Abstract A005: “Nobody will tell you. You've got to ask!” Race-based differences in patient-provider communication efficacy and social support between Black and White women with breast cancer
Authors: Anderson Janeane N. , Blue Ryan , Graff J. Carolyn , Krukowski Rebecca A. , Graetz Ilana 
Published: August 2020

Purpose: The purpose of this qualitative research study was to explore patient perceptions of patient-centered communication from oncology care providers among Black and White women taking an adjuvant endocrine therapy (AET) medication to treat breast cancer.

Methods: Four 90-minute focus groups were conducted from December 2017 to January 2018 in Memphis, TN, a Mid-South region of the United States with significant Black-White breast cancer mortality disparities. Focus groups were stratified by race (Black and White) and patient length on AET (i.e., &lt; 6 month AET use or &gt; 6 month AET use) (N=28). They were moderated by a race-concordant moderator, using a semistructured interview guide, and audio recorded, transcribed verbatim, coded according to conventions of value-based coding, and analyzed by emergent themes. Participants were compensated with a notebook and $40 merchant gift card. Results In our study, race-based differences in participants' perceptions of information provision and patient-centered patient-provider communication emerged. Black women were more likely than White women to report being proactive and assertive in requesting information related to AETs. Yet, Black women were less likely than White women to report having their informational needs met by providers, namely treatment length, AET symptom management, and effects of AET on pre-existing chronic conditions. One Black participant said, “Nobody will tell you about it [her lab reports]. You've got to ask! If you don't, you won't get any answers.” White women in our study were more likely to report receiving social support from health care providers and praise longstanding relationships. Conversely, Black women in our study shared personal stories of disempowered, paternalistic interactions with providers and frequently mentioned the importance of changing providers to increase their comfort. As such, they were more likely than White women to report relying on their faith in God and nonmedical social support networks to manage symptoms and adhere to prescribed AET regimens. In addition, unlike White women in our sample, Black women said they had no problem discussing sensitive topics, like sexual dysfunction and menopause, with providers but believed those discussions made their providers feel uncomfortable.

Conclusion: Race-based differences in patient-provider communication may contribute to unmet informational and social support needs among Black women with breast cancer during the AET phase. Findings from our study suggest that Black women, compared to White women, experience poorer patient-provider communication and patient-centered cancer care.

Implications: Study results have implications for cancer care in diverse clinical settings. Communication skills training programs should include cultural competency curricula and help oncologists identify and address social support challenges facing Black female patients during the adjuvant phase of breast cancer treatment.

Citation Format: Janeane N. Anderson, Ryan Blue, J. Carolyn Graff, Rebecca A. Krukowski, Ilana Graetz. “Nobody will tell you. You've got to ask!” Race-based differences in patient-provider communication efficacy and social support between Black and White women with breast cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A005.