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Torres P, Guitelman J, Lucio A, Rini C, Molina Y. Medical Advocacy among Latina Women Diagnosed with Breast Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:495. [PMID: 38673406 PMCID: PMC11049890 DOI: 10.3390/ijerph21040495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/06/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
Medical advocacy has continued to significantly impact quality of life and survivorship outcomes among Latina breast cancer survivors in the United States. However, little is known about the unique experiences of Latina survivors, including the perceived value, process, and context in which they practice medical advocacy. To help address this gap, we conducted a qualitative, secondary analysis of semi-structured focus groups with 18 Latina breast cancer survivors from Chicago, Illinois. Eligible women had to self-identify as (1) female, (2) Latina, (3) 18 years or older, and (4) having a breast cancer diagnosis 5 years ago or more. In total, 61% of participants were 50-59 years old, 83% were born in Mexico, and 100% spoke Spanish. The three emergent themes from the focus groups were (1) the cultural need for Latina advocates and support groups; (2) the process and experiences of becoming a community advocate within Latine culture; and (3) the cultural contexts for advocacy by Latina breast cancer survivors. Latina survivor advocates share strengths of receiving ongoing health education, peer support, and access to resources when being linked to a support group furthering their exposure to role models, increasing their awareness of opportunities in medical advocacy, and providing an entry to participate in medical advocacy.
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Affiliation(s)
- Paola Torres
- University of Illinois Cancer Center, University of Illinois, Chicago, IL 60612, USA;
| | - Judith Guitelman
- Asociación Latina de Asistencia y Prevención del Cáncer de Mama (ALAS-WINGS), Chicago, IL 60657, USA;
| | | | - Christine Rini
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Yamilé Molina
- University of Illinois Cancer Center, University of Illinois, Chicago, IL 60612, USA;
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA
- Hospital & Health Sciences Systems Mile Square Health Center, University of Illinois, Chicago, IL 60612, USA
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Ramirez RD, Suarez-Balcazar Y, Fischer HC, Magasi SR. The Occupational Participation of Latinx Cancer Survivors and Their Family Caregivers Living in Survivorship: A Qualitative Exploration Informed by Multiple Stakeholders. Occup Ther Health Care 2021; 36:116-140. [PMID: 33825595 DOI: 10.1080/07380577.2021.1907868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to examine the lived experiences of Latinx cancer survivors and their family caregivers during survivorship. Eighteen semi-structured interviews were conducted with a variety of stakeholders including Latinx cancer survivors (n = 8), their family caregivers (n = 5), and cancer care providers (n = 5). Data were analyzed thematically to describe occupational participation. Latinx families lived in political, economic, language, and social contexts that facilitated and hindered their well-being. Survivors simultaneously experienced occupational deprivation and posttraumatic growth. To promote occupational justice, occupational therapy practitioners and researchers are called to partner with Latinx survivors and their families to facilitate skills needed for everyday participation.
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Affiliation(s)
- R D Ramirez
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Y Suarez-Balcazar
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - H C Fischer
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - S R Magasi
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
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The Hispanic/Latino Immigrant Cancer Survivor Experience in the United States: A Scoping Review. ANNUAL REVIEW OF NURSING RESEARCH 2019; 37:119-160. [PMID: 30692155 DOI: 10.1891/0739-6686.37.1.119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Olagunju TO, Liu Y, Liang LJ, Stomber JM, Griggs JJ, Ganz PA, Thind A, Maly RC. Disparities in the survivorship experience among Latina survivors of breast cancer. Cancer 2018; 124:2373-2380. [PMID: 29624633 DOI: 10.1002/cncr.31342] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/13/2018] [Accepted: 02/13/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND The authors investigated disparities in the survivorship experience among Latinas with breast cancer (BC) in comparison with non-Latinas. METHODS A cross-sectional bilingual telephone survey was conducted among 212 Latina and non-Latina women within 10 to 24 months after a diagnosis of BC (AJCC TNM staging system stage 0-III) at 2 Los Angeles County public hospitals. Data were collected using the Preparing for Life as a (New) Survivor (PLANS) scale, Perceived Efficacy in Patient-Physician Interactions Questionnaire (PEPPI), Breast Cancer Prevention Trial (BCPT) Symptom Checklist, Satisfaction with Care and Information Scale, Consumer Assessment of Healthcare Providers and Systems (CAHPS) tool, Charlson Comorbidity Index adapted for patient self-report, and the 12-item Short Form Health Survey. Controlling variables included age, stage as determined by the American Joint Committee on Cancer (AJCC) TNM staging system, educational level, and study site in multivariate analyses. RESULTS The mean ages of Latinas and non-Latinas were 51.5 years and 56.6 years, respectively. Compared with non-Latinas, Latinas reported less BC survivorship knowledge (27.3 vs 30.7; P<.0001), were more dissatisfied with BC care information (2.3 vs 3.4; P<.0001), reported lower PEPPI scores (38.2 vs 42.2; P = .03), and experienced more BCPT symptoms (6.4 vs 5.0; P = .04). No differences were noted regarding their confidence in survivorship care preparedness (42.7 vs 41; P = .191), satisfaction with BC survivorship care (9.6 vs 8.8; P = .298), or their discussion with physicians (9.6 vs 8.1; P = .07). These ethnic group differences persisted in multivariate analyses, with the exception of PEPPI. CONCLUSIONS Latina survivors of BC experienced disparities in BC knowledge and satisfaction with information received, but believed themselves to be prepared for survivorship and were as satisfied with providers, care received, and discussions with physicians as non-Latinas. Cancer 2018;124:2373-80. © 2018 American Cancer Society.
