Loyola University Chicago

Marcella Niehoff School of Nursing

Regina Conway-Phillips, PhD, RN

Using Grounded Theory to Discover the meaning and Experiences of Breast Cancer Screening and Early Detection in Never or Rarely Screened African American Women

Investigator: Regina Conway-Phillips, PhD, RN

African American women (AAW) experience a disproportionately high breast cancer burden and mortality rate despite having a lower incidence of the disease. AAW have a lower incidence rate than White women (WW), however the incident rate is increasing in AAW while it is decreasing in WW. Notably, there is growing concern that the convergence of the incidence rates may result in a greater disparity in mortality rates for AAW. Findings noted in the literature have attributed this disparity to a variety of factors including but not limited to late stage at diagnosis due to lack of adherence to breast cancer screening (BCS) guidelines. Adoption of BCS behaviors in AAW is posited to result in earlier detection, earlier treatment and thus reduced mortality rate. Studies conducted over the past 15 years on AAW breast cancer screening behaviors have focused on the identification of multiple factors contributing to AAW’s lack of adoption of BCS behaviors including but not limited to physical, systematic and psychosocial barriers. Few studies have focused on “never screened” or “rarely screened” AAW to discover the meaning and experiences of breast health, breast cancer, breast cancer screening and early detection. The purpose of this qualitative study is to use a grounded theory approach to discover the meaning and experiences of breast health,  breast cancer screening and early detection in never or rarely screened AAW.

The findings of this study can contribute to nursing practice, as nurses are challenged to provide information and care in a way that promotes and optimizes health and prevents illness. It is imperative that nurses understand the decision making process of at risk women who do not choose BCS as part of their preventive health practice.  In addition, it is important for nurses to understand the experience of BCS behaviors of AAW in order to develop culturally sensitive interventions to promote adoption of BCS behaviors and practice. As nurses continue to care for more people from diverse cultural backgrounds it is crucial that they be prepared and understand the influence of culture on preventive health behavior as well as the meaning of preventive health behaviors to AAW and other racially and ethnically diverse groups. This knowledge can contribute to the design of new approaches to promote BCS and reduce the disparity in breast cancer incidence and outcomes for AAW.