Community Members to Work with ASU & UA to Assess Health Care Disparities

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Great strides have been made in medical treatment for many types of cancer, yet some groups of women are benefitting more than others.

Researchers from the ASU College of Nursing & Healthcare Innovation (CONHI) and the University of Arizona (UA) have been awarded a two-year grant from the National Cancer Institute to examine the causes and possible solutions to cancer disparities among minority women with breast cancer.  The research team will collaborate with sixty Mexican American and African American women from Phoenix and Tucson on the research project to advance health care equality for minority patients diagnosed with cancer.

“African Americans have the highest mortality rate of any racial/ethnic group for all cancers combined and the incidence of breast cancer is increasing faster among Latinos than any other group,” states Dr. Maureen Campesino, associate professor of  nursing at ASU CONHI and principal investigator for the project.

“Even more disturbing is the fact the disparities persist even when controlling for socioeconomic status, access to health insurance, and clinical factors such as a patient’s treatment eligibility,” Campesino continues. “We hope that by working closely with women in the community who have been diagnosed with breast cancer, we will begin to understand what factors contribute to this disparity.”

As Dr. Ester Ruiz, associate professor of nursing at CONHI and member of the research team recounts, “I know someone who was diagnosed with breast cancer during the time she was going through a divorce. Although she’s a teacher, bilingual, and usually able to advocate for herself very well, she was so exhausted by the treatment and process that she became frozen when having to deal with the medical system. I have to say that the system was not kind to her. They attempted to push her into an intervention within a week after a conclusive diagnosis after having dragged their heels for 1½ years.”

Dr. Johannah Uriri Glover, assistant professor of nursing at ASU and research team member, says, “Little is known about how cultural factors may affect cancer care and treatment experience. There’s a lot of evidence showing that healthcare experiences can be significantly stressful for some African Americans and Latinos. Studies with these patients in primary care settings have revealed that mistrust of the medical care system and communication difficulties with providers are factors that can influence health care.”

Indeed, a study undertaken in 2002¹ and approved by the Governing Board of the National Research Council, reported that minority focus group participants indicated they “often feel that health care providers treat them differently and assume they are less educated, poor or deserving of less respect because of their race or culture.”  Additionally, the study notes, “Non-English- speaking participants, especially those in the Hispanic group, recounted many examples of personal situations in hospitals and other settings where they were forced to deal with serious health conditions without the benefit of interpreters or patient healthcare staff willing to assist them.”

Team member Dr. Linda Larkey has been has been implementing outreach programs for Arizona Latinas for many years and has seen how the gap in information can affect health behavior and care. Larkey is a UA associate professor of family and community medicine, public health and integrative medicine and member of the Arizona Cancer Center.  She notes, “There is an invisible link between the care that is received and the barriers to communication that arise from both unintentional miscommunication and outright mistreatment.”  Larkey adds, “This link is challenging to study because of the multifaceted emotions and interpretations involved."

The complexity of the project demands a large and diverse team of researchers. Many are of the same racial/ethnic groups as the women in the study and can speak their preferred language. The team hopes their diversity will help the women participating in the study feel more open and comfortable in sharing their experiences.

In addition to Drs. Campesino, Larkey, Uriri Glover and Ruiz, the team includes Dr. Delia Saenz, vice provost for undergraduate education and associate professor of psychology at ASU who brings expertise in the areas of intergroup bias and ethnic identity; and Dr. Mary Koithan, UA associate professor of nursing who will assist the team in qualitative data analysis. To provide insight into healthcare experiences of patients dealing with cancer, the team is also working with consultants Dr. Robert Krouse, an oncology physician, associate professor of surgery, UA School of Medicine and member of the Arizona Cancer Center; and Dr. Gloria Juarez, an oncology nurse researcher at the City of Hope Cancer Center in Los Angeles, California.

The ASU CONHI team expects the understanding gained from their study will help develop effective strategies to improve health care for minority women with breast cancer and other types of cancer or health conditions.

To participate in the study, please call Dr. Maureen Campesino at (602) 496-0804 or email her at maureen.campesino@asu.edu.

For more information please visit:
ASU CONHI at http://nursing.asu.edu/
University of Arizona College of Nursing:  http://www.nursing.arizona.edu/
National Cancer Institute:  http://www.cancer.gov/
Arizona Cancer Center:  http://www.azcc.arizona.edu/
City of Hope Cancer Center:  http://www.cityofhope.org/home.htm

To learn more about how ASU is engaged with the community, please visit ASU in the Community’s Program Database which connects you to a wide variety of specific ASU outreach efforts.