Comparing breast cancer awareness campaigns through four different ethnicities

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Content Comparing Breast Cancer
Awareness Campaigns Through
Four Different Ethnicities
By
Taryn Nicole Goscinski

A Thesis Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment for the Degree
MASTER OF ARTS
(STRATEGIC PUBLIC RELATIONS)
May 2015
Copyright 2015 Taryn Nicole Goscinski

2

Dedication:

I
dedicate
this
Master’s
thesis
to
my
mother,
Cynthia
Ann
Wood,
the

strongest
woman
I
have
ever
known.

She
taught
me
about
strength,
courage
and

bravery.

She
was
a
fighter
for
five
years
and
up
until
the
very
end
of
her
life.
Even

though
she
did
not
beat
breast
cancer,
she
will
always
be
a
survivor.

RIP
Mommy
7/31/56-‐8/27/09

3

Table
of
Contents:

ABSTRACT:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐5

Research
Methodology
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
5

PREFACE:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐5

INTRODUCTION:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐8

SECTION
I:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐11

Breast
Cancer
Awareness
Outreach
to
Caucasian
Women
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐11

Introduction:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐11

Challenges:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
14

Ashkenazi
Jewish:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐14

Susan
G.
Komen
Foundation:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐15

Championing
Mammograms:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐19

Social
Media
Use:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐19

Financial
Resources:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
20

Future
Goals:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐20

Interview
with
Gwen
Baker:
Susan
G.
Komen
Foundation:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
22

Surviving
Breast
Cancer:
Donna
Hartman-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐26

Surviving
Breast
Cancer:
Shirley
Horn:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐28

SECTION
II:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
33

Breast
Cancer
Awareness
Outreach
To
African
American
Women
33

Introduction:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐33

The
Sisters
Network
Inc.:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐36

Social
Media
Use:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐37

Interview
with
Valerie
Rochester:
The
Black
Women’s
Health
Imperative:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐38

Future
Goals:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐41

SECTION
III:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
42

Breast
Cancer
Awareness
Outreach
to
Hispanic/Latina
Women
-‐-‐-‐42

Introduction:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐42

Community
Outreach
Organizations:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐43

Challenges:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
45

Disparities/Poverty:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
47

Interpreters:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
48

Family:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
49

Self
Reliance:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐50

Elements
Affecting
Women
in
the
U.S.:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐51

Social
Life:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐52

Religion:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
52

Fatalism
and
Fear:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐53

4

Social
Media
Use:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐54

Interview
with
Katherine
Briant:
Fred
Hutchinson
Cancer
Research
Center:
-‐-‐-‐-‐-‐-‐-‐-‐59

Future
Goals:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐62

SECTION
IV:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
63

Breast
Cancer
Awareness
Outreach
to
Asian
American
Women
-‐-‐-‐-‐63

Introduction:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐63

Challenges
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
64

“Asian
Women
Don’t
Get
Breast
Cancer:”
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐64

Family
Influence:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐66

Mammograms/Dense
Breasts:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐67

National
Asian
Breast
Cancer
Initiative:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
68

Survivorship
Among
Asian-‐American
Women:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐69

Social
Media
Use:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐70

Future
Goals:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐71

Interview:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐71

SECTION
V:
Multiethnic
Organizations
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
72

The
National
Cancer
Institute:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
72

Interview
with
Jennifer
Metz:
The
California
Health
Collaborative:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
75

Intercultural
Cancer
Council:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐77

Outreach/Future
Goals:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
79

SECTION
VI:
Conclusion:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐80

SECTION
VII:
Overall
Recommendations:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
84

SECTION
VIII:
Appendix
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
88

Charts
and
Graphs:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
88

Interview
Transcripts:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐93

Interview
Contacts:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐113

SECTION
VIIII:
Bibliography:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
114

SECTION
X:
Endnotes:
-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐
116

5

Abstract:

This
paper
compares
breast
cancer
awareness
campaigns
through
Caucasian,

African
American,
Hispanic/Latina
and
Asian
American
ethnicities.

It
examines

current
awareness
campaigns
and
outreach
efforts
for
each
ethnic
group
and

explores
the
similarities
and
differences
between
them.

It
also
looks
at
the

challenges
that
each
ethnicity
may
face
when
trying
to
reach
its
target
audience.

