Investigator: Candidus Nwakasi, Providence College
Mentor: Brown University, University of Rhode Island

Theme: Cancer
Title: An Evaluation of Cancer Survivorship in Blacks/Latinx in Rhode Island 
Award: Early Career Development (2022-2024)

Abstract: Cancer survivorship covers the period starting from cancer diagnoses and treatment to end of life — with focus on the effect of cancer and treatment on the health and wellbeing of patients, their caregivers, families, and friends during the survivorship experience. Compared to Whites, Black and Latinx cancer survivors and their families experience disproportionate adverse effects of cancer and cancer therapy. This is due to extreme psychosocial, physical, emotional, and financial challenges they experience, thus, highlighting racial/ethnic disparity in cancer survivorship. It is important to identify and address the root causes of these disparities, and one way to accomplish this is to explore the role that culture plays in cancer health, especially cancer survivorship. For instance, trust/communication difficulty with health care providers, inaccurate risk perception, social support, religion and spirituality, identifying with a race/ethnicity, and cancer-related stigma are some sociocultural factors that can influence cancer survivorship among Black/Latinx populations. Therefore, clinical and non-clinical interventions must consider some of these factors if they are to be effective in improving the health and quality of life of Black and Latinx cancer survivors and their families. The study setting will be Rhode Island. Aging increases the risk of cancer, and Rhode Island is racially and ethnically diverse with an older age structure that is higher than the national average. The study has 3 objectives. One, to deepen the understanding of the quality of life of Blacks/Latinx (including migrants) undergoing cancer therapy and those in post-cancer therapy. Two, to explore cultural practices that may contribute to the issues of cancer survivorship disparity (e.g., adherence to survivorship care plans and accessing quality care) experienced by this group. Three, to identify culturally relevant recommendations for an effective cancer survivorship care plan. Using a sociocultural lens (e.g., the PEN-3 cultural model), we propose 2 specific aims to explore the cancer survivorship experiences of Black/Latinx patients. One, to identify supportive and obstructive practices of families and communities that may influence cancer survivorship and compliance with care plans. Two, to assess the role of stigmatization on cancer survivorship by exploring how the intersection of cancer-related stigma and other stigma-related issues such as race, body image, socioeconomic status, and immigration status, affect survivorship. Semi-structured interviews of over 40 survivors and 5-10 focus groups of over 40 of their families/friends/informal caregivers will be used to achieve these aims. The findings will help inform the development of a culturally relevant cancer survivorship intervention for disadvantaged racial/ethnic groups in Rhode Island.

Relevance: This proposed study will help address the issue of racial/ethnic cancer survivorship disparities by deepening our understanding of the experiences of Black and Latinx cancer survivors in Rhode Island, an aging, racially and ethnically diverse state. Findings from this study will help inform tailored, culturally relevant interventions to improve the health and quality of life of Black and Latinx cancer survivors and their families.