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Affiliation(s)
- Tinuke O Olagunju
- Schulich Interfaculty Program in Public Health, Western University, London, Ontario, Canada
| | - Yihang Liu
- United Health Group, Cypress, California
| | - Li-Jung Liang
- Department of Medicine, David Geffen School of Medicine, Los Angeles, California
| | | | - Jennifer J Griggs
- Division of Hematology/Oncology, Department of Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan
| | - Patricia A Ganz
- Department of Medicine, David Geffen School of Medicine, Los Angeles, California.,Division of Cancer Prevention and Control Research, University of California at Los Angeles Jonson Comprehensive Cancer Center, Los Angeles, California
| | - Amardeep Thind
- Schulich Interfaculty Program in Public Health, Western University, London, Ontario, Canada
| | - Rose C Maly
- Department of Family Medicine, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California
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Abstract
In the USA, undocumented Latino immigrants may have poorer health because of barriers to health care, stressors, and detrimental effects of immigration enforcement. Previous immigrant health research, however, suggests that recently arrived Latino immigrants have better health than US-born Latinos and their health deteriorates over time. Given the current environments that undocumented immigrants face, legal status is a structural factor that likely influences the patterns of immigrant health. Therefore, the aim of this study was to examine the extent to which physical and mental health differed by legal status and duration in the USA for the Latino population in Los Angeles County, California. We conducted analysis of Latino respondents (n = 1396) to the Los Angeles Family and Neighborhood Survey (L.A.FANS) Wave II. We examined self-reported health, depression measured by the Composite International Diagnostic Interview-Short Form, and blood pressure collected by trained interviewers. Respondents reported their legal status, time in the USA, and other sociodemographic characteristics. Regression models were used to test associations between each outcome and 1) legal status and 2) legal status by duration (≤ 15 and > 15 years) in the USA. Without taking duration into account, we found no significant differences in outcomes between undocumented, documented, or US-born Latinos. Taking duration into account, shorter duration undocumented immigrants had worse self-reported health than the US born. Undocumented immigrants, regardless of duration, had higher blood pressure than documented immigrants who had been in the USA for less time and the same level of blood pressure as the US born. In contrast, shorter duration documented immigrants had lower blood pressure compared to longer duration documented immigrants and US-born counterparts, and marginally lower blood pressure than shorter duration undocumented immigrants. The findings suggest that the "health advantage" generally presumed to exist among immigrants may not affect undocumented immigrants.
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Affiliation(s)
| | - Anne R Pebley
- University of California, Los Angeles, Los Angeles, CA, USA
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Young MEDT, Madrigal DS. Documenting legal status: a systematic review of measurement of undocumented status in health research. Public Health Rev 2017; 38:26. [PMID: 29450097 PMCID: PMC5809888 DOI: 10.1186/s40985-017-0073-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/16/2017] [Indexed: 11/29/2022] Open
Abstract
Background Undocumented status is rarely measured in health research, yet it influences the lives and well-being of immigrants. The growing body of research on undocumented status and health shows the need to assess the measurement of this legal status. We discuss the definition of undocumented status, conduct a systematic review of the methodological approaches currently taken to measure undocumented status of immigrants in the USA, and discuss recommendations for advancement of measurement methods. Methods We conducted a systematic review of 61 studies indexed in PubMed, conducted in the USA, and published from 2004 to 2014. We categorized each of the studies’ data source and type, measurement type, and information for classifying undocumented participants. Studies used self-reported or proxy measures of legal status. Results Information to classify undocumented participants included self-reported status, possession of a Social Security number, possession of health insurance or institutional resources, concern about deportation, and participant characteristics. Findings show it is feasible to collect self-reported measures of undocumented status. Conclusions We recommend that researchers collect self-reported measures of undocumented status whenever possible and limit the use of proxy measures. Validated and standardized measures are needed for within and across country measurement. Authors should provide methodological information about measurement in publications. Finally, individuals who are undocumented should be included in the development of these methodologies. Trial registration This systematic review is not registered.
