Black Women Survive Breast Cancer with Community-Based Care

PURPOSE Community-based breast cancer support agencies who address non-medical, social determinants of health needs that serve as barriers to maximizing breast health outcomes may play a vital role in mitigating breast cancer mortality. They share a common emphasis on addressing social, economic, and psychological needs of breast cancer survivors and those at risk of breast cancer. This paper is third in a series of papers exploring why the rate of breast cancer mortality is two times higher for African American women than white women in Memphis. We sought insights from community-based breast cancer support agencies because they have a close-up view of circumstances and decision-making among women at risk of and surviving breast cancer, and a close view of primary care, surgical, and insurance environments impacting these women. METHODS For this qualitative descriptive research study, data were collected using semi-structured in-depth focus groups with five breast cancer support agencies in Memphis. Categories and patterns were established using thematic analysis and a deductive a priori template of codes. RESULTS The main themes identified within support agencies were barriers to the use of services, education, health system support, and emotional support. Numerous sub themes included medication costs, support group supplemental programming, eligibility for mobile services, patient/provider communication, optimism, and family advice. Procrastinating, fearfulness, insurance, childcare, and transportation were barriers to care. Support agencies noted that one unique barrier that African American women who live in underserved areas of Memphis face in maintaining breast health is poor physician’s office management; in fragmented health care systems, information and patients can be lost to follow-up. DISCUSSION/CONCLUSIONS Community-based breast cancer support agencies, who focus on social determinants of health, play a critical role as connectors for women with breast cancer who live in medically underserved areas and must find their way within a fragmented medical system. GRANT SUPPORT This research was funded by the Tennessee Department of Health, grant number A17-1251