A

main
objective
of
this
paper
is
to
identify
whether
there
are
consistencies
in
how
to

effectively
reach
and
educate
women
about
breast
cancer
awareness.

Regardless
of

ethnicity,
age,
education
or
income,
all
women
need
to
learn
about
the
preventative

measures,
recommended
examinations
and
care
for
breast
cancer
during
and
after
a

diagnosis.

This
paper
also
explores
the
similarities
and
differences
in
designated

community
group’s
future
plans
for
breast
cancer
education.

It
discusses
possible

different
ways
for
segmenting
women,
whether
by
community
or
ethnicity,
to

encourage
the
dissemination
of
adequate
breast
cancer
education.

Along
with
an

outline
of
numerous
ethnic-‐focused
breast
cancer
advocacy
organizations,
the

obstacles
and
personal
feelings
of
each
ethnicity
are
also
discussed.

6

Preface:

• Research
Methodology

Qualitative
primary
research
was
performed
through
a
series
of
interviews

that
were
conducted
via
email.

Each
interview
was
with
an
individual
who
works

for
a
breast
cancer
organization
that
serves
a
specific
ethnic
group,
as
identified
by

the
author
through
secondary
online
research.

Each
interview
participant
was
sent

an
identical
series
of
questions
to
answer,
which
asked
how
the
organization
they

are
a
part
of
works
toward
providing
their
target
ethnic
group
with
breast
cancer

awareness
and
education.

Respondents
provided
details
regarding
their
respective

organization’s
use
of
social
media,
web
use,
traditional
media
and
outreach
efforts.

Six
individuals
provided
feedback:

• Gwen
Baker,
Director
of
Mission
Programs
for
Susan
G.
Komen
Los
Angeles,

representing
the
Caucasian
ethnicity.

• Valerie
Rochester,
Director
of
Programs
for
the
Black
Women’s
Health

Imperative,
representing
African
Americans.

• Katherine
Briant,
Community
Health
Education
Manager
of
the
Fred

Hutchinson
Cancer
Research
Center
in
Seattle,
Washington
representing
the

Hispanic/Latina
ethnic
group.

• Questionnaires
also
were
completed
by
Shirley
Horn
and
Donna
Hartman

both
Caucasians,
who
are
both
two-‐time
breast
cancer
survivors
and
who

were
working
at
a
breast
cancer
advocacy
organizations
at
the
time
of
this

research.

7

• Jennifer
Metz,
Project
Coordinator
and
Health
Educator
of
the
California

Health
Collaborative,
also
discussed
how
her
organization
attempts
to
reach

multiple
ethnic
groups
in
a
variety
of
ways.

The
author
also
conducted
content
analysis
of
11
breast
cancer
advocacy

organizations
that
appeared
to
have
targeted
a
specific
ethnicity.

Where
available,

content
from
these
organizations’
past
awareness
campaigns
were
compared
to

their
current
messages
to
show
any
changes
that
had
taken
place.

Content
analysis

was
also
done
on
any
statements
regarding
each
organization’s
future
goals
and
any

articulated
strategies
behind
future
plans.

The
secondary
research
consisted
of
reviewing
previously
published
articles

regarding
studies
done
on
reaching
multiple
ethnicities
through
social
media,
and

epidemiological
data
on
how
each
ethnicity
is
affected
by
breast
cancer.

Numerous

journal
articles
were
read
to
determine
the
struggles
that
different
ethnicities
face

when
learning
about
breast
cancer
and
going
through
the
diagnosis.

Numerous

periodicals
also
were
read
on
past
studies,
including
extensive
survey
and
focus

groups
research
that
identified
the
positives
and
negatives
of
employing
traditional

and
social
media
to
educate
communities
about
breast
cancer
preventatives
and

treatments.
A
complete
Bibliography
is
provided
on
page
114.

8

Introduction:

“Every
60
seconds,
somewhere
in
the
world,
someone
dies
of
breast
cancer.”
1

Today,
breast
cancer
is
the
second
leading
cause
of
death
among
women
and
the

most
common
type
of
cancer
diagnosed
in
American
women
regardless
of
race
or

ethnicity.

“Aside
from
skin
cancer,
breast
cancer
is
the
most
common
cancer
among

women
in
the
U.S.”

2

While
lung
cancer
is
the
leading
cause
of
cancer
death
for

women
in
the
U.S.,
breast
cancer
is
a
close
second.

