ASPO Abstracts

Authors: Mitchell KR, Osborne, ML, Brassil, KJ, & Brown, RF

Category: Cancer Health Disparities
Conference Year: 2020

Abstract Body:
Purpose of the study: Existing cancer care disparities are attributed to biological, behavioral, and socioeconomic differences. Patient-centered care (PCC) factors such as respecting values, needs, and preferences, have been linked to care outcomes and failure to value these factors may contribute to disparities. We contend that these factors could influence patient care priorities which may vary according to race. We explored differences between these factors among non-Hispanic blacks (NHB) and non-Hispanic whites (NHW) to understand their influence on patient priorities and NHB care outcomes. Methods: A thematic content analysis of semi-structured individual interviews was conducted. The interviews were audio-recorded and transcribed verbatim. Two trained researchers independently identified themes for: 1) values, 2) unmet needs, 3) preferences, and 4) priorities. Results: The sample consisted of 10 cancer patients, 4 NHB and 6 NHW aged 25 to over 60 yrs old, 50% females in both groups. Four themes emerged under 1) values: a) social roles, b) social interactions, c) religious/spiritual beliefs, and d) optimism. Optimism emerged for NHW participants only. 2) Unmet needs included: a) timely access to care, b) emotional social support, c) informational social support, d) instrumental social support, and e) self-advocacy. The informational social support sub-theme long term treatment plan only emerged among NHB patients. Four preferences themes emerged: a) healthcare engagement, b) care logistics, c) types of provider support, and d) treatment. The healthcare engagement sub-theme research participation was only seen among NHW. The following themes emerged as patient priorities: a) highest quality of care, b) care experience, c) outcomes, and d) family. No racial differences in patient priorities were observed. Conclusions: We observed differences in values, needs, and preferences between NHB and NHW; notably, however, these racial differences were not reflected in patient priorities for care. These study findings are limited by a small sample, but provide support for further investigation of how racial differences in PCC factors may affect evaluations of and engagement in cancer care, and potentially care outcomes.

Keywords: patient centered care, healthcare disparities, Psycho-Oncology

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