Jennifer Beth Unger, PhD

Breast cancer is the leading cause of cancer incidence and mortality among Hispanic women. Healthcare underutilization partially explains later detection, treatment delays, and higher mortality among Hispanics relative to non-Hispanic Whites. Some Hispanics underutilize the healthcare system due to barriers such as low health literacy, low understanding of the healthcare system, lack of insurance, lack of access to culturally competent care, and cultural values or beliefs. Navigating the healthcare system requires sufficient health literacy to advocate for one’s needs, understand treatment regimens, and make informed choices. Cultural values in Hispanic cultures such as respeto (not questioning authority figures) can make Hispanics reluctant to request clarification of physicians’ instructions or second opinions. Hispanics might feel less empowered to request health information and services and to advocate for their needs, potentially leading to poor patient-provider communication, low satisfaction with quality of care, and low adherence to medical treatment regimens. Culturally appropriate interventions are needed to improve patient activation among Hispanics during cancer treatment and follow-up.

We will collect qualitative data from Hispanic breast cancer patients, family members, and providers to inform the development of culturally appropriate health education materials to improve patient activation. This formative work will produce a set of culturally grounded messages to include in a fotonovela about patient activation during cancer treatment, which we will develop and evaluate in a subsequent grant.