ASPO Abstracts
Understanding African American Iowans' experiences in healthcare, and how those experiences shape cancer prevention and control behaviors
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: Black and African American Iowans experience higher mortality from each leading cancer compared to Iowans of other races. The purpose of this pilot research was to conduct community-engaged research to understand and address the disparate burden of cancer among Black and African American Iowans. Methods: In collaboration with our community partners (AV; and, members of the Black Hawk County Steering Committee), we identified a need to understand how experiences in the healthcare system, specifically experiences of racism, impact individuals' desire and ability to engage in cancer prevention and control behaviors. We conducted twenty semi-structured interviews with African American Iowans mostly living in Black Hawk County during summer 2022. Interviewees were recruited by our Community Co-I (AV) using a snowball sampling method. Interview questions focused on attitudes towards and experiences in the healthcare system, medical (mis)trust, and engagement with cancer screening. Interviews were transcribed, coded, and thematic analysis conducted. Results: Several themes were identified in our analyses of interview transcripts. Barriers to engagement in cancer prevention and control behaviors included: cultural stigma; everyday racism and racism in healthcare; medical mistrust; poor communication; the need to be heard; and, the need for sustainable community interventions. Facilitators to engagement include the ability to choose in healthcare; and, the ability to seek care outside the local setting. Conclusion: This study identified barriers and facilitators to engaging in cancer prevention and control behaviors among African American Iowans, indicating areas for potential interventions. Community engagement played a key role in identifying priorities and shaping the directions of this work. Next steps include an environmental scan, and data sharing with community members to identify future research opportunities.
Keywords: qualitative research, community engagement, racism in healthcare, medical mistrust