2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

324939
Equity in managing pain and side effects from cancer treatment: Findings from photovoice and focus group interviews with breast cancer survivors


Tuesday, November 3, 2015 : 10:50 a.m. - 11:10 a.m.

Cleo Samuel, PhD, Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
Nora Jones, MEd, 501(C)3 agency which sponsors anti-racism workshops, The Partnership Project, Greensboro, NC
Kristin Black, PhD, Gillings School of Global Public Health / Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC
Carol Cothern, BS, Greensboro Health Disparities Collaborative, The Partnership Project, Greensboro, NC
Samuel Cykert, MD, Division of General Medicine and Clinical Epidemiology and NC Area Health Education Centers Program, University of North Carolina Chapel Hill, Chapel Hill, NC
Eugenia Eng, MPH, DrPH, Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC
Alexandra Lightfoot, EdD, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC
Omar Rasul, The Partnership Project, Greensboro, NC
Linda Robertson, DrPH, RN, MSN, Department of Medicine, University of Pittsburgh, Pittsburgh, PA
Jennifer Schaal, MD, The Partnership Project, Greensboro, NC
Christina Hardy, MPH, Center for Health Promotion and Disease Prevention, University of North Carolina Gillings School of Public Health, Chapel Hill, NC
Anise Gold-Watts, MPH, UNC Chapel Hill, Chapel Hill, NC
Sarah Kowitt, MPH, School of Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC
Anna Dardick, UNC Chapel Hill, Chapel Hill, NC
Kea Turner, MPH, MA, UNC Chapel Hill, Chapel Hill, NC
Background: Compared with white breast cancer patients, black patients are more likely to report pain and other treatment-related symptoms.  Less is known about racial differences in patients' experiences with symptom management during the course of their treatment and whether such differences contribute to disparities in cancer treatment completion.  As part of an NCI-funded systems change intervention to improve racial equity in treatment quality and completion among black and white early-stage cancer patients, we assessed racial differences in the presence of treatment-related symptoms and symptom management experiences among breast cancer survivors.

Methods: We conducted 12 focus groups with breast cancer survivors (6 black focus groups; 6 white focus groups) from two cancer centers and a photovoice study with members of a Black breast cancer survivor support group. Using a community-based participatory research approach, our racially diverse community-academic team developed focus group guides, trained coders, and conducted qualitative data analyses.

Results: Both black and white breast cancer survivors expressed concerns regarding their symptom management experiences during treatment; however, blacks more often reported dissatisfaction with the management of treatment-related symptoms, including pain, medication side effects, and skin toxicity/irritations.  Factors that contributed to suboptimal symptom management included poor patient-provider communication regarding possible and definite treatment side effects, care coordination difficulties, and staff demeanor and dismissiveness/unresponsiveness.

Conclusion: Monitoring race-specific data on the quality of treatment-related symptom management aligns with federal policies on meaningful use of health care data and is critical to efforts aimed at increasing transparency and accountability to reduce disparities in breast cancer treatment outcomes.

Learning Areas:

Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Provision of health care to the public
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe racial differences in treatment-related symptoms and symptom management experiences among breast cancer patients. Explain how a CBPR approach can increase transparency and accountability within research partnerships. Discuss alternative approaches for eliciting and developing patient reported outcomes measures for cancer care.

Keyword(s): Community-Based Research (CBPR), Cancer

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A

Qualified on the content I am responsible for because: I am a co-investigator on this NCI-funded study (ACCURE) and am leading the study's supplemental project on racial differences in symptom management and palliative care.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4115.0: Using CBPR to Eliminate Health Disparities