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Affiliation(s)
- Maria-Elena De Trinidad Young
- 1Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, 36-071 CHS, Box 951772, Los Angeles, CA 90095-1772 USA
| | - Daniel S Madrigal
- 2California Environmental Health Tracking Program, Public Health Institute, 555 12th Street, 10th Floor, Oakland, CA 94607 USA
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Castro-Echeverry E, Kao LS, Robinson EK, Silberfein EJ, Ko TC, Wray CJ. Relationship between documentation status and survival for medically underserved Hispanic breast cancer patients. J Surg Res 2013; 180:284-9. [DOI: 10.1016/j.jss.2012.04.072] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 03/30/2012] [Accepted: 04/27/2012] [Indexed: 10/28/2022]
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Campesino M, Saenz DS, Choi M, Krouse RS. Perceived discrimination and ethnic identity among breast cancer survivors. Oncol Nurs Forum 2012; 39:E91-100. [PMID: 22374505 DOI: 10.1188/12.onf.e91-e100] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine ethnic identity and socio-demographic factors in minority patients' perceptions of healthcare discrimination in breast cancer care. DESIGN Mixed methods. SETTING Participants' homes in the metropolitan areas of Phoenix and Tucson, AZ. SAMPLE 39 women treated for breast cancer in the past six years: 15 monolingual Spanish-speaking Latinas, 15 English-speaking Latinas, and 9 African Americans. METHODS Two questionnaires were administered. Individual interviews with participants were conducted by nurse researchers. Quantitative, qualitative, and matrix analytic methods were used. MAIN RESEARCH VARIABLES Ethnic identity and perceptions of discrimination. FINDINGS Eighteen women (46%) believed race and spoken language affected the quality of health care. Perceived dis-respect from providers was attributed to participant's skin color, income level, citizenship status, and ability to speak English. Discrimination was more likely to be described in a primary care context, rather than cancer care. Ethnic identity and early-stage breast cancer diagnosis were the only study variables significantly associated with perceived healthcare discrimination. CONCLUSIONS This article describes the first investigation examining ethnic identity and perceived discrimination in cancer care delivery. Replication of this study with larger samples is needed to better understand the role of ethnic identity and cancer stage in perceptions of cancer care delivery. IMPLICATIONS FOR NURSING Identification of ethnic-specific factors that influence patient's perspectives and healthcare needs will facilitate development of more effective strategies for the delivery of cross-cultural patient-centered cancer care.
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Haile RW, John EM, Levine AJ, Cortessis VK, Unger JB, Gonzales M, Ziv E, Thompson P, Spruijt-Metz D, Tucker KL, Bernstein JL, Rohan TE, Ho GYF, Bondy ML, Martinez ME, Cook L, Stern MC, Correa MC, Wright J, Schwartz SJ, Baezconde-Garbanati L, Blinder V, Miranda P, Hayes R, Friedman-Jiménez G, Monroe KR, Haiman CA, Henderson BE, Thomas DC, Boffetta P. A review of cancer in U.S. Hispanic populations. Cancer Prev Res (Phila) 2012; 5:150-63. [PMID: 22307564 DOI: 10.1158/1940-6207.capr-11-0447] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There are compelling reasons to conduct studies of cancer in Hispanics, the fastest growing major demographic group in the United States (from 15% to 30% of the U.S. population by 2050). The genetically admixed Hispanic population coupled with secular trends in environmental exposures and lifestyle/behavioral practices that are associated with immigration and acculturation offer opportunities for elucidating the effects of genetics, environment, and lifestyle on cancer risk and identifying novel risk factors. For example, traditional breast cancer risk factors explain less of the breast cancer risk in Hispanics than in non-Hispanic whites (NHW), and there is a substantially greater proportion of never-smokers with lung cancer in Hispanics than in NHW. Hispanics have higher incidence rates for cancers of the cervix, stomach, liver, and gall bladder than NHW. With respect to these cancers, there are intriguing patterns that warrant study (e.g., depending on country of origin, the five-fold difference in gastric cancer rates for Hispanic men but not Hispanic women). Also, despite a substantially higher incidence rate and increasing secular trend for liver cancer in Hispanics, there have been no studies of Hispanics reported to date. We review the literature and discuss study design options and features that should be considered in future studies.