Although
breast
cancer
does
not
discriminate
between
age
(over
25
years

old),
ethnicity,
income
or
even
gender,
the
ways
that
each
ethnicity
is
affected
may

be
different.

Different
races
have
different
rates
of
risks,
which
may
involve

diagnosis
rate,
the
age
at
which
breast
cancer
is
most
commonly
identified,
and

survival
and
mortality
rates.

The
author’s
secondary
research
confirmed
that

women
of
different
ethnicities
may
be
more
likely
to
be
diagnosed
with
breast

cancer
at
a
relatively
older
or
younger
age,
have
a
more
aggressive
case
of
breast

cancer,
or
be
more
likely
to
seek
alternative
treatment
and
screenings.

A
person’s

ethnic
background
may
also
influence
various
factors
related
to
how
women
may

seek
and
handle
treatment
or
get
screenings
and
mammograms,
as
well
their

feelings
toward
the
disease
and
their
knowledge
about
breast
cancer
overall.

Numerous
nonprofit
breast
cancer
advocacy
organizations
have
been

established
that
may
focus
on
raising
money
for
research,
finding
a
cure
for
the

disease,
educating
women,
all
presumably
with
the
goal
of
reaching
and
benefitting

the
most
women
most
effectively.

While
many
organizations
focus
on
breast
cancer

and
all
women,
others
target
a
specific
ethnicity.

It
is
up
for
debate
about
whether

9

one
is
superior
at
building
awareness
and
what
the
most
effective
tools
are
to
reach

women.

Each
organization
may
also
differ
in
its
future
goals
regarding
breast
cancer.

Some
appear
to
raise
money
to
fund
research
to
develop
a
cure
to
breast
cancer,

while
others
aim
at
finding
the
cause.

Some
organizations
are
segmenting
and

targeting
women
by
their
ethnicity
and
tackling
the
challenges
of
reaching
that

specific
group,
while
others
provide
education
and
support
more
universally
for
all

women.

Still
others
appear
to
be
organizing
campaigns
by
geographical

neighborhood
or
community.

10

Figure
1:
Susan
G.
Komen
Foundation
Breast
Cancer

Incidence
and
Mortality
Figure

3

This
graph
is
comparing
the
higher
rate
of
breast
cancer
incidence
in
white
women
to
black
women,

in
contrast
to
the
higher
mortality
rate
in
black
women
to
white
women
in
breast
cancer.

(This
will
be
discussed
further
in
the
thesis)

11

Section
I:
Breast
Cancer
Awareness
Outreach
to

Caucasian
Women

• Introduction:

The
definition
of
“Caucasian”
is:
“of,
constituting,
or
characteristic
of
a
race
of

humankind
native
to
Europe,
North
Africa,
and
southwest
Asia
and
classified

according
to
physical
features-‐
used
especially
in
referring
to
persons
of
European

descent
having
usually
light
skin
pigmentation.”

4

For
the
purpose
of
this
paper,
the

Caucasian
ethnicity
is
also
referred
to
as
“white”
when
comparing
to
the
other

ethnicities
mentioned.

According
to
the
Susan
G.
Komen
Foundation
Website,
overall
breast
cancer

incidence
is
the
highest
for
Caucasian
women
when
compared
to
other
ethnicities

due
to
the
fact
that
white
women
are
more
likely
to
seek
breast
cancer
screenings
in

advance,
which
makes
their
diagnosis
numbers
higher
because
the
cancer
is

identified
sooner.

However,
white
women
also
have
the
second
highest
mortality

rate,
surpassed
only
by
African
American
women.

From
1999
to
2005,
breast

cancer
diagnoses,
especially
among
white
women,
declined.

The
Susan
G.
Komen

Foundation
Website
says
Caucasians
are
more
likely
to
live
longer
after
a
positive

breast
cancer
diagnosis
because
they
seek
mammograms
and
receive
treatment

sooner
than
women
of
other
ethnicities.

5

12

Figure
2:
Breast
Cancer
Incidence
Graph

6

The
graph
above
from
The
Komen
Foundation
compares
the
incidence
rates
of
breast
cancer

among
different
ethnicities.

It
clearly
shows
that
although
one
ethnic
group
may
have
a
high
breast

cancer
diagnosis
rate,
its
mortality
rate
may
be
lower
than
other
ethnic
groups.

