Cultural Beliefs among Latinas: The Role of Acculturation and Impact on Timeliness of Breast Cancer Care
thesisposted on 27.02.2015, 00:00 by Rani I. Gallardo
Certain cultural beliefs related to breast cancer may act as a barrier to a woman seeking breast cancer preventive services or timely follow-up for a breast symptom. For Latinas, holding beliefs that are inconsistent with healthcare-seeking behavior may lead to low or delayed utilization of care regardless of access. This study explores factors associated with breast cancer beliefs among Latina women and how this might lead to delays in seeking care or receiving treatment for breast cancer. Data were obtained from a population-based sample of 181 urban Latina women recruited as part of the Breast Cancer Care in Chicago (BCCC) study. Women were ages 30–79 and had been diagnosed with primary in situ or invasive breast cancer. Interviews included a cultural beliefs scale spanning a range of beliefs that could be inconsistent with motivation to seek timely healthcare. The total number of beliefs was dichotomized at the sample mean, such that patients holding three or more beliefs were compared to patients holding two or less beliefs. Sociodemographic, socioeconomic, acculturation, and access/care utilization factors were examined as potential confounders. Three outcomes were examined: patient delay, clinical delay, and total delay. Seventy-five percent of women held one or more beliefs. The belief most commonly held was, “Faith in God can protect you from breast cancer” (48%). Fifty percent of the sample had an acculturation score of zero (Mean=1). Lower acculturation was associated with greater beliefs. Patients with less income, less education, and lacking private health insurance also tended to hold more beliefs (p<.05). Both clinical delay (57% versus 43%, p=.07) and total delay (59% versus 32%, p=.0005) were more common for women holding three or more beliefs versus two or less. After adjusting for age, education, income, and acculturation, holding three or more beliefs was associated with 3.35 times the odds of experiencing a total delay compared to holding two or less beliefs. Cultural beliefs may predispose certain Latina women who are less acculturated and of lower socioeconomic status to prolong seeking care for breast symptoms and may influence delays in receiving treatment for breast cancer.