title: African American Women: Surviving Breast Cancer Mortality against the Highest Odds.
abstract: Among the country's 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African American women are twice as likely to die from breast cancer as White women. This qualitative study of African-American breast cancer survivors explores experiences during and post treatment that contributed to their beating the high odds of mortality. Using a semi-structured interview guide, a focus group session was held in 2012 with 10 breast cancer survivors. Thematic analysis and a deductive a priori template of codes were used to analyze the data. Five main themes were identified: family history, breast/body awareness and preparedness to manage a breast cancer event, diagnosis experience and reaction to the diagnosis, family reactions, and impact on life. Prayer and family support were central to coping, and survivors voiced a cultural acceptance of racial disparities in health outcomes. They reported lack of provider sensitivity regarding pain, financial difficulties, negative responses from family/friends, and resiliency strategies for coping with physical and mental limitations. Our research suggested that a patient-centered approach of demystifying breast cancer (both in patient-provider communication and in community settings) would impact how women cope with breast cancer and respond to information about its diagnosis.
authors.affiliation: Department of Clinical Pharmacy, University of Tennessee Health Science Center, 881 Madison, Suite 202, Memphis, TN 38163, USA. swhiteme@uthsc.edu.
authors.forename: Shelley
authors.initials: S
authors.lastname: White-Means
authors.affiliation: Mustard Seed, Inc., 653 Mississippi Blvd, Memphis, TN 38126, USA. muriel_rice@att.net.
authors.forename: Muriel
authors.initials: M
authors.lastname: Rice
authors.affiliation: Loewenberg School of Nursing, University of Memphis, 3567 Community Health Building, Memphis, TN 38152, USA. jdaprmnt@memphis.edu.
authors.forename: Jill
authors.initials: J
authors.lastname: Dapremont
authors.affiliation: Department of Management, Fogelman College of Business and Economics, University of Memphis, Memphis, TN 38152, USA. bddavis@memphis.edu.
authors.forename: Barbara
authors.initials: B
authors.lastname: Davis
authors.affiliation: Shelby County Health Department, Memphis, TN 38105, USA. judy.martin@shelbycountytn.gov.
authors.forename: Judy
authors.initials: J
authors.lastname: Martin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008875:Middle Aged; D018802:Patient-Centered Care; D036301:Qualitative Research; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data*; D013714:Tennessee / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
keywords: African American women; breast cancer; focus group; health disparities; patient/provider communication; survivorship