A $1.58 million grant will support work by a health communication scholar at the University of Tennessee (UT) Health Science Center's College of Nursing and a medical oncologist at West Cancer Center and Research Institute (WCCRI) to identify sociocultural and structural factors that are root causes of cancer health disparities for Black women in the Mid-South.
Assistant Professor Janeane Anderson, PhD, MPH, is a social scientist and health communication scholar at the College of Nursing whose research focuses on how interpersonal factors affect health outcomes among Black adults. "For the last seven years, my research has explored how interpersonal factors, specifically patient-clinician communication, impact health outcomes among Black adults. In the South, we see delays, access issues, and unnecessary burden at every step of the cancer continuum for Black women. I'm trying to understand why and what can be done to change it," she said.
The study, "A prospective qualitative exploration of multilevel factors affecting outcome disparities among Black women with or at high risk for breast cancer in the U.S. Mid-South region," is funded by Gilead Sciences, Inc. – a biopharmaceutical company based in Foster City, CA, that also develops antiviral drugs used in the treatment of HIV/AIDS, hepatitis C, influenza, and COVID-19. Dr. Anderson will serve as Co-Principal Investigator on the three-year grant, along with Co-PI Gregory Vidal, MD, PhD, director of clinical research and a medical oncologist at West Cancer Center and Regional One Health. Dr. Vidal, an expert in breast cancer, is also an Associate Professor in the College of Medicine at UT Health Science Center.
Although Black women have a 4% lower incidence of breast cancer than White women, they still have a death rate 40% higher than that group, according to "Breast Cancer Statistics, 2022," published by the American Cancer Society. Southern states experience a disproportionate cancer burden in the United States. Two states in the Mid-South, Arkansas and Mississippi, are among the top 10 with the highest overall cancer rates in the nation, according to data from the Centers for Disease Control (CDC).
The qualitative study will examine health care access and engagement issues for Black women who have de-novo metastatic breast cancer or are at high risk of breast disease. De-novo metastatic breast cancer is breast cancer that has already spread to other parts of the body at the time of the initial cancer diagnosis. The study is guided by the Socio-Ecological Model (SEM) and Critical Race Theory (CRT). SEM is a concept of health that includes intrapersonal, interpersonal, organizational, environmental and public policy factors. The SEM framework supports the idea that behaviors both affect and are affected by various contexts. CRT suggests that race is a sociological rather than biological designation and that racism pervades society. Therefore, Black women are exposed to prejudice and discrimination on individual, relational, institutional/community, and societal levels – even if they are unaware of it.
The breast cancer study will include three groups of people:
- The first group of 75 will be adult Black women, including trans men, who have de-novo metastatic breast cancer.
- A second group of 75 Black women will include those who are at high risk for breast disease.
- The third group will include 100 clinicians who provide primary, gynecology, or oncology care in the Mid-South region: eastern Arkansas, western Tennessee, and northern Mississippi. Black, indigenous, and other people of color (BIPOC) clinicians and/or those whose practice comprises significant numbers of Black adults will be eligible. The researchers will explore the providers' perceptions of what contributes to the vulnerability of Black women with this disease.
The study is scheduled to begin July 1. Potential volunteers will be recruited from WCCRI clinic sites in West Memphis, AR, Memphis, TN, Germantown, TN, Paris, TN, and Corinth, MS.
Dr. Anderson and Dr. Vidal look forward to the data that the study will provide about factors that delay Black women in seeking health care or prevent them from adhering to a care plan following a breast cancer diagnosis.
I think if we can identify a unique constellation of factors, it will help us target those barriers. This will give us our best opportunity to intervene."
Dr. Janeane Anderson, PhD, MPH, Assistant Professor
One way to intervene is to provide clinicians with specific communication training to help mitigate the challenges faced by Black women with breast cancer, she said.
Dr. Vidal said, "This study would be the most extensive qualitative evaluation of how social, economic and health factors affect cancer patients in the midsouth. Given the similarities of Memphis to other cities, the result could have applications beyond the borders of Memphis."
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