Advertisement

Journal of Immigrant and Minority Health

, Volume 20, Issue 3, pp 674–679 | Cite as

Qualitative Study of Latino Cancer Patient Perspectives on Care Access and Continuity in a Rural, U.S.-Mexico Border Region

  • Eunjeong Ko
  • María Luisa Zúñiga
  • Helen Palomino
  • Diana Peacher
  • Mercedes Watson
Original Paper

Abstract

Access to quality cancer care for cancer patients living in the rural U.S.-Mexico border region is complex due to common binational health care-seeking behaviors and regional socio-economic and cultural characteristics. But little is known about the challenges border dwelling residents face when navigating their cancer care systems. In-depth interviews were conducted with 22 cancer patients in Southern California. Thematic analysis was applied to identify patterns of meaning in the data. Emerging themes were: (1) delays in cancer care coordination: (a) poor coordination of cancer care (b) U.S. and cross-border discordance in cancer diagnosis; (2) regional shortage of cancer specialists; and (3) financial hardship. Findings revealed that care needs distinctly involved care coordination in/outside of the patient’s community and bi-national care coordination. In addition to local solutions to improve cancer coordination through community-based partnerships, efforts to bridge care in a two-nation context are also imperative.

Keywords

Rural Cancer patients Latino Care barriers Binational care U.S.-Mexico border 

Notes

Compliance with Ethical Standards

Conflict of interest

We would like to declare that there is no conflict of interest for all authors.

Informed Consent

All study participants signed the informed consent and this study was approved by the San Diego State University Institutional Review Board.

