Breast Cancer Health Literacy among Immigrant Latinas

Breast cancer is the leading cause of cancer death for Latinas yet they tend not to participate in positive breast health behaviors (PBHB): breast self-exam (BSE), clinical breast exam (CBE) and mammography screening. They also tend to present in late stage disease, experience less disease free survival that contribute to higher mortality rates. Objective. To report preliminary data from an educational intervention intended to improve breast cancer health literacy and promote PBHB among immigrant Latinas. Methods. We used a quasi-experimental design (200 intervention group participants and 200 delayed intervention group participants). All participants completed the Breast Health Literacy Survey and took part in a Focused Discussion Group. The intervention consisted of an animated educational and instructional video and breast self-exam training. We used Atlas.ti qualitative software to analyze 15 of 32 audio-taped FGD. Baseline survey data is reported using descriptive statistics pending 3 month follow-up survey results. Results. Qualitative data revealed that breast cancer health literacy resulted from experience with a family member or friend having been diagnosed with breast cancer. However, their most important sources of health information are doctors, television and radio. There was consensus agreement that breast cancer is curable yet the majority of women felt that if they were to develop breast cancer they would have no hope for survival. The impact of having breast cancer on their family was consistently mentioned across groups. Data from the Breast Cancer Health Literacy Survey revealed that 1) 65% did not know how or were unsure how to do a SBE, 93% believed a woman should examine her own breasts, 80% believed SBE should be done monthly but only 42.5% did so, 17% believed SBE should be done yearly and 16% did so yearly; 2) 98% perceived CBE as important, 80% believed it should be done yearly by a doctor, 84% reported having had a CBE, 61% reported having a CBE in the last 12 months, but 43% believed that women find breast lumps not doctors and 17% reported having been told they had a lump in their breast; 3) 55% reported having ever had a mammogram, 38% had one during the past 12 months, 15% reported having had an abnormal mammogram, 11% reported having had a biopsy or surgery for a breast lump, 2% were told they had breast cancer and 1% received medicines for breast cancer; 4) 19% had a family history of breast cancer but 51% did not know it is a risk factor. Conclusions. Breast cancer screening is sub-optimal among immigrant Latinas. There is a lack of concordance between what they know and believe about screening for breast cancer and PBHB. This contradiction appears to be related to their socio-economic status, political status and beliefs about access to health care, which may work together to result in socio-political marginalization within healthcare delivery systems. Ethno-medical (cross-cultural) studies are needed among immigrant women to better determine how best to improve their PBHB