Background and Purpose: The purpose of this study was to examine the relationship between the race-related thoughts and feelings of black individuals with cancer and their perspectives on treatment-related issues. Research suggests that black patients' race-related thoughts/feelings may contribute to racial disparities in cancer treatment, but there is a dearth of information on how these thoughts/feelings may affect patients' perspectives on treatment and related issues. Further, the few studies that have examined these relationships have typically used one measure (e.g., perceived discrimination), implicitly assuming that other measures would show equivalent effects. This study addressed two questions: (a) whether black patients' scores on three measures of race-related thoughts/feelings would be correlated; and (b) whether the three measures would show comparable patterns of association with patients' socio-demographic characteristics, self-reported health, and perspectives on cancer treatment.
Methods: Participants were self-identified black patients scheduled for initial consultations to discuss adjuvant or neo-adjuvant chemotherapy for breast, colon, or lung cancer at one of two cancer centers in Detroit, Michigan. After consenting to participate in the study, patients completed three measures of related, but conceptually distinct aspects of race-related thoughts and feelings: racial identity (i.e., the extent to which patients' race is an integral part of their self-identity); group-based suspicion of medical care (i.e., the extent to which patients believe Blacks as a group should be suspicious of the healthcare they receive); and perceived past discrimination (i.e., the extent to which a patient has experienced discrimination in different settings). Patients also completed measures of socio-demographic characteristics, subjective health and well-being, and perspectives on treatment.
Results: A total of 101 patients participated. They were predominantly older (mean age=59.94) women (90%) with breast cancer (81%). Regarding the first research question, findings showed the three measures were not significantly related to one another. Regarding the second question, the three measures showed different patterns of association with the other measures of interest. For example, whereas suspicion was significantly (p<.05) negatively correlated with education (i.e., less education, more suspicion), perceived discrimination was positively correlated with education. Regarding subjective health and well-being, discrimination was marginally positively associated with poorer overall health (p=.09), and racial identity was negatively associated with dependence on others for daily care. Whereas racial identity was positively associated with the amount of social support patients reported receiving, suspicion was negatively associated with support. Regarding perspectives on treatment, suspicion was negatively associated with past adherence, health literacy, trust of physicians, ease of getting to a treatment center, perceived extent of recovery from the recent cancer surgery, believing that physicians would play a major role in the success of their cancer treatment, and willingness to make joint treatment decisions with their physician. Discrimination was also negatively associated with trust in physicians, self-reported ease of getting to a treatment center, and willingness to let their physician make treatment decisions on their own.
Conclusion: Findings suggest that these three measures may represent quite different constructs and are potentially related to different clinical consequences. Research and clinical interventions that address relationships between patients' racial attitudes to improve medical outcomes should consider what aspect might be most relevant to the specific focus of the research.
Citation Format: Susan Eggly, Louis A. Penner, Richard Gonzalez, Hayley Thompson, Rifky Tkatch, Robert Chapman, Terrance L. Albrecht. Correlates of race-related thoughts and feelings among black cancer patients. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A49.
- ©2015 American Association for Cancer Research.