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Health Education & Behavior
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Psychosocial Influences on Suboptimal Adjuvant Breast Cancer Treatment Adherence Among African American Women: Implications for Education and Intervention

Carol Magai, PhD

Long Island University, Brooklyn, New York, cmagai{at}liu.edu

Nathan S. Consedine, PhD

Long Island University, Brooklyn, New York

Brenda A. Adjei, EdD

Long Island University, Brooklyn, New York

Dawn Hershman, MD, MPh

Columbia University, New York, New York

Alfred Neugut, MD, PhD

Columbia University, New York, New York

Despite lower incidence, African American women are at increased risk of dying from breast cancer relative to their European American counterparts. Although there are key differences in both screening behavior and tumor characteristics, an additional part of this mortality difference may lie in the fact that African American women receive suboptimal adjuvant chemotherapy and may receive suboptimal hormonal therapy, therapies that are known to increase survival. The authors consider ethnic differences in the psychosocial factors that have been shown to relate to poor screening adherence and consider how they may influence adherence to breast cancer adjuvant treatment, thus the receipt of suboptimal adjuvant chemo or hormonal therapy. To this end, they review ethnic differences in cognitive, emotional, and social network variables. Psychosocial variables should be included in research designed to understand cancer disparities as well interventions that can be tailored to culturally diverse populations to improve treatment adherence.

Key Words: breast cancer • African Americans • treatment adherence

This version was published on December 1, 2008

Health Education & Behavior, Vol. 35, No. 6, 835-854 (2008)
DOI: 10.1177/1090198107303281
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