13

Figure
3:
Breast
Cancer
Mortality
Graph

7

This
graph,
also
from
The
Komen
Foundation,
shows
that
while
African-‐American
women
have
the

second
highest
incidence
rate,
shown
in
the
previous
graph,
they
also
have
the
highest
mortality
rate.

14

• Challenges:

In
the
author’s
opinion
one
of
the
greatest
obstacles
when
researching
breast

cancer
among
white
women
is
the
large
number
of
individuals
in
this
group.

The

author
found
that
there
are
also
no
breast
cancer
advocacy
organizations
that

specifically
targeted
only
Caucasian
women,
as
was
found
for
other
ethnicities.

There
was
no
stand-‐alone
data
for
Caucasian
women
and
the
majority
of
facts
and

statistics
found
for
“white
women”
were
only
listed
in
comparison
to
other
ethnic

groups.

The
statistics
for
white
women
are
rarely
listed
separately;
instead;
their

numbers
may
be
the
baseline
against
which
all
other
ethnicities
are
compared.

Based
on
the
author’s
experience,
it
is
challenging
for
a
Caucasian
woman
to
find

information
that
strictly
affects
her
race.

While
breast
cancer
advocacy

organizations
that
reach
out
to
all
women
include
general
breast
cancer
figures,
an

argument
could
be
made
that
more
specific
content
needs
to
be
identified
and

distributed
for
the
white
community.

• Ashkenazi
Jewish:

One
important
subsection
of
the
Caucasian
group
that
faces
a
great
risk
of

breast
cancer
are
women
of
Ashkenazi
Jewish
heritage.

According
to
the
Susan
G.

Komen
website,
breast
cancer
is
higher
among
Jewish
women
when
compared
to

other
women.

The
increased
likeliness
is
due
to
a
stronger
occurrence
of
the
BRCA1

and
BRCA2
gene
mutations
in
Jewish
women
of
Eastern
European
decent.

15

“BRCA1
and
BRCA2
(BReast
CAncer
genes
1
and
2)
are
the
best-‐known
genes

linked
to
breast
cancer
risk.

BRCA1/2
can
be
passed
to
you
from
either
parent
and

can
affect
the
risk
of
cancers
in
both
women
and
men.”

8

According
to
the
Susan
G.
Komen
Foundation
Website,
mutations
in
the

BRCA1/2
genes
cause
an
increased
risk
of
breast
cancer
in
any
woman.

Without

taking
ethnicity
into
account,
women
face
an
eight
percent
chance
of
breast
cancer

by
the
age
of
70,
but
a
12
percent
risk
of
breast
cancer
by
the
age
of
85.

Women

with
a
BRCA1
gene
mutation
have
a
55
to
65
percent
chance
of
developing
breast

cancer,
while
BRCA2
carries
approximately
a
45
percent
risk.

However,
according

to
the
Susan
G.
Komen
foundation,
of
the
Ashkenazi
women
diagnosed
with
breast

cancer,
10
percent
in
the
U.S.
will
have
a
BRCA1/2
gene
mutation.

9

• Susan
G.
Komen
Foundation:

As
there
are
no
organizations
that
focus
only
on
Caucasian
breast
cancer

awareness
and
education,
the
author
used
one
of
the
most
established
and
well-‐
known
breast
cancer
organizations
as
the
focus
for
the
content
analysis
of
a

Caucasian
organization’s
communications.

In
1980,
Nancy
G.
Brinker’s
sister,
Susan,
was
dying
of
breast
cancer
and

Brinker
promised
her
that
she
would
find
a
cure
for
the
disease.

From
that
promise,

the
Susan
G.
Komen
Breast
Cancer
Foundation
emerged
in
1982.

Starting
with
just

$200
and
a
handful
of
donors,
Brinker
has
grown
the
Komen
Foundation
into
the

world’s
largest
nonprofit
fundraiser
for
breast
cancer.

10

Since
its
beginning,
the

organization
has
invested
over
$2.5
billion
in
breast
cancer
research,
community

16

education
and
programs
toward
building
awareness
and
treatment
in
over
30

countries.

11

The
organization’s
biggest
goal
is
raising
money,
which
is
applied
toward

research
for
a
cure
for
breast
cancer
and
to
educate
women
about
prevention
and

treatment.

Since
1982,
the
Komen
Foundation
has
expanded
globally
and
created

numerous
trademarks
and
symbols
for
breast
cancer.

