Flannel, Maisha

Gehlert, Sarah

Habif, J.

Hovmand, P.

Noel, L.

Williams, Faustine

Zoellner, Nancy

English

East Tennessee State University

East Tennessee State UniversityDigital Commons @ East Tennessee State UniversityETSU Faculty Works Faculty Works2016Addressing Racial Disparities in Breast CancerTreatment Delays: An Application of Group ModelBuilding (GMB)Faustine WilliamsEast Tennessee State University, williamsf2@etsu.eduNancy ZoellnerSocial System Design LabMaisha FlannelSaint Louis City Department of HealthL. NoelNYU Silver School of Social WorkJ. HabifSocial System Design LabSee next page for additional authorsFollow this and additional works at: https://dc.etsu.edu/etsu-worksPart of the Health Services Research Commons, Oncology Commons, Race and EthnicityCommons, and the Women's Health CommonsThis Presentation is brought to you for free and open access by the Faculty Works at Digital Commons @ East Tennessee State University. It has beenaccepted for inclusion in ETSU Faculty Works by an authorized administrator of Digital Commons @ East Tennessee State University. For moreinformation, please contact digilib@etsu.edu.Citation InformationWilliams, Faustine; Zoellner, Nancy; Flannel, Maisha; Noel, L.; Habif, J.; Hovmand, P.; and Gehlert, Sarah. 2016. Addressing RacialDisparities in Breast Cancer Treatment Delays: An Application of Group Model Building (GMB). Poster presentation. American PublicHealth Association. https://doi.org/10.13140/RG.2.2.19474.45769Addressing Racial Disparities in Breast Cancer Treatment Delays: AnApplication of Group Model Building (GMB)Creator(s)Faustine Williams, Nancy Zoellner, Maisha Flannel, L. Noel, J. Habif, P. Hovmand, and Sarah GehlertThis presentation is available at Digital Commons @ East Tennessee State University: https://dc.etsu.edu/etsu-works/66IntroductionAddressing Racial Disparities in Breast Cancer Treatment Delays: An Application of Group Model Building (GMB)Williams F1; Zoellner N2; Flannel M3; Noel L4; Habif Jnr D2; Hovmand P2; Gehlert S5College of Public Health, East Tennessee State University1; Social System Design Lab2; Saint Louis City Department of Health3;NYU Silver School of Social Work4; Brown School of Social Work, Washington University in Saint Louis5ResultsApproach & MethodsAcknowledgementConclusionsObjective • To examine social, and environmental factors that cause women with suspicious mammograms not to seek treatment.• Approach: To effectively unpack the complex dynamics responsible for the widening BC disparities gap between black women, and white women in St. Louis, a system dynamics group model building (GMB) method was used.• GMB is an approach for visualizing the endogenous (feedback) sources driving observed dynamic behavior, in this case delays in BC treatment for black women.• Core Modeling Team (CMT): A five member CMT comprised of faculty from Washington University School of Medicine, Brown School Social Systems Design Lab, and St. Louis City Department of Health affiliates were responsible for planning, and facilitating the GMB workshops as well as recruited eligible women for the study.• Eligibility Criteria: (1) Women or family members who experienced a disparity in BC diagnosis or treatment, in addition to (2) healthcare workers or volunteers working with this population.• Breast cancer (BC) remains the most commonly diagnosed cancer among United States (US) women, and the second most common cause of death among women after lung cancer.  • Black women are 42% more likely to die from BC than white women.• In St. Louis, Missouri, BC trends are similar to patterns seen throughout the US. • However, there is great regional variation in mortality. Women residing in North St. Louis, a predominately black community, experience the highest rates of mortality.•• Sample: Thirty-four women participated in the workshop, representing two stakeholder groups: • Black women from the community (BC survivors, family, and caregivers from the northern St. Louis area).• Community support members (navigators, research coordinators, city workers, and volunteers) working with communities on women’s health issues.• The Process: Three 2-hour sessions were conducted:• Black women from the community (n=28)• Community support members (n=6)• The two groups combined (n=34). • Session Objective: The objective of sessions 1 and 2 was to elicit factors contributing to BC diagnosis as well as treatment delays, and develop a dynamic hypothesis to explain the disparities in the form of a causal loop diagram (CLD). In the third session participants evaluated the synthesized CLD, and identified places to intervene in the system.• Most commonly reported factors of treatment delays in the scientific literature are those related to socioeconomic status. This work reveals new insights showing that these disparities are due to the interplay of numerous factors working together.• Findings also suggest that developing effective interventions for complex problems like treatment delays require true stakeholder engagement.This work was supported by funding from the National Cancer Institute U54 CA155596.Image 1. CLD showing factors identified by participants to be contributing to BC treatment delay in St. Louis Figure 1. Ranking of factors by “dots” of importance and intervention • The CLD built by the women included 8 subsystems including: mental health, fear, access to healthcare, income, religion/spirituality, social support, knowledge on breast health, and personal mindset on health/life.• The subsystems are causally-linked, and include feedback loops, providing explanations for trends in BC treatment delays in St. Louis.• Figure 1 illustrates places in the system that were of greatest concern to participants, and where they want to see interventions added to reduce BC treatment disparities between black, and white women in St. Louis.• The women also identified a set of recommendations for action based on the CLD structure. This includes formation of a community-based action group on women’s health education in St. Louis, design, in addition to implementation of strategies to train patient navigators, as well as other healthcare professionals on the best way(s) to address women’s fear of cancer at the time of diagnosis. View publication stats

Addressing Racial Disparities in Breast Cancer Treatment Delays: An Application of Group Model Building (GMB)

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Addressing Racial Disparities in Breast Cancer Treatment Delays: An Application of Group Model Building (GMB)

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