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Affiliation(s)
- Robert W Haile
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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Sharkey JR, Johnson CM, Dean WR. Nativity is associated with sugar-sweetened beverage and fast-food meal consumption among Mexican-origin women in Texas border colonias. Nutr J 2011; 10:101. [PMID: 21962014 PMCID: PMC3196692 DOI: 10.1186/1475-2891-10-101] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Accepted: 09/30/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trends of increasing obesity are especially pronounced among Mexican-origin women. There is little understanding of dietary patterns among U.S.- and Mexico-born Mexican-origin individuals residing in new-destination immigrant communities in the United States, especially behaviors related to obesity, such as consumption of sugar-sweetened beverages (SSB) and fast-food meals (FFM). METHODS The study used survey data of 599 adult Mexican-origin women from the 610 women who completed the 2009 Colonia Household and Community Food Resource Assessment (C-HCFRA), which was completed in person by trained promotora-researchers in 44 colonias near the Texas border towns of Progreso and La Feria. Data included demographic characteristics (age, education, nativity or country of birth, household income, household composition, and employment status), access to transportation, self-reported height and weight, food and nutrition assistance program participation, and consumption of SSB and FFM. Descriptive statistics were calculated by nativity (U.S.-born vs. Mexico-born); multivariable linear regression models were estimated for correlates of consumption of SSB and FFM. RESULTS There are three major findings related to nativity. First, U.S.-born women consumed more SSB and FFM than Mexican-born counterparts in the same areas of colonias. Second, in the combined sample and controlling for other population characteristics, being born in Mexico was independently associated with FFM (fewer FFM), but not with SSB. Third, in analyses stratified by nativity, FFM and SSB were associated with each other among both nativity groups. Among Mexico-born women only, age, presence of a child, or being a lone parent was significantly associated with SSB; full-time employment, being a lone parent, and SSB consumption were each independently associated with increased frequency of FFM. CONCLUSIONS Our analyses revealed differences in prevalence and correlates of SSB and FFM based on country of birth. Nativity, as a proxy for acculturation, may indicate the extent that immigrants have adopted behaviors from their new environment. However, nativity could also indicate limited accessibility to resources such as food/nutrition assistance programs, transportation, and proper documentation. Additionally, future research should focus on expanding our understanding of the meaning of nativity among individuals who share common contextual factors, but may have different life course experiences and resources needed to transition into a new place. Additional measures should be considered such as educational and occupational background, migration history, documentation status, and dietary acculturation, which may better explain heterogeneity within Hispanic subgroups.
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Affiliation(s)
- Joseph R Sharkey
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX (USA
| | - Cassandra M Johnson
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX (USA
- UNC Center for Health Promotion and Disease Prevention and Department of Nutrition, UNC Gillings School of Global Public Health, Chapel Hill, NC (USA
| | - Wesley R Dean
- Program for Research in Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX (USA
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Lopez-Class M, Gomez-Duarte J, Graves K, Ashing-Giwa K. A contextual approach to understanding breast cancer survivorship among Latinas. Psychooncology 2011; 21:115-24. [PMID: 21674680 DOI: 10.1002/pon.1998] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 04/01/2011] [Accepted: 04/09/2011] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The purpose of this review is to describe the empirical literature on the health-related quality of life (HRQOL) in Latina breast cancer survivors by exploring the social determinants of health. In framing the key domains of survivors' quality of life within a ecological-contextual model that evaluates individual and societal contributions to health outcomes, we provide a comprehensive landscape of the diverse factors constituting Latina survivors' lived experiences and their resultant quality of life outcomes. METHODS We retrieved 244 studies via search engines and reference lists, of which 37 studies met the inclusion criteria. RESULTS Findings document the importance of the social determinants of HRQOL, with studies documenting ecological and contextual factors accounting for significant variance in HRQOL outcomes. Our review identifies a dearth of research examining community-, institutional-, and policy-level factors, such as health care access, legal and immigration factors, physical and built environments, and health care affordability and policies affecting Latina breast cancer survivors' HRQOL. CONCLUSIONS Overall research on Latina breast cancer survivorship is sparse, with even greater underrepresentation within longitudinal and intervention studies. Results highlight a need for clear documentation of the comprehensive care needs of underserved cancer survivors and interventions considering integrated systems of care to address the medical and ecological factors known to impact the HRQOL of breast cancer survivors.
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Affiliation(s)
- Maria Lopez-Class
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
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