Exploring the Psychosocial Needs of Breast Cancer Survivors Among Young African American Women in Georgia: A Research Grant Proposal Pubblico

Reed, Minda Dionne (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/nk322f18w?locale=it
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Abstract

Young African-American (AA) women with breast cancer (under age 45) suffer poorer health outcomes than other survivor groups and may face distinct challenges in managing their diagnosis, treatment and aftercare. Research suggests that young AA survivors may have unmet psychosocial needs requiring culturally appropriate and age-specific clinical and therapeutic strategies as a result of these unique experiences. Previous work regarding quality of life issues in breast cancer survivorship has failed to distinguish psychosocial needs specific to young AA women. The proposed study seeks to identify psychosocial needs and areas of unmet need among young AA breast cancer survivors by exploring their perspectives on the issue, as well as those of the providers who care for and provide health services to them at each phase of the cancer continuum from detection to end-of-life. Using a mixed methods sequential exploratory approach, this study will explore common experiences, themes, and phenomena related to the psychological, emotional, and social aspects of breast cancer that affect young AA women through focus groups and a survey for survivors, as well as interviews with providers. The interviews will also assess the cultural competence and perceived self-efficacy of providers to effectively manage the psychosocial needs of this population. Information from this pilot study of Georgia women will be used to educate cancer care providers about the psychosocial health needs of young AA survivors as well as to inform the development of targeted interventions to address identified needs in order to improve the quality of care delivered to this high risk population.

Table of Contents

Chapter I: Introduction......................................................................................3

Background.......................................................................................................3

Breast Cancer Disparities and African-American Women......................................4

Psychosocial Effects of Breast Cancer..................................................................6

A Threat to Public Health (Problem Statement)...................................................6

Definition of Terms............................................................................................7

Chapter II: Literature Review..............................................................................9

Introduction to the Review of Literature..............................................................9

Overview of the Burden of Breast Cancer in the United States..............................10

Health Disparities in Breast Cancer....................................................................11

Breast Cancer in Georgia...................................................................................13

Theoretical Framework.....................................................................................15

Psychosocial Needs of Women with Breast Cancer...............................................17

Psychosocial Needs Specific to Young AA Women with Breast Cancer...................18

Cultural Competence of Health Care Providers...................................................20

Summary and Implications for Proposed Research..............................................21

Chapter III: Methodology..................................................................................24

Description of Grant Announcement..................................................................24

Proposal Review Criteria...................................................................................24

Additional Funding Agencies for Breast Cancer Research.....................................29

Description of Grant Review Process Methodology...............................................31

Description of Grant Proposal Reviewers.............................................................32

Chapter IV: External Reviewer Comments...........................................................37

Reviewer 1........................................................................................................37

Reviewer 2........................................................................................................57

Reviewer 3........................................................................................................60

Reviewer 4........................................................................................................67

Reviewer 5........................................................................................................70

References........................................................................................................73

Chapter v: Research Proposal.............................................................................79

Specific Aims....................................................................................................79

Background and Significance..............................................................................80

Cultural Competence of Cancer care providers.....................................................81

Conceptual framework and determinants of health..............................................81

Statement of cancer relevance............................................................................82

Innovation.......................................................................................................83

Research design................................................................................................84

Environment.....................................................................................................91

Ethical Considerations.......................................................................................91

References........................................................................................................93

Appendices.......................................................................................................96

Appendix A.......................................................................................................96

Appendix B........................................................................................................97

Appendix C........................................................................................................98

Appendix D........................................................................................................99

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