and gathered preliminary feedback on infusing cultural and socioecological responsiveness.
  
  
  METHODS
  The study embraced a community-based participatory research framework. Three facilitated, structured, consensus meetings were conducted with AABCS (N = 25) and advocates (N = 3) to provide information towards identifying the content domains of an SCP that are culturally responsive to AABCS.
  
  
  RESULTS
  AABCS recommended inclusion of patient-centered information on the purpose and use of the SCP. They raised concerns that higher mortality in AABCS may be due to greater comorbidities and inadequate surveillance and follow-up care. Participants recommended that the SCP document all comorbidities and medications, regardless of relationship to cancer; referrals for cancer-related providers; and culturally informed health advisories.
  
  
  CONCLUSIONS
  Study findings indicate that the available SCP template lacked adequate content on health history, comorbidity, health promotion, and functioning. These factors constitute the underlying clinical, psychosocial, and behavioral risks for poor disease outcomes that may be exacerbated in AABCS.
  
  
  CONCLUSIONS
  SCPs are intended to educate and activate patients to join their oncology care team as informed partners. However, the emerging science and implementation of SCPs seem void of patient input. Our investigation suggests a practical approach for survivor engagement in the SCP discourse to increase their cultural responsiveness and patient-centeredness.
authors.affiliation: CCARE, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010-3000, USA. kashing@coh.org
authors.forename: Kimlin
authors.initials: K
authors.lastname: Ashing-Giwa
authors.forename: Carolyn
authors.initials: C
authors.lastname: Tapp
authors.forename: Shirley
authors.initials: S
authors.lastname: Brown
authors.forename: Gingi
authors.initials: G
authors.lastname: Fulcher
authors.forename: June
authors.initials: J
authors.lastname: Smith
authors.forename: Eudora
authors.initials: E
authors.lastname: Mitchell
authors.forename: Rhonda H
authors.initials: RH
authors.lastname: Santifer
authors.forename: Kommah
authors.initials: K
authors.lastname: McDowell
authors.forename: Virginia
authors.initials: V
authors.lastname: Martin
authors.forename: Betty
authors.initials: B
authors.lastname: Betts-Turner
authors.forename: Deborrah
authors.initials: D
authors.lastname: Carter
authors.forename: Monica
authors.initials: M
authors.lastname: Rosales
authors.forename: Paris Adkins
authors.initials: PA
authors.lastname: Jackson
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D010344:Patient Advocacy / Q000523:psychology / Q000706:statistics & numerical data; D010347:Patient Care Planning / Q000592:standards / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D015996:Survival Rate; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data