Wednesday, April 4, 2012

Subject Choice #2: Increasing Early Detection Awareness for Breast Cancer Among Low Income African American Women

On October 15th, 2001, James “Rhio” O’Connor woke up after a chest biopsy, only to learn 2 weeks later that he had pleural mesothelioma and had less than a year to live. Pleural mesothelioma is a form of lung cancer that occurs in the mesothelium, a thin layer of cells that protects and lubricates the lungs The disease is caused by inhaling asbestos, a naturally occurring mineral that O’Connor was exposed to when he was younger (for more information about mesothelium, please go to Despite the odds of survival, O’Connor decided to challenge his fate and met head to head with“Mr. Meso (Surviving Mesothelioma)”. He embraced a healthier lifestyle by consuming a nutritionally balanced diet, exercising regularly, and maintaining his emotional health. In his book, They Said Months, I Chose Years! James explained that, “…whatever happens happens and you cannot go through life second guessing yourself because that is not living (Rhio, 9).” It was with this mindset that James lived an additional 7 ½ years.

To this day, O’Connor’s story serves as an inspiration to all. Unfortunately, not everyone has the exposure or access to adequate healthcare information and treatment that helped O’Connor in his fight against cancer. This is particularly true among low income ethnic minorities, whose disparities are especially an issue in the United States. According to the article Cancer Prevention Among Racial Ethnic Minorities, African Americans have the highest mortality rates among all ethnic groups. Among all minority breast cancer victims, African American women have the highest mortality rate of 35.9%. In addition, the survival rate for African American women is “73% compared to the 88% among white women (Phillips, 97).” This disparity is largely caused by societal, economic, and psychological constraints that make it difficult to seek preventative health care. As such, one way to improve progress on the detection of breast cancer among low income African American women is to create an informational online video that shares the stories of African American breast cancer survivors. This creates a more emotional and culturally relevant approach towards motivating the target population to seek early detection screenings and diagnostic services.

In order to address this issue, it is essential to understand the psychological, cultural and economic causes of high incidence and mortality rates among African American women with breast cancer. According to the report Barriers to Breast Cancer Control for African-American Women, it is important to understand that kinship is the key component of African American culture. Kinship is the value of immediate and extended family. African American women, in particular, set family before themselves when they make personal decisions. Therefore, when they become ill, they are more concerned with how their illness will affect the family rather than the self. Because they do not want to burden their loved ones with financial and emotional stress, African American women tend to forgo a mammography. According to the report Breast Cancer Screening Behaviors Of African American Women, there are five “social processes” that African American women over the age of 50 go through when deciding to get a mammography. These processes are: “prior experience with healthcare providers and systems, fears and fatalistic beliefs about breast cancers and related treatments; valuing the opinion of significant others; relying on religious beliefs and supports; and care-giving responsibilities of significant others (Conway-Phillips, 99).” These processes often result with experiences that combine fear, mistrust, and denial towards breast cancer treatment and preventative care. In addition, African American women often misperceive breast cancer as “the white women’s disease” and believe they are less affected by it. To add to the complexity of the issue, African American women with low income only seek treatment for short term and immediate needs. They do not seek expensive, long term treatment until the illness becomes severe.

By taking into account the cultural, psychological, and economic factors for African American women, we can implement an innovative and effective intervention program to promote awareness of breast cancer prevention and control. According to the article Breast Cancer Prevention among Racial Ethnic Minorities, the most successful intervention strategies for ethnic minority groups are ones that involve community participation and ones that use culturally relevant approaches. This applies especially to African American women, who base many of their decisions on those they care deeply about. In a recent study conducted in St. Louis Missouri, a group of low income African American women watched a video of African American breast cancer survivors sharing their personal stories. The study concluded that “narratives reduced counter-arguing and increased cognitive rehearsal, which may increase acceptance and motivation to act on health information in populations most adversely affected by cancer disparities (McQueen, 674).” This means that those who saw the video are more likely to talk about breast cancer detection with their family and seek preventative care. This study revealed an interesting phenomenon, but it was never replicated on a larger scale. What would happen if we took advantage of today’s online social media, and uploaded a similar video to a larger audience?

Today, the advent of YouTube, Facebook, and other social media help spread the incredible stories of ordinary people to a mass audience in a matter of seconds. StoryCorps is a non-profit organization especially well known for recording stories of everyday Americans. According to their national website, they have conducted 40,000 interviews with roughly 80,000 participants. Coincidentally, the organization has already created the Griot Initiative, which is dedicated to honoring and preserving the stories of the African American community. As such, I propose a public health campaign called the “Minority Breast Cancer Intitative (MBCI)”, in which the StoryCorps Griot Initiative collaborates with the National Breast Cancer Foundation’s Early Detection Plan to make a breast cancer awareness video targeted toward low-income African American women. The National Breast Cancer Foundation Inc. is a well publicized non-profit organization, and is widely recognized for its National Mammography Program. According to GuideStar’s online non-profit analysis, the organization provides 85 medical facilities that provide free mammograms and diagnostic care services in 48 states in 2010. Part of the organization’s goal is to reduce breast cancer mortality by spreading early detection awareness. As such, MBCI’s goal aligns with that of the NBCF.

