Abstract B028: The stages of change model approach to reducing endocrine-disrupting chemical exposures linked to breast cancer risk for Black women
Authors: Teteh Dede K , Clark Phyllis Clark , Mitchell Eudora , Kittles Rick , Montgomery Susanne 
Published: September 2020

In the US Black women (BW) are more likely to die from breast cancer (BC) than White women. Research increasingly supports the association between ingredients found in hair and personal care products and BC risk, linked to endocrine disrupting chemicals (EDCs). BW spend more money on hair products (HPs) containing EDCs than other racial groups. Some scholars posit that for many BW, hair is synonymous with identity. To further explore the complex interplay between hair, identity, and breast health we developed and validated the Black Identity, Hair Product Use, and Breast Cancer Scale (BHBS). The purpose of this study is to provide direction on the utility of the scale in capturing sociocultural factors related to BC risk and HPs use for intervention planning. Methods: The 11-item BHBS scale includes two subscales, one measuring sociocultural perspectives about hair and identity (5-items) and the other perceived breast cancer risk related to HPs (6-items). Response options strongly disagree/disagree are categorized as “low importance” and strongly agree/agree as “high importance”. Analysis includes descriptive and inferential statistics. Survey data was analyzed using SPSS Version 25. Results: Participants (N=185) were African/Caribbean and African American women ages 29 to 79. Eight percent (n=15) had been diagnosed with BC. Forty percent had a mammogram previously and 59.5% intended to have a mammogram in the future. BW (89.5%) who are concerned about BC and intend to watch the ingredients of products were more likely to intend to have a mammogram in the future (p=0.02). 46.6% of BW who are concerned about BC and intend to watch the ingredients of the products they use, felt pressure from their female friends to straighten their hair (p=0.04). On the contrary, 84.6% women who plan to adjust how they use HPs because of their concern about BC: 1) did not think it necessary for BW to have their hair straight in order to be successful in business (p=0.03) and 2) did not think BW needed to straighten their hair in order to attract Black men (p=0.003). Furthermore, 92.4% of women who wanted to learn more about the health risks of HPs (88% of all), agreed that BW needed to straighten their hair to attract Black men (p=0.03). Overall, participants were interested in learning more about BC risk and HPs use through social media (88.1%) and from their stylist (82.2%). Discussion: In the US straight hair for BW continues to represent Eurocentric ideals of beauty and acceptance resulting in BW using HPs containing EDCs. While many of our participants intend (contemplation) to watch ingredients or learn (contemplation) more about HP related health risks, they felt pressure (friends, partners) to straighten their hair. However, those who worry (contemplation) about ingredients or plan (preparation) to adjust their HPs use, felt less need to submit to peers, or societal ideals of success and mate selection linked to straight hair. Thus, the stages of change model maybe used to develop health-related behavior interventions for our participants.

Citation Format: Dede K Teteh, Phyllis Clark Clark, Eudora Mitchell, Rick Kittles, Susanne Montgomery. The stages of change model approach to reducing endocrine-disrupting chemical exposures linked to breast cancer risk for Black women [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B028.