References

  1. 1.
    Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, Ruhl J, Howlader N, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Cronin K, Chen HS, Feuer, EJ, Stinchcomb DG, Edwards BK. SEER cancer statistics review, 1975–2007. Bethesda: National Cancer Institute; 2010.Google Scholar
  2. 2.
    Mojica CM, Glenn BA, Chang C, Bastani R. The relationship between neighborhood immigrant composition, limited English proficiency, and late-stage colorectal cancer diagnosis in California. Biomed Res Int. 2015. doi: 10.1155/2015/460181.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Mobley LR, Kuo T-M. Demographic disparities in late-stage diagnosis of breast and colorectal cancers across the USA. J Racial Ethn Health Disparities. 2016;4:1–12.Google Scholar
  4. 4.
    Casey MM, Thiede Call K, Klingner JM. Are rural residents less likely to obtain recommended preventive healthcare services? Am J Prev Med. 2001;21(3):182–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Elewonibi BR, Thierry AD, Miranda PY. Examining mammography use by breast cancer risk, race, nativity, and socioeconomic status. J Immigr Minor Health. 2016. doi: 10.1007/s10903-016-0502-3.PubMedGoogle Scholar
  6. 6.
    Stern MC, Fejerman L, Das R, Setiawan VW, Cruz-Correa MR, Perez-Stable EJ, Figueiredo JC. Variability in cancer risk and outcomes within US Latinos by national origin and genetic ancestry. Curr Epidemiol Rep. 2016;3:181–90.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Su D, Pratt W, Stimpson JP, Wong R, Pagán JA. Uninsurance, underinsurance, and health care utilization in Mexico by US border residents. J Immigr Minor health. 2014;16(4):607–12.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Bergmark R, Barr D, Garcia R. Mexican immigrants in the US living far from the border may return to Mexico for health services. J Immigr Minor Health. 2010;12(4):610–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Wallace SP, Mendez-Luck C, Castañeda X. Heading south: why Mexican immigrants in California seek health services in Mexico. Med Care. 2009;47(6):662–9.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Collins D, Villagran MM, Sparks L. Crossing borders, crossing cultures: barriers to communication about cancer prevention and treatment along the U.S./Mexico border. Patient Educ Couns. 2008;71(3):333–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Baldwin L-M, Cai Y, Larson EH, Dobie SA, Wright GE, Goodman DC, Matthews B, Hart LG. Access to cancer services for rural colorectal cancer patients. J Rural Health. 2008;24(4):390–9.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Massarweh NN, Chiang Y-J, Xing Y, Chang GJ, Haynes AB, You YN, Feig BW, Cormier JN. Association between travel distance and metastatic disease at diagnosis among patients with colon cancer. J Clin Oncol. 2014;32(9):942–8.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Celaya MO, Rees JR, Gibson JJ, Riddle BL, Greenberg ER. Travel distance and season of diagnosis affect treatment choices for women with early-stage breast cancer in a predominantly rural population (United States). Cancer Causes Control. 2006;17(6):851–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Fernandez ME, Wippold R, Torres-Vigil I, Byrd T, Freeberg D, Bains Y, Guajardo J, Coughlin SS, Vernon SW. Colorectal cancer screening among Latinos from U.S. cities along the Texas–Mexico border. Cancer Causes Control. 2008;19(2):195–206.CrossRefPubMedGoogle Scholar
  15. 15.
    Coughlin SS, Uhler RJ, Richards T, Wilson KM. Breast and cervical cancer screening practices among Hispanic and non-Hispanic women residing near the United States-Mexico border, 1999–2000. Fam Community Health. 2003;26(2):130–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Nuño T, Castle PE, Harris R, Estrada A, García F; Yuma Project Technical Team. Breast and cervical cancer screening utilization among Hispanic women living near the United States-Mexico border. J Women’s Health. 2011;20(5):685–93.CrossRefGoogle Scholar
  17. 17.
    Jaramillo S, Hui D. End-of-life care for undocumented immigrants with advanced cancer: documenting the undocumented. J Pain Symptom Manag. 2016;51(4):784–8.CrossRefGoogle Scholar
  18. 18.
    Molina Y, Silva A, Rauscher GH. Racial/ethnic disparities in time to a breast cancer diagnosis: the mediating effects of healthcare facility factors. Med Care. 2015;53(10):872–8.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Ko E, Zúñiga ML, Peacher D, Palomino H, Watson M. Efficacy of cancer care communication between clinicians and Latino patients in a rural U.S.-Mexico border region: a qualitative study of barriers and facilitators to better communication. J Cancer Educ. 2016. doi: 10.1007/s13187-016-1100-8.
  20. 20.
    Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRefGoogle Scholar
  21. 21.
    McNulty JA, Nail L. Cancer survivorship in rural and urban adults: a descriptive and mixed methods study. J Rural Health. 2015;31(3):282–91.CrossRefPubMedGoogle Scholar
  22. 22.
    Walsh J, Young JM, Harrison JD, Butow PN, Solomon MJ, Masya L, White K. What is important in cancer care coordination? A qualitative investigation. Eur J Cancer Care. 2011;20(2):220–7.CrossRefGoogle Scholar
  23. 23.
    Servin AE, Muñoz FA, Strathdee SA, Kozo J, Zúñiga ML. Choosing sides: HIV health care practices among shared populations of HIV-positive Latinos living near the US-Mexico border. J Int Assoc Physicians AIDS Care 2012;11(6):348–55.CrossRefGoogle Scholar
  24. 24.
    Meilleur A, Subramanian SV, Plascak JJ, Fisher JL, Paskett ED, Lamont EB. Rural residence and cancer outcomes in the United States: issues and challenges. Cancer Epidemiol Biomark Prev. 2013;22(10):1657–67.CrossRefGoogle Scholar
  25. 25.
    Aboagye JK, Kaiser HE, Hayanga AJ. Rural-urban differences in access to specialist providers of colorectal cancer care in the United States: a physician workforce issue. JAMA Surg. 2014;149(6):537–43.CrossRefPubMedGoogle Scholar
  26. 26.
    Ann Bettencourt B, Schlegel RJ, Talley AE, Molix LA. The breast cancer experience of rural women: a literature review. Psycho-oncology. 2007;16(10):875–87.CrossRefPubMedGoogle Scholar
  27. 27.
    Hoerster KD, Beddawi S, Michael Peddecord K, Ayala GX. Healthcare use among California farmworkers: predisposing and enabling factors. J Immigr Minor Health. 2010;12(4):506–12.CrossRefPubMedGoogle Scholar
  28. 28.
    De Jesus M, Xiao C. Cross-border health care utilization among the Hispanic population in the United States: implications for closing the health care access gap. Ethn Health. 2013;18(3):297–314.CrossRefPubMedGoogle Scholar
  29. 29.
    Natale-Pereira A, Enard KR, Nevarez L, Jones LA. The role of patient navigators in eliminating health disparities. Cancer. 2011;117(S15):3541–50.CrossRefGoogle Scholar
  30. 30.
    Palomino H, Peacher D, Ko E, Woodruff SI, Watson M. Barriers and challenges of cancer patients and their experience with patient navigators in the rural US/Mexico border region. J Cancer Educ. 2015;32:1–7.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Eunjeong Ko
    • 1
  • María Luisa Zúñiga
    • 2
  • Helen Palomino
    • 3
  • Diana Peacher
    • 3
  • Mercedes Watson
    • 3
  1. 1.School of Social WorkSan Diego State UniversitySan DiegoUSA
  2. 2.School of Social Work, Center for Alcohol and Drug StudiesSan Diego State UniversitySan DiegoUSA
  3. 3.Cancer Resource Center of the DesertEl CentroUSA

Personalised recommendations