The
Komen
Foundation
is

headquartered
in
Dallas,
TX,
but
has
117
affiliates
across
the
U.S.
as
well
as
in
Italy,

Germany
and
Puerto
Rico.

One
of
the
projects
the
Komen
Foundation
is
best
known

for
is
the
Race
for
the
Cure,
which
raises
money
to
fund
research
and
community

advocacy
and
education.

12

The
first
Race
for
the
Cure
took
place
in
1983
in
Dallas
with
800
participants.

As
of
2014,
the
Race
had
grown
to
now
more
than
150
races
on
four
continents,

with
over
1.6
million
participants.

One
of
the
most
significant
contributions
that

Komen
has
made
to
breast
cancer
awareness
was
establishing
the
pink
ribbon
as

the
universal
symbol
for
breast
cancer.

Komen
first
distributed
the
iconic
pink

ribbon
at
its
New
York
City
Race
for
the
Cure
in
1991.

Since
then,
the
pink
ribbon

has
been
included
on
everything
from
t-‐shirts
to
events
signage.

13

In
2007,
the
Komen
Foundation
made
medical
history
when
it
awarded
the

first-‐ever
grant
ever
for
the
Komen
Tissue
Bank.

This
is
the
only
biorepository
of
its

kind
with
the
purpose
of
studying
the
causes
and
prevention
of
breast
cancer

through
collections
of
normal
breast
tissue.

The
organization’s
website
reports
that

the
25
th

anniversary
of
the
Race
for
the
Cure
was
celebrated
in
2008.

17

The
Komen
Foundation’s
mission
is
not
only
to
save
lives
by
finding
a
cure

for
breast
cancer,
but
to
end
breast
cancer
forever.

It
helps
those
currently
suffering

from
breast
cancer,
but
constantly
pushes
to
discover
the
cause
of
breast
cancer
and

prevent
it.

The
Komen
Foundation
also
educates
women
on
prevention,
treatment,

medical
options,
family
history,
risks,
and
survivorship.

The
organization
wants
to

reassure
women
with
breast
cancer
and
their
family
and
friends
that
they
are
not

alone
and
that
there
is
a
community
of
support
for
them.

According
to
its
website,

the
organization
also
wants
to
empower
those
affected
and
help
all
to
receive

quality
care.

Komen’s
Affiliates
fund
more
than
2,000
community
organizations,
which

provide
educational
programs,
screening,
and
additional
resources
related
to
breast

cancer
diagnosis
and
care
for
all
ethnicities
and
genders.

Investing
over
$1.8
billion

in
grants
since
1982,
the
Komen
Foundation
has
also
provided
emergency
financial

help
for
people
facing
breast
cancer
who
lack
the
necessary
funds.

Each
Komen
Affiliate
retains
75%
of
the
funds
that
it
raises
from
the
Komen

Race
for
the
Cure
5K
walk/run,
with
the
remaining
funds
going
to
overall
breast

cancer
research.

The
money
that
the
community
affiliates
raise
is
dedicated
to
local

education
and
awareness
projects,
and
screenings
and
treatment
in
the
respective

community.

According
to
the
website,
“Komen’s
investments
have
helped
drive

down
breast
cancer
mortality
by
34%
since
1991.”

14

In
1982,
the
five-‐year
survival
rate
for
women
with
Stage
I
breast
cancer
was

74%.

With
the
help
of
the
research
funding
and
educational
programs
supported
by

the
Komen
Foundation,
that
number
is
now
up
to
99%.

As
it
notes
on
its
website,

18

the
organization
is
making
it
possible
for
early
stage
breast
cancer
to
not
be
a
death

sentence
and
that
if
it’s
detected
and
treated
early,
many
women
can
survive
this

disease.

The
website
states
that
although
the
Komen
Foundation
has
made
progress

and
major
strides
in
breast
cancer
research,
there
will
be
no
stopping
until
there
is
a

cure.

15

Figure
4:
Komen
Foundation
Mammogram
Chart

16

This
chart
compares
the
rate
of
receiving
of
mammograms
in
women
over
40
years
of
age
in
the

ethnic
groups
Caucasian,
African
American,
Hispanic/Latina,
Asian
American
and
American
Indian

and
Alaska
Native,
which
was
not
an
ethnic
group
studied
in
this
paper.

