Factors leading to disparity in lung cancer diagnosis among black/African American communities in the USA: a qualitative study
Objective This study has two objectives: first, to explore the diagnostic experiences of black/African American (BAA) patients with lung cancer to pinpoint pitfalls, suboptimal experiences and instances of discrimination leading to disparities in outcomes compared with patients of other ethnic backg...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/10/e073886.full |
| _version_ | 1797634677495824384 |
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| author | Matthew Thompson Morhaf Al Achkar Tanimola Martins Nicholas Thuo Eugene Manley, Maisha Standifer Dawood H Sultan Nicholas R Faris Angela Hill Rohan Jeremiah |
| author_facet | Matthew Thompson Morhaf Al Achkar Tanimola Martins Nicholas Thuo Eugene Manley, Maisha Standifer Dawood H Sultan Nicholas R Faris Angela Hill Rohan Jeremiah |
| author_sort | Matthew Thompson |
| collection | DOAJ |
| description | Objective This study has two objectives: first, to explore the diagnostic experiences of black/African American (BAA) patients with lung cancer to pinpoint pitfalls, suboptimal experiences and instances of discrimination leading to disparities in outcomes compared with patients of other ethnic backgrounds, especially white patients. The second objective is to identify the underlying causes contributing to health disparities in the diagnosis of lung cancer among BAA patients.Methods We employed a phenomenological research approach, guiding in-depth interviews with patients self-identifying as BAA diagnosed with lung cancer, as well as caregivers, healthcare professionals and community advocates knowledgeable about BAA experiences with lung cancer. We performed thematic analysis to identify experiences at patient, primary care and specialist levels. Contributing factors were identified using the National Institute of Minority Health and Health Disparities (NIMHD) health disparity model.Results From March to November 2021, we conducted individual interviews with 19 participants, including 9 patients/caregivers and 10 providers/advocates. Participants reported recurring and increased pain before seeking treatment, treatment for non-cancer illnesses, delays in diagnostic tests and referrals, poor communication and bias when dealing with specialists and primary care providers. Factors contributing to suboptimal experiences included reluctance by insurers to cover costs, provider unwillingness to conduct comprehensive testing, provider bias in recommending treatment, high healthcare costs, and lack of healthcare facilities and qualified staff to provide necessary support. However, some participants reported positive experiences due to their insurance, availability of services and having an empowered support structure.Conclusions BAA patients and caregivers encountered suboptimal experiences during their care. The NIMHD model is a useful framework to organise factors contributing to these experiences that may be leading to health disparities. Additional research is needed to fully capture the extent of these experiences and identify ways to improve BAA patient experiences in the lung cancer diagnosis pathway. |
| first_indexed | 2024-03-11T12:12:02Z |
| format | Article |
| id | doaj.art-b10ca7eb1bff4db480d90958590b9813 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T12:12:02Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-b10ca7eb1bff4db480d90958590b98132023-11-07T12:05:07ZengBMJ Publishing GroupBMJ Open2044-60552023-10-01131010.1136/bmjopen-2023-073886Factors leading to disparity in lung cancer diagnosis among black/African American communities in the USA: a qualitative studyMatthew Thompson0Morhaf Al Achkar1Tanimola Martins2Nicholas Thuo3Eugene Manley,4Maisha Standifer5Dawood H Sultan6Nicholas R Faris7Angela Hill8Rohan Jeremiah91 Family Medicine, Univeristy of Washington, Seattle, WA, USA9 Oncology, Wayne State University/Karmanos Cancer Institute, Detroit, MI, USA2 Health and Community Science, University of Exeter, Exeter, UK1 Family Medicine, Univeristy of Washington, Seattle, WA, USA3 SCHEQ Foundation, New York, New York, USA4 Health Policy, Morehouse School of Medicine, Atlanta, Georgia, USA5 Public Health, Mercer University, Atlanta, Georgia, USA6 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, Tennessee, USA7 Pharmacotherapuetics and Clinical Research, University of South Florida, Tampa, Florida, USA8 Global Health, University of Illinois at Chicago, Chicago, Illinois, USAObjective This study has two objectives: first, to explore the diagnostic experiences of black/African American (BAA) patients with lung cancer to pinpoint pitfalls, suboptimal experiences and instances of discrimination leading to disparities in outcomes compared with patients of other ethnic backgrounds, especially white patients. The second objective is to identify the underlying causes contributing to health disparities in the diagnosis of lung cancer among BAA patients.Methods We employed a phenomenological research approach, guiding in-depth interviews with patients self-identifying as BAA diagnosed with lung cancer, as well as caregivers, healthcare professionals and community advocates knowledgeable about BAA experiences with lung cancer. We performed thematic analysis to identify experiences at patient, primary care and specialist levels. Contributing factors were identified using the National Institute of Minority Health and Health Disparities (NIMHD) health disparity model.Results From March to November 2021, we conducted individual interviews with 19 participants, including 9 patients/caregivers and 10 providers/advocates. Participants reported recurring and increased pain before seeking treatment, treatment for non-cancer illnesses, delays in diagnostic tests and referrals, poor communication and bias when dealing with specialists and primary care providers. Factors contributing to suboptimal experiences included reluctance by insurers to cover costs, provider unwillingness to conduct comprehensive testing, provider bias in recommending treatment, high healthcare costs, and lack of healthcare facilities and qualified staff to provide necessary support. However, some participants reported positive experiences due to their insurance, availability of services and having an empowered support structure.Conclusions BAA patients and caregivers encountered suboptimal experiences during their care. The NIMHD model is a useful framework to organise factors contributing to these experiences that may be leading to health disparities. Additional research is needed to fully capture the extent of these experiences and identify ways to improve BAA patient experiences in the lung cancer diagnosis pathway.https://bmjopen.bmj.com/content/13/10/e073886.full |
| spellingShingle | Matthew Thompson Morhaf Al Achkar Tanimola Martins Nicholas Thuo Eugene Manley, Maisha Standifer Dawood H Sultan Nicholas R Faris Angela Hill Rohan Jeremiah Factors leading to disparity in lung cancer diagnosis among black/African American communities in the USA: a qualitative study BMJ Open |
| title | Factors leading to disparity in lung cancer diagnosis among black/African American communities in the USA: a qualitative study |
| title_full | Factors leading to disparity in lung cancer diagnosis among black/African American communities in the USA: a qualitative study |
| title_fullStr | Factors leading to disparity in lung cancer diagnosis among black/African American communities in the USA: a qualitative study |
| title_full_unstemmed | Factors leading to disparity in lung cancer diagnosis among black/African American communities in the USA: a qualitative study |
| title_short | Factors leading to disparity in lung cancer diagnosis among black/African American communities in the USA: a qualitative study |
| title_sort | factors leading to disparity in lung cancer diagnosis among black african american communities in the usa a qualitative study |
| url | https://bmjopen.bmj.com/content/13/10/e073886.full |
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