Abstract B17: Predictors of chemotherapy attitudes in African American women with breast cancer

Background: Studies have noted that compared to white women with breast cancer, black women receive less appropriate adjuvant therapies such as chemotherapy. It has been suggested that black women may have less favorable views about chemotherapy or that cultural factors such as medical mistrust may affect their utilization. Little research has been conducted to quantitatively examine chemotherapy attitudes in black breast cancer patients. Our aims were to: 1) examine the association between cultural beliefs and chemotherapy attitudes and 2) identify predictors of chemotherapy attitudes.

Methods: We conducted structured telephone interviews with patients after their definitive diagnosis. Eligible women were black patients diagnosed with T_1,2,3 N_any M₀ disease. Key measures were: cultural beliefs (e.g., medical mistrust, religiosity, and collectivism), perceptions of disease severity, healthcare satisfaction, and demographic factors. Eighty-eighty women were recruited from two cancer centers (74%) and physician practices (26%). Ages ranged from 29 to 78 years (m=54.3). Most were either never married (31%) or currently unmarried (35%). Sixty-five percent had at least a high school diploma and 68% were privately insured. Patients reported high levels of religiosity (m=30; SD: 5.0; range: 12–36), moderate levels of collectivist beliefs (m=8.9; SD: 2.6; range: 6–14) and moderate levels of medical mistrust (m=28.8; SD: 5.8; range: 16–42). Women had moderately positive attitudes about chemotherapy (m=18.4; SD: 4.7; range: 4–28). In the multivariate multiple regression model, predictors of having positive chemotherapy attitudes were: age (=.−255), medical mistrust (=.−283), and perceptions of disease severity (=.500) (p<.0001) controlling for other factors.

Conclusions: These preliminary findings suggest that women's perception regarding the severity of their disease was the strongest predictor of chemotherapy attitudes. Also, younger women and those with lower levels of medical mistrust had more positive attitudes about chemotherapy. Further studies are needed to examine the effect of chemotherapy attitudes on women's actual treatment adherence.