Abstract PO-159: Patient relatedness with healthcare providers: An intersectional mixed-methods analysis focused on race and sexual orientation in breast cancer screening and treatment
Authors: Tredway Kristi , Camp Melissa S. , Poteat Tonia , Dean Lorraine T. 
Published: January 2022

Abstract
The provider-patient relationship is important in breast cancer care, and the patient's ability to relate to healthcare providers (HCPs) across intersectional identities is also important. Self-determination theory outlines autonomy (a sense of independence), competence (experiencing mastery), and relatedness (feeling connected to others) as key factors for attaining optimum health. In our previous paper, we identified relatedness as a likely key component for the experiences of racial and sexual minorities with HCPs. This mixed-methods study included a nationally representative sample of 728 participants and focused on the experiences of women who are racial and sexual minorities accessing breast cancer screenings and treatment. Relatedness was measured using a 3-point Likert-type scale and those respondents selecting “very important” were offered the opportunity to explain their selection in an open-ended qualitative response. Using intersectional categories, we compared the survey response differences between four groups: 1) Black heterosexual women (BHW; n=185), 2) Black sexual minority women (BSMW; n=96), 3) White heterosexual women (WHW; n=307), and 4) White sexual minority women (WSMW; n=140). Across all participants, relatedness by sex was rated high, while relatedness by religious beliefs and age were rated low. Within Black groups, race was next important, in contrast with White groups, where sexual orientation was next important. Taking an intersectional look at relatedness preferences by sex, 32% of WHW, 40% of BHW, 57% of WSMW, and 66% of BSMW claim that having a female HCP is important to them, the numbers increasing as women's lived experiences become more and more intersectional. In regards to race, 32% of BHW, and 59% of BSMW claim that a HCPs race is important to them compared with 3% of WHW and 2% of WSMW, highlighting how race is a concern for Black women but not for White women. Finally, in terms of sexual orientation, the data show that 5% of WHW, 19% of BHW, 18% of WSMW, and 42% of BSMW claim that a HCPs sexual orientation is important to them, illuminating a provocative set of numbers, with WHW not concerned about it, BHW wanting sexual majority HCPs, and WSMW and BSMW preferring relatedness with other sexual minority HCPs. This quantitative data is supported by the rich qualitative data in which participants explain why these features of relatedness are important. This study supports previous research on female patient preference for female physicians while adding important elements of intersectionality for a richer understanding. This work also expands the research on patient preference for HCP race and sexual orientation as having an intersectional perspective illuminated distinct differences for these women based on race and sexual orientation. What needs to happen now is an increase in the ability for HCPs to express relatedness with a diverse range of patients. Given the research identifying Black and LGBTQ people being hesitant to seek medical care, this can be a route for addressing that health disparity.
Citation Format: Kristi Tredway, Melissa S. Camp, Tonia Poteat, Lorraine T. Dean. Patient relatedness with healthcare providers: An intersectional mixed-methods analysis focused on race and sexual orientation in breast cancer screening and treatment [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-159.