Abstract
Latinas are more likely to delay recommended follow-up care than non-Latina White (NLW) women after an abnormal mammogram result. Ethnic differences in communication needs and experiences with health-care staff and providers may contribute to these delays as well as satisfaction with care. Nonetheless, little research has explored the aspects of communication that may contribute to patient comprehension, adherence to follow-up care, and satisfaction across ethnicity. The purpose of this exploratory, qualitative study was to identify patients’ communication needs and experiences with follow-up care among Latina and NLW women who received an abnormal mammogram. We conducted 41 semi-structured interviews with 19 Latina and 22 NLW women between the ages of 40 and 74 who had received an abnormal mammogram. Communication themes indicated that women’s needs and experiences concerning abnormal mammograms and follow-up care varied across ethnicity. Latinas and NLW women appeared to differ in their comprehension of abnormal results and follow-up care as a result of language barriers and health literacy. Both groups of women identified clear, empathic communication as being important in patient-provider communication; however, Latinas underscored the need for warm communicative styles, and NLW women emphasized the importance of providing more information. Women with high levels of satisfaction with patient-provider interactions appeared to have positive perspectives of subsequent screening and cancer treatment. To improve patient satisfaction and adherence to follow-up care among Latinas, educational programs are necessary to counsel health-care professionals with regard to language, health literacy, and empathic communication needs in health-care service delivery.
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References
American Cancer Society (2012) Cancer facts & figures 2012 - PDF brochure. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-031941.pdf. Accessed 5 Feb 2012
Siegel R, Naishadham D, Jemal A (2012) Cancer statistics for Hispanics/Latinos, 2012. CA Cancer J Clin 62(5). doi:10.3322/caac.21153
Miller BA, Hankey BF, Thomas TL (2002) Impact of sociodemographic factors, hormone receptor status, and tumor grade on ethnic differences in tumor stage and size for breast cancer in US women. Am J Epidemiol 155(6):534–545. doi:10.1093/aje/155.6.534
Ooi SL, Martinez ME, Li CI (2011) Disparities in breast cancer characteristics and outcomes by race/ethnicity. Breast Cancer Res Treat 127(3):729–738. doi:10.1007/s10549-010-1191-6
Smith RA, Cokkinides V, Brawley OW (2012) Cancer screening in the United States, 2012. CA Cancer J Clin 62(2):129–142. doi:10.3322/caac.20143
Austin LT, Ahmad F, McNally M-J, Stewart DE (2002) Breast and cervical screening in Hispanic women: a literature review using the Health Belief Model. Women’s Health Issues 12:122–129
Molina Y, Thompson B, Espinoza N, Ceballos R (2013) Breast cancer interventions serving US-based Latinas: current approaches and directions. Women’s Health 9:335–350
Press R, Carrasquillo O, Sciacca RR, Giardina EG (2008) Racial/ethnic disparities in time to follow-up after an abnormal mammogram. J Women’s Health (Larchmt) 17(6):923–930. doi:10.1089/jwh.2007.0402
Ramirez AG, Pérez-Stable EJ, Penedo FJ, Talavera GA, Carrillo JE, Fernandez ME, Holden AEC, Munoz E, San Miguel S, Gallion K (2013) Navigating Latinas with breast screen abnormalities to diagnosis. Cancer 119(7):1298–1305. doi:10.1002/cncr.27912
Ashing-Giwa KT, Gonzalez P, Lim J-W, Chung C, Paz B, Somlo G, Wakabayashi MT (2010) Diagnostic and therapeutic delays among a multiethnic sample of breast and cervical cancer survivors. Cancer 116:3195–3204
Niederdeppe J, Levy AG (2007) Fatalistic beliefs about cancer prevention and three prevention behaviors. Cancer Epidemiol Biomark Prev 16:998–1003
Allen JD, Shelton RC, Harden E, Goldman RE (2008) Follow-up of abnormal screening mammograms among low-income ethnically diverse women: findings from a qualitative study. Patient Educ Couns 72:283–292
Mojica CM, Bastani R, Ponce NA, Boscardin WJ (2007) Latinas with abnormal breast findings: patient predictors of timely diagnostic resolution. J Women’s Health 16:1468–1478
Karliner LS, Kaplan CP, Juarbe T, Pasick R, Pérez-Stable EJ (2005) Poor patient comprehension of abnormal mammography results. J Gen Intern Med 20(5):432–437. doi:10.1111/j.1525-1497.2005.40281.x
Mojica CM, Bastani R (2010) Receipt of diagnostic tests for breast cancer: validity of self-reports among low-income, mostly Latina, indigent women. Eval Health Prof 33:437–451
Moy B, Park ER, Feibelmann S, Chaing S, Weissman JS (2006) Barriers to repeat mammography: cultural perspectives of African-American, Asian, and Hispanic women. Psycho-Oncology 15:623–634
Marin G, VanOss Marin B (1991) Research with Hispanic populations. Sage Publications, Newbury Park
Miles MB, Huberman AM (2013) Qualitative data analysis: a methods sourcebook. Sage Publications, Thousand Oaks
Elder JP, Ayala GX, Parra-Medina D, Talavera GA (2009) Health communication in the Latino community: issues and approaches. Annu Rev Public Health 30:227–251
Marcus EN, Koru-Sengul T, Miao F, Yepes M, Sanders L (2013) How do breast imaging centers communicate results to women with limited English proficiency and other barriers to care? J Immigr Minor Health 1–8. doi:10.1007/s10903-012-9771-7
Kreps GL, Sparks L (2008) Meeting the health literacy needs of immigrant populations. Patient Educ Couns 71:328–332
Flores G (2006) Language barriers to health care in the United States. N Engl J Med 355:229–231
Taplin SH, Yabroff R, Zapka JM (2012) A multilevel research perspective on cancer care delivery: the example of follow-up to an abnormal mammogram. Cancer Epidemiol Biomark Prev. doi:10.1158/1055-9965.EPI-12-0265
Zapka J, Taplin SH, Price RA, Cranos C, Yabroff R (2010) Factors in quality care—the case of follow-up to abnormal cancer screening tests—problems in the steps and interfaces of care. JNCI Monogr 2010(40):58–71. doi:10.1093/jncimonographs/lgq009
Acknowledgments
The authors would like to thank Noah Espinoza for technical support. The current project was funded in part by multiple National Institutes of Health/National Cancer Institute grants (P50CA148143, R25CA92408) and Fred Hutchinson Cancer Research Center Faculty Development Funds. The opinions or assertions contained herein are the private ones of the authors and are not considered as official or reflecting the views of the National Institutes of Health.
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Molina, Y., Hohl, S.D., Ko, L.K. et al. Understanding the Patient-Provider Communication Needs and Experiences of Latina and Non-Latina White Women Following an Abnormal Mammogram. J Canc Educ 29, 781–789 (2014). https://doi.org/10.1007/s13187-014-0654-6
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DOI: https://doi.org/10.1007/s13187-014-0654-6