Why is it that African American and Hispanic women have lower incidence rates of breast cancer than white women but higher mortality rates? One theory is that, for a variety of reasons, they are more likely to be diagnosed late, when the disease is in an advanced stage. A new nurse-led intervention program, currently being pilot-tested by African American nurse researchers at Villanova University College of Nursing in Villanova, Pa., has shown promising initial success in addressing one key cause of delays in diagnosis: barriers that prevent minority women from getting breast biopsies.
The goals of the project, led by Villanova assistant professor Patricia K. Bradley, PhD, RN, were to identify African American women’s fears and issues about having a breast biopsy and then develop an educational intervention that would help black women who have been advised to get a biopsy prepare for the procedure. The women’s biggest concerns, the researchers found, were: lack of knowledge about biopsies, lack of support resources (e.g., transportation and child care), fear that the procedure will hurt, fear of undergoing anesthesia and fear of what the biopsy might find.
With support from the National Cancer Institute, Thomas Jefferson University and other organizations, Bradley and her team developed a set of patient materials designed for use in educational counseling sessions to be delivered by nurses. They include an informational booklet, a “questions to ask your doctor” checklist and a support needs form for identifying required support resources and how to get them. All of the materials were written at an eighth grade reading level and were pre-tested with focus groups of black women and a literacy specialist.
The booklet, Having a Breast Biopsy, is designed to be conveniently portable so women can carry it in their purse, read it on the bus, etc. The cover features multicultural portraits of real breast cancer survivors of various races and ethnicities. In clear, simple language, the text explains what’s involved in getting a breast biopsy, different types of biopsies (fine needle aspiration, core needle and surgical) and what to do before and after the procedure. It directly addresses women’s fears in a reassuring way and encourages them to “get the support you need.”
In Phase Two testing of the counseling intervention with a group of 23 African American women, participants responded very positively to the information and encouragement to seek early intervention for their diagnosis. The researchers are now in the process of obtaining grant funding to pilot-test the program on a larger scale. If you are an oncology nurse who would be interested in piloting the intervention at your site, contact Dr. Bradley at [email protected].
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