Medical Advocacy and Supportive Environments for African-Americans Following Abnormal Mammograms


African-American women experience disproportionately adverse outcomes relative to non-Latina White women after an abnormal mammogram result. Research has suggested medical advocacy and staff support may improve outcomes among this population. The purpose of the study was to understand reasons African-American women believe medical advocacy to be important and examine if and how staff can encourage and be supportive of medical advocacy. A convenience-based sample of 30–74-year-old women who self-identified as African-American/Black/of African descent and who had received an abnormal mammogram result was recruited from community-based organizations, mobile mammography services, and the local department of health. This qualitative study included semi-structured interviews. Patients perceived medical advocacy to be particularly important for African-Americans, given mistrust and discrimination present in medical settings and their own familiarity with their bodies and symptoms. Respondents emphasized that staff can encourage medical advocacy through offering information in general in a clear, informative, and empathic style. Cultural competency interventions that train staff how to foster medical advocacy may be a strategy to improve racial disparities following an abnormal mammogram.

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We thank our participants for their perspectives, time, and effort during this study. For their guidance and assistance with recruitment and data collection, we greatly appreciate Edree Allen-Agbro and Arthur J. Walker. We would also like to thank Marilyn L. Calbert and the staff from the participating clinic sites and programs for their recruitment efforts, including Julie Anne Black, Leanne White, Carri Pender, Jodi Olson, and Kris Edwards. Aminata Trawally and Michelle Nguyen are thanked for their technical assistance with transcription services. This work was supported by the National Cancer Institute under grant numbers P50CA148143, R25CA92408, and K01CA154938-01A1. The opinions or assertions contained herein are the private ones of the authors and are not considered as official or reflecting the views of the National Institutes of Health.

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Correspondence to Yamile Molina.

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Molina, Y., Hempstead, B.H., Thompson-Dodd, J. et al. Medical Advocacy and Supportive Environments for African-Americans Following Abnormal Mammograms. J Canc Educ 30, 447–452 (2015).

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  • Abnormal mammogram disparities
  • African-American
  • Communication
  • Breast cancer screening
  • Follow-up
  • Qualitative
  • Medical advocacy