Defense Date

3-20-2015

Graduation Date

Spring 1-1-2015

Availability

One-year Embargo

Submission Type

dissertation

Degree Name

PhD

Department

Nursing

School

School of Nursing

Committee Chair

Joan Such Lockhart

Committee Member

Joan Lockhart

Committee Member

Rosemary Donley

Committee Member

Maria Katapodi

Keywords

Health and environmental sciences, Breast disease, Breast health, Genetics, Predictors, Review, Screening

Abstract

PURPOSE: The purpose of this study was to describe the breast cancer screening behaviors and cancer genetic services (genetic testing and counseling) use among African American female breast cancer survivors diagnosed between the ages of 20-45 years of age (Young Breast Cancer Survivors -YBCS). Additionally, this study examined factors that predicted these breast cancer screening behaviors.

THEORETICAL FRAMEWORK: An expanded version of the Theory of Planned Behavior (Ajzen, 1991) as modified by (Katapodi et al., 2013) guided this study. According to the original theory, knowledge/attitudes, subjective norms regarding the behavior, and perceived control towards the behavior predicts one's intention to perform a health behavior.

METHOD: This secondary data analysis of baseline data retrieved from a randomized efficacy trial (Katapodi et al., 2013) used logistic regression to identify predictors of breast cancer screening and cancer genetic services use.

RESULTS: Participants were 340 African American female YBCS between the ages of 33-63 years old (mean age was 50.5±SD=5.6), diagnosed with invasive breast cancer or Ductal Carcinoma Insitu (DCIS) approximately (11±SD=4) years ago (mean age of diagnosis 40±SD=4). The majority of participants obtained a clinical breast exam (CBE) and mammography as recommended. Overall, genetic counseling and testing was low among the study sample. The majority (76%) of those who did not use cancer genetic services responded that "no one ever suggested" that they needed these services. Logistic regression analyses revealed that income was positively associated with both genetic counseling (B=.254, p=.011) and testing (B=.297, p=.011), while education (B= -.328, p=.052), and lack of access to healthcare services due to cost (B=-1.100, p=.033) were negatively associated with genetic counseling.

SIGNIFICANCE TO NURSING: With a higher incidence of early onset breast cancer, African American women may have a higher burden of inherited breast cancer and should undergo genetic testing when deemed eligible for these services. Cancer genetic services are crucial for ensuring that African American YBCS are able to optimally manage their breast cancer risk. Advanced practice nurses can ensure that women who are at increased risk for developing breast cancer are empowered with accurate information to facilitate informed decision making.

Format

PDF

Language

English

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