Article

Contextualizing the Survivorship Experiences of Haitian Immigrant Women With Breast Cancer: Opportunities for Health Promotion

Erin Kobetz

Janelle Menard

Noella Dietz

Gabrielle Hazan

Hosanna Soler-Vila

Suzanne Lechner

Joshua Diem

Pascale Auguste

breast neoplasms, survivorship, cancer survivorship, focus groups
ONF 2011, 38(5), 555-560. DOI: 10.1188/11.ONF.555-560

Purpose/Objectives: To examine challenges faced by Haitian immigrant women managing a breast cancer diagnosis.

Research Approach: Trained community health workers conducted focus groups with Haitian women who were breast cancer survivors. A grounded theory approach guided analysis of transcripts.

Setting: A large community-based organization in Miami, FL.

Participants: 18 women took part in three focus groups. Participants were 40 years or older, were ethnically Haitian, and had been diagnosed with breast cancer 6-12 months prior to the study.

Methodologic Approach: Data were collected as part of an ongoing community-based participatory research initiative in Little Haiti, the largest enclave of Haitian settlement in Miami, FL. Community health workers, integral to the initiative, recruited participants through their extensive social networks and community contacts.

Main Research Variables: Screening knowledge, illness beliefs, social and economic consequences of a breast cancer diagnosis, and advice for breast health education.

Findings: Emergent themes suggest that Haitian breast cancer survivors face multiple challenges, including misperceptions about screening guidelines, disease etiology, and risk; a reduced capacity to earn a living because of physical debility; and diminished social support.

Conclusions: Future research must continue to examine the impact of breast cancer on Haitian immigrant women and identify key strategies, such as community outreach and support programs, to improve their quality of life.

Interpretation: Nurses can play an essential role in such strategies by providing culturally relevant clinical care and partnering with community stakeholders to define the scope and focus of public health intervention.

