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Abstract
This study examines how a sample of African American women understands the uncertainties fundamental to cancer risk communication. Utilizing data from four focus groups, Problematic Integration (PI) theory is applied as an interpretive lens for illustrating their felt difficulties of talking openly about cancer and breast cancer in everyday life. The women describe worry about cancer and its prevalence among African American women; ambivalence and uncertainty; belief that what is not uncertain is certain and awful; fear and avoidance; contradictions in “claiming” and “rebuking” cancer; and hopefulness.
Acknowledgements
The author thanks the following individuals for their help with developing the interview protocol, formative research, recruiting participants, editing and coding transcripts, and reviewing relevant literature: Patreece Boone-Broaddus (focus group moderator), Kim Kennedy, Shana Albright, Amy George Rush, Joselyn Howell, Christina Williams. She also acknowledges Ross Brownson, Matthew Kreuter, and Doug Luke at Washington University for help with research design, and Kate Sauerwin and Amber Williams at the University of Kentucky for their research assistance. An earlier version of this paper was presented at the 58th annual conference of the International Communication Association, Quebec, Canada, in May, 2008. Funding for this research was supported from a grant from the National Cancer Institute's Center of Excellence in Cancer Communication Research program (CA-P50-95815).
Notes
1. Powe (Citation1995) identified cancer fatalism as an important construct that taps into “the belief that death is inevitable when cancer is present” (p. 385). The Powe Fatalism Inventory has been adapted for use in studies of breast and other kinds of cancer (Powe & Finnie, Citation2003). Research has identified sociocultural correlates to cancer fatalism that include lower education, poorer self-rated health, and a less optimistic outlook on life (Farmer, Reddick, D'Agostino, & Jackson, Citation2007; Kreuter et al., Citation2003).
2. This study is part of a larger research project that collected data from focus group participants in response to cancer communication in media. Black newspaper readership was utilized as a sampling frame to solicit individuals familiar with free local Black media storytelling practices and to ensure basic literacy among participants. After contacting Black women from a formative research participant pool database no women were excluded from this initial round of recruitment as all women were familiar with and reported reading the newspaper, although other recruiting materials solicited Black newspaper readers. The local Black newspaper considered in this study is free, widely available to diverse populations, and purports to have the highest readership penetration of any metropolitan newspaper in the city. However, given that this sample consists of women reading Black newspapers, the women participating in this research may be more concerned with social issues.
3. Individuals who did not attend their scheduled session were invited to reschedule. Although women responded to the recruitment advertising and were recruited individually, the groups included some women who were acquainted with one another from social service agencies and nonprofit organizations.
4. Following axial coding, two available participants reacted to the conclusions drawn from these data to provide further feedback. The participants were particularly helpful in confirming the twin themes of spirituality and hopefulness in the discourse, specifically as a counterpoint to what prior research has suggested may be underlying pessimism (and fatalism) about cancer diagnosis.
5. This theme regarding why individuals, family members, and loved ones do not talk about cancer was identified and explored in greater detail in Theme 5, which follows.
6. Linking God, spiritual, or religious faith to the promotion of cancer prevention behavior is a concern that must be systematically examined. Harris, Parrott, and Dorgan (Citation2004, pp. 114–115) caution against “experts in communication” using “strategies to achieve particular aims that may actually limit an audience's care consideration of an action.” However, Harris et al. conclude that neglecting the spiritual dimensions to health communication research “presents an ethical dilemma of its own” (p. 115).