ASPO Abstracts
Exploring patient experiences with health care ratings: Black cancer patient perspectives
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2021
Abstract Body:
Purpose: Black patients report worse patient experiences with healthcare compared to non-Hispanic
white patients and recent evidence suggests that it has negative influences on healthcare utilization
and health outcomes. The objective of this study is to explore the multilevel factors that contribute to
the ratings of Black cancer survivors' experiences with medical care.
Methods: We conducted semi-structured in-depth interviews with 18 Black cancer survivors who were
recruited from cancer survivorship support groups and Facebook between 2019-2020. All interviews
were audio recorded, professionally transcribed, and uploaded into Dedoose software for analysis. A
deductive grounded theory approach using the Socio-Ecological Model (SEM), and an inductive
constant comparison approach, were used to identify additional themes that emerged. Two-
independent coders analyzed all transcripts and met to iteratively compare codes and refine the
codebook.
Results: Participants included breast, colorectal, and prostate cancer survivors aged 29 to 88 years
old. We applied SEM as an organizing framework, to understand the individual, interpersonal,
organizational, and environmental influences that Black cancer survivors consider when rating their
patient experience with medical providers. Common themes within the individual level included
perceptions of prejudice and discriminatory behavior by professionals in the health care setting.
Themes within the interpersonal level included communication with doctors and doctors' expertise –
such as empathy, emotional reassurance, authentic listening, and cultural competence. On an
organizational level, communication and modes of communication, care coordination, and
accessibility of healthcare facilities were all factors described to the influence of interactions with
medical providers and consequently patients' ratings. Environmental factors included the physical
space and social resources of medical facilities, such as common areas, personal space, and parking
availability.
Conclusion: All SEM levels influence Black cancer survivors' rating of their quality of cancer care.
This grounded theory study suggests that multilevel intervention research is needed to improve the
patient experience of black cancer survivors.
Keywords: Cancer survivors; African American; patient experiences; qualitative research