In order for this plan to take action, StoryCorps and NBCF should create an MBCI webpage, which will provide the narrative video and links to NBCF services and those of other breast cancer organizations. To create the video, NBCF and StoryCorps should form an MBCI project team. This team will send inquiries to organization members through e-mail, forums, or any communication channel they find most effective. The team will ask for African American breast cancer survivors to volunteer and share their survival stories. StoryCorps can also search in their archives for pre-recorded stories and see if they can be granted the permission to publicize them. Once the storytellers are selected, the interviews will be filmed and combined into one video. The video will be uploaded on the StoryCorps website, the StoryCorps Youtube channel, the NBCF website and the NBCF Facebook page. When the video is finished, there will be a clear message that links viewers to the MBCI webpage. A follow-up survey will pop-up before the user leaves the site, and the number of website visitors should be tracked. The results will monitor the effectiveness of this awareness video. In the long term, if feedback is positive, more videos will be posted that are targeted toward different minority groups. For instance, the MBCI project can create a video that consists of Hispanic and Latina women who share their experiences in Spanish. This can help break the linguistic barriers that prevent Hispanic and Latinas from seeking early detection. By utilizing online resources, MBCI serves to spread beast cancer awareness.

Since President Richard Nixon passed the National Cancer Act in 1971, there has been significant progress in the screening, detection, and treatment of breast cancer. According to the 2011 Annual Report Against Cancer, the FDA passed a new drug called exemestane, which treats early breast cancer among post-menopausal women. In addition, a clinical trial showed that most women who use additional regional nodal irradiation decrease their recurrences at the early-stage of breast cancer. Though these findings shed light on future progress, the war against cancer is not over. Healthcare disparities remain an issue in this country, and not everyone has equal information and access to preventative services. The Minority Breast Cancer Initiative is an idea that attempts to overcome the barriers that prevent African American women from seeking early detection screenings and diagnostic services for breast cancer. It is merely a drop in an ocean of brainstorms, and it hopes to aid in the wave of progress.

Works Cited

“Asbestos.” US EPA. Environmental Protection Agency , n.d. Web. 21 Mar. 2012. .

“Asbestos Exposure and Cancer Risk.” National Cancer Institute and the National Institutes of Health. National Cancer Institute, n.d. Web. 21 Mar. 2012. .

Cleeland, Charles S., and Rene Gonin. "Pain And Treatment Of Pain In Minority Patients With Cancer." Annals Of Internal Medicine 127.9 (1997): 813. Nursing & Allied Health Collection: Comprehensive. Web. 21 Mar. 2012.

Conway-Phillips, R, and S Millon-Underwood. "Breast Cancer Screening Behaviors Of African American Women: A Comprehensive Review, Analysis, And Critique Of Nursing Research." ABNF Journal 20.4 (2009): 97-101. CINAHL with Full Text. Web. 25 Mar. 2012.

Griffin-Sobel, Joyce P. “War on Cancer: Victory or Defeat?” Nursing Clinics of North America 43.2 (2008): 277-282. Science Direct. Web. 21 Mar. 2012. .

Guidry, Jeffrey J. “Barriers to Breast Cancer Control Among African American Women.” Supplement: Summit Reading of Breast Cancer Among African American Women 97.Supplement 1 (2003): 318-323. MEDLINE. Web. 25 Mar. 2012. .

Mesothelioma Cancer Alliance. James F. Early LLC, n.d. Web. 21 Mar. 2012. .

National Breast Cancer Foundation, Inc.. N.p., n.d. Web. 25 Mar. 2012. < >.

O’Connor, Rhio. They Said Months. I Chose Years! A Mesothelioma Survivor’s Story Share your own customer images Search inside this book Tell the Publisher! I’d like to read this book on Kindle Don’t have a Kindle? Get your Kindle here, or download a FREE Kindle Reading App. They Said Months. I Chose Years! A Mesothelioma Survivor’s Story. Amazon. N.p., n.d. Web. 21 Mar. 2012. .

Payne, Richard. “Quality of Life Concerns in Patients with Breast Cancer.” Cancer Supplement: Summit Reading of Breast Cancer Among of African American Women 37.Supplement 1 (2003): 311-317. MEDLINE. Web. 25 Mar. 2012. .

Phillips, JM, and S Williams-Brown. “Cancer Prevention among Racial Ethnic Minorities.” Seminary Oncology Nursing (Nov. 2005): 278-285. Johns Hopkins POC-IT Guides. Web. 25 Mar. 2012. .

Twombly, Renee. “Cancer Surpasses Heart Disease as Leading Cause of Death for All But the Very Elderly.” Journal of the National Cancer Institute 97.5: 330-331. Oxford Journals. Web. 21 Mar. 2012. .

“Understanding Narrative Effects: The Impact of Breast Cancer Survivor Stories on Message Processing, Attitudes, and Beliefs Among African American Women.” Health Psychology 30.674-682: n. pag. MEDLINE. Web. 25 Mar. 2012. .

Vogelzang, Nicholas J., et al. “Clinical cancer advances 2011: Annual Report on Progress Against Cancer from the American Society of Clinical Oncology.” Journal of Clinical Oncology (Dec. 2011): n. pag. Wolters Kluwer Health Ovid SP. Web. 21 Mar. 2012. .

“What Is Cancer?” American Cancer Society. N.p., n.d. Web. 21 Mar. 2012. .