Jump to a section

    References

    Ashing-Giwa, K. T., Padilla, G. V., Bohórquez, D. E., Tejero, J. S., & Garcia, M. (2006). Understanding the breast cancer experience of Latina women. Journal of Psychosocial Oncology, 24(3), 19-52. http://dx.doi.org/10.1300/J077v24n03_02
    Barnes, J., Kroll, L., Burke, O., Lee, J., Jones, A., & Stein, A. (2000). Qualitative interview study of communication between parents and children about maternal breast cancer. BMJ, 321, 479-482. http://dx.doi.org/10.1136/bmj.321.7259.479
    Bernard, H. R. (2006). Research methods in anthropology: Qualitative and quantitative approaches. Lanham, MD: Altamira Press.
    Chen, M. A., Vanek, J., & Carr, M. (2005). Mainstreaming informal employment and gender in poverty reduction: A handbook for policy-makers and other stakeholders. London, England: Commonwealth Secretariat.
    Chung, L. K., Cimprich, B., Janz, N., & Mills-Wisneski, S. M. (2009). Breast cancer survivorship program: Testing for cross-cultural relevance. Cancer Nursing, 32, 236-245. http://dx.doi.org/10.1097/NCC.0b013e318196c67b
    Coffman, M. J., Shobe, M. A., & O'Connell, B. (2008). Self-prescription practices in recent Latino immigrants. Public Health Nursing, 25, 203-211. http://dx.doi.org/10.1111/j.1525-1446.2008.00697.x
    Corbin, J., & Strauss, A. (2007). Basics of qualitative research: Grounded theory procedures and techniques. London, England: Sage.
    Darby, K., Davis, C., Likes, W., & Bell, J. (2009). Exploring the financial impact of breast cancer for African American medically underserved women: A qualitative study. Journal of Health Care for the Poor and Underserved, 20, 721-728. http://dx.doi.org/10.1353/hpu.0.0176
    Echeverria, S. E., & Carrasquillo, O. (2006). The roles of citizenship status, acculturation, and health insurance in breast and cervical cancer screening among immigrant women. Medical Care, 44, 788-792. http://dx.doi.org/10.1097/01.mlr.0000215863.24214.41
    Erwin, D. O., Spatz, T. S., Stotts, R. C., Hollenberg, J. A., & Deloney, L. A. (1996). Increasing mammography and breast self-examination in African American women using the Witness Project model. Journal of Cancer Education, 11, 210-215.
    Gany, F., Trinh-Shevrin, C., Aragones, A. (2008). Cancer screening and Haitian immigrants: The primary care provider factor. Journal of Immigrant and Minority Health, 10, 255-261. http://dx.doi.org/10.1007/s10903-007-9076-4
    Gany, F. M., Shah, S. M., & Changrani, J. (2006). New York City's immigrant minorities: Reducing cancer health disparities. Cancer, 107(8, Suppl.), 2071-2081. http://dx.doi.org/10.1002/cncr.22155
    Gibson, L. M., & Hendricks, C. S. (2006). Integrative review of spirituality in African American breast cancer survivors. ABNF Journal, 17(2), 67-72.
    Gierisch, J. M., Earp, J. A., Brewer, N. T., & Rimer, B. K. (2010). Longitudinal predictors of nonadherence to maintenance of mammography. Cancer Epidemiology, Biomarkers and Prevention, 19, 1103-1111.
    Gullatte, M. M., Hardin, P., Kinney, A., Powe, B., & Mooney, K. (2009). Religious beliefs and delay in breast cancer diagnosis for self-detected breast changes in African-American women. Journal of the National Black Nurses Association, 20(1), 25-35.
    Hamilton, J. B., Powe, B. D., Pollard, A. B., III, Lee, K. J., & Felton, A. M. (2007). Spirituality among African American cancer survivors: Having a personal relationship with God. Cancer Nursing, 30, 309-316. http://dx.doi.org/10.1097/01.NCC.0000281730.17985.f5
    Hilton, B. A., & Gustavson, K. (2002). Shielding and being shielded: Children's perspectives on coping with their mother's cancer and chemotherapy. Canadian Oncology Nursing Journal, 12, 198-217.
    Israel, B. A., Schulz, A. J., Parker, E. A., Becker, A. B., Allen, A. J., III, & Guzman, J. R. (2003). Critical issues in developing and following community-based participatory research principles. In M. Minkler & N. Wallerstein (Eds.), Community-based participatory research for health(pp. 53-76). San Francisco, CA: Jossey-Bass.
    Kobetz, E., Mendoza, A. D., Barton, B., Menard, J., Allen, G., Pierre, L., … McCoy, C. (2010). Mammography use among Haitian women in Miami, Florida: An opportunity for intervention. Journal of Immigrant and Minority Health, 12, 418-421. http://dx.doi.org/10.1007/s10903-008-9193-8
    Lewis, J. D., Chagpar, A. B., Shaughnessy, E. A., Nurko, J., McMasters, K., & Edwards, M. J. (2010). Excellent outcomes with adjuvant toremifene or tamoxifen in early stage breast cancer. Cancer, 116, 2307-2315.
    Meade, C. D., Menard, J., Thervil, C., & Rivera, M. (2009). Addressing cancer disparities through community engagement: Improving breast health among Haitian women. Oncology Nursing Forum, 36, 716-722. http://dx.doi.org/10.1188/09.ONF.716-722
    Pisu, M., Azuero, A., McNees, P., Burkhardt, J., Benz, R., & Meneses, K. (2010). The out of pocket cost of breast cancer survivors: A review. Journal of Cancer Survivorship, 4, 202-209. http://dx.doi.org/10.1007/s11764-010-0125-y
    Saint-Jean, G., & Crandall, L. A. (2005). Sources and barriers to health care coverage for Haitian immigrants in Miami-Dade county, Florida. Journal of Health Care for the Poor and Underserved, 16(1), 29-41.
    Shen, Y., Yang, Y., Inoue, L. Y., Munsell, M. F., Miller, A. B., & Berry, D. A. (2005). Role of detection method in predicting breast cancer survival: Analysis of randomized screening trials. Journal of the National Cancer Institute, 97, 1195-1203. http://dx.doi.org/10.1093/jnci/dji239
    Sohmer, R., Jackson, D., Katz, B., & Warren, D. (2005). The Haitian community in Miami-Dade: A "Growing the middle class" supplement. Washington, DC: Brookings Institution.
    Summers, C., Saltzstein, S. L., Blair, S. L., Tsukamoto, T. T., & Sadler, G. R. (2010). Racial/ethnic differences in early detection of breast cancer: A study of 250,985 cases from the California Cancer Registry. Journal of Women's Health, 19, 203-207. http://dx.doi.org/10.1089/jwh.2008.1314
    Wade, C., Chao, M. T., & Kronenberg, F. (2007). Medical pluralism of Chinese women living in the United States. Journal of Immigrant and Minority Health, 9, 255-267. http://dx.doi.org/10.1007/s10903-007-9038-x