Beliefs, perceptions, and preferences for treatment in Latinas with breast cancer

Research documents that breast cancer is the leading cause of death in Latina females. The exact numbers are unknown, but studies reveal that Latinas with breast cancer underuse recommended follow-up chemotherapy, decreasing their rates of survival. Although several factors may be responsible, cultural influences are a possible barrier. However, there is a gap in the literature about how culture affects decisions about breast cancer treatment. This focused ethnographic study examined the role of cultural beliefs and perceptions in the decision-making process for Latina women about whether or not to receive chemotherapy following a breast cancer diagnosis. Drawing from Douglas\u27 cultural theory of risk, archived in-depth interview data from 20 Latina breast cancer survivors were open coded into 56 primary codes which were then categorized into hierarchical trees of overarching themes and subcategories. Unique elements of the patterns observed in these data were analyzed and interpreted to explain how culture may influence Latina breast cancer patients to underuse recommended chemotherapy. The results of this qualitative analysis revealed that various cultural factors including social role-related themes, avoidance of information and communication, as well as employment and immigration status influenced the treatment decisions of Latina women. Analysis suggested that these cultural factors influenced both the amount and quality of information Latina women had available to make these decisions, as well as how they processed information to reach their decisions. Results of this study can accelerate social change by drawing increased attention to cultural differences in medical decision making, by informing the communication process between medical providers and their Latina patients, and thus eventually increasing survival from breast cancer among Latinas

Municipalities Collaborating in Public Health: The Danish Smoking Prevention and Cessation Partnership

This study explored the Smoking Prevention and Cessation Partnership (SPCP) which builds upon a collaboration between two Danish municipalities targeted at the prevention of tobacco smoking. The aim of the study was to describe the processes of SPCP, to examine the difficulties this collaboration faced, and to assess how these experiences could be used to improve future partnership collaboration. We employed qualitative methodology comprising 12 semi-structured one-to-one interviews with SPCP’s stakeholders and an analysis of the partnership documents and reports. The findings suggested that the main potentials of the partnership were the personal relations between the members and stakeholders with the possibilities of the creation of new connections with other actors. Barriers to successful partnership building were the implementation of the new Local Government Reform as a competing task, and that the two municipalities were heterogenic in respect to organizational issues and working methods. Other impediments included the lack of continuity in leadership, the lack of clarity regarding the form of collaboration and roles, as well as different expectations of the stakeholders. We conclude that four factors remain critical for partnerships. The first is the clarity of the collaborative effort. Second, partnerships need to take into account the structural circumstances and culture/value systems of all stakeholders. Third is the impact of contextual factors on the development of the partnership; and the fourth factor is the bearing of personal/individual factors on the partnership e.g., personal engagement in the project. Early attention to these four factors could contribute to more effective partnership working