Abstract A044: Black identity, hair product use, and breast cancer: Exploring breast health issues in Black women
Authors: Teteh Dede K. , Ericson Marissa , Mitchell Eudora , Clark Phyllis , Kittles Rick , Montgomery Susanne 
Published: August 2020

Abstract
Introduction: The parent study investigated the potential role of hair products for breast cancer etiology in a community sample of Black women. Black women are diagnosed and die from breast cancer more than White women. Hair across the African diaspora is synonymous with identity. Black women use more hair products containing endocrine-disrupting chemicals than other races. Currently there is no hair, identity, and health scale. To better understand the cultural influence of hair product usage for Black women, given the possible link between product use and breast cancer, we assessed identity, perceived risk, knowledge, and attitude about Black hair and breast cancer. The purpose of this study was to validate a hair, identity, and breast health scale in a diverse sample of Black women.
Methods: In phase 1 of our study we explored the cultural and personal meaning of hair for Black women (N=125). Transcribed qualitative interviews were analyzed using grounded theory methods. Survey items were created based on emerging themes. In the survey phase of the study, Black women completed a 27-item scale to rate the degree of agreement with statements related to identity, hair products, and breast cancer diagnosis. Principal component analyses were conducted to investigate the underlying factor structure of influence of hair and identity on cancer diagnosis. A confirmatory factor analysis (CFA) confirmed whether one, two, or three factors best explain our identity, hair product use, and breast cancer diagnosis scale.
Results: Our participants (N = 211) comprised 70% African American, 18% African, and 7% Caribbean Black women aged 29 to 64. Factor analysis yielded two factors that accounted for 61% of the total variance. Five items tapping into sociocultural perspectives about hair and identity loaded on Factor 1 and accounted for 32% of the total variance. Cronbach's alpha for this 5-item subscale was 0.82 (95% CI = 0.77-0.86). Six items assessing hair product usage, perceived risk, and breast cancer diagnosis accounted for 29% of the total variance. Cronbach's alpha for the 6-item subscale was 0.82 (95% CI =0.74-0.86). Confirmatory factor analysis confirmed the two-factor structure (root mean square error of approximation= 0.03; Comparative fit index= 0.91; Tucker Lewis index = 0.88) for this newly created identity, hair product use, and breast cancer diagnosis scale.
Conclusions: As we seek to better understand cultural influences that perpetuate disparities in mammography screening rates, the impact of hair on identity for Black women should also be recognized. Our hair, identity, and breast health scale may provide insights to comprehend the social and behavioral patterns of Black women in relation to breast cancer prevention and hair product risk. Considering these sociocultural perspectives of women across the African diaspora may yield culturally appropriate strategies that inform interventions about identity, hair product risk, and breast cancer prevention.
Citation Format: Dede K. Teteh, Marissa Ericson, Eudora Mitchell, Phyllis Clark, Rick Kittles, Susanne Montgomery. Black identity, hair product use, and breast cancer: Exploring breast health issues in Black women [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 A044.