“Girl, just pray …”: Factors That Influence Breast and Cervical Cancer Screening Among Black Women in Rochester, MN

Background: Black women in Minnesota and beyond have a greater burden of death due to some cancers than their White counterparts. Delayed screening and treatment may explain these disparate statistics. The purpose of this study was to work in collaboration with a local Black faith-based organization to gain an updated understanding of Black women's knowledge, attitudes, and behaviors related to breast and cervical cancer, and determine to what extent known factors persist as barriers to accessing cancer screening among Black women in Rochester, MN. We also sought to identify unique barriers for Black women residing in a particularly health resource rich community. Methods: Using a community-based participatory research approach, two academic institutes worked in collaboration with a local Black faith-based organization to conduct focus groups. Focus groups were utilized to identify factors that may limit Black women's access to cancer screening and health care. Results: Forty-five eligible participants attended one of eight focus group sessions. All participants self-identified as Black women and most were born in the United States. Content analysis of participant responses suggested that Black women's health-seeking behaviors related to breast and cervical cancer screening continue to be very much influenced by known factors that serve as barriers to screening services. Four primary themes pertaining to these influential factors emerged from participants' focus group discussions: 1) knowledge of cancer, risk factors, and screening options; and 2) socioeconomic factors, 3) psycho-social factors, including lack of trust of doctors specifically involved in clinical research, and 4) cultural factors, including reliance on religious practice in place of medical intervention. Conclusion: Black women face real and perceived barriers to cancer screening even where health resources are abundant. Results reiterate an on going need for culturally appropriate interventions to improve Black women's breast and cervical cancer screening participation by minimizing barriers and engaging entire communities – including Black women, religious leaders, and health care providers.