19

• Championing
Mammograms:

Komen
also
recognizes
the
importance
of
a
mammogram
and
a
yearly
check

up
to
dramatically
reduce
the
risk
of
breast
cancer,
since
detecting
a
malignant
lump

or
tumor
early
enough
can
increase
a
woman’s
chance
of
survival.

Posted
on
the

Komen
Foundation’s
webpage
are
lists
of
mammogram
data
points
pertaining
to

any
question
or
concern
someone
may
have,
such
as:

“About
80-‐90
percent
of

breast
cancers
in
women
without
symptoms
in
the
U.S.
will
be
detected
by

mammography.”

17

As
seen
in
Figure
4,
Caucasian
women
over
the
age
of
40
are
more
likely
to

receive
a
mammogram
than
any
other
ethnicity.

Many
other
ethnicities,
possibly

due
to
cost
and
misinformation,
delay
being
screened
for
breast
cancer,
which
then

delays
treatment
for
those
in
whom
a
tumor
is
found.

• Social
Media
Use:

The
Komen
Foundation
has
utilized
social
media
to
spread
breast
cancer

awareness
and
reach
the
largest
audience
possible.

The
organization
is
very
active

on
Twitter
and
Facebook,
posting
daily
inspirations,
survivor
stories,
research

breakthroughs
and
hopeful,
motivational
messages.

Currently
@SusanGKomen,
has

over
95,600
followers
on
Twitter
and
over
815,000
“page
likes,”
which
were

continuously
rising
every
week
the
author
was
conducting
her
research.

The

Komen
Foundation
is
a
part
of
numerous
hashtags
on
Twitter
and
Facebook,

including
#MotivationalMondays,
#PerfectPinkParty,
and
#WhatGivesMeStrength.

Its
#MotivationalMondays
hashtag
encourages
women
to
post
personal
stories
of

20

survival
and
what
continues
to
give
them
the
strength
to
fight
the
breast
cancer

battle.

The
#WhatGivesMeStrength
hashtag
asks
women
who
have
conquered

breast
cancer
or
are
currently
fighting
the
disease
to
post
what
personally
gives

them
the
ability
to
continue
to
persevere.

• Financial
Resources:

For
the
2014-‐15
national
Susan
G.
Komen
Race
for
a
Cure,
the
official

sponsors
were
American
Airlines,
Ford,
New
Balance,
Walgreens
and
Self
Magazine.

Aside
from
being
sponsored,
the
Komen
Foundation
does
considerable
promoting

and
fundraising
through
their
website,
social
media
channels
and
through
the
sale
of

branded
product.

Outside
of
the
U.S.
government,
the
Komen
Foundation
provides

the
largest
amount
of
funding
from
a
non-‐profit.

18

To
date,
Komen
has
invested

more
than
$847
million
to
just
researching
a
cure
and
currently
manages
more
than

500
active
research
grants
with
funds
that
total
over
$300
million.

19

• Future
Goals:

The
overall
encompassing
goal
of
the
Susan
G.
Komen
Breast
Cancer

Foundation
is
for
Nancy
Brinker
to
be
able
to
keep
the
promise
she
made
to
her

sister
so
many
years
ago
to
end
breast
cancer
forever.

While
the
organization

continues
to
raise
money
in
search
of
a
cure
for
breast
cancer,
it
also
educates

women.

Currently,
the
organization
is
building
more
programs
that
reach
more

women
about
the
importance
of
getting
tested
early
and
following
through
with

yearly
checkups.

The
foundation
also
educates
women
about
preventative

21

measures
that
they
can
take,
what
to
look
for
in
their
personal
and
family
history

and
their
treatment
options
if
diagnosed.

20

An
analysis
of
the
organization’s
website
indicates
it
also
is
working
to
build

additional
outreach
to
individual
ethnicities.

The
Komen
Foundation
acknowledges

how
great
of
an
impact
race
and
ethnicity
play
in
diagnoses
and
survival
rates
and

know
that
there
is
no
“one
size
fits
all”
breast
cancer
awareness
campaign.

Bringing

in
more
funding
and
sponsors
would
provide
the
opportunities
to
build
more

campaigns
that
target
separate
ethnicities
and
to
customize
the
campaigns
to
fit
the

particular
communication
needs
of
a
given
ethnicity.

The
foundation
recently
added

Spanish
copy
to
its
website
and
a
review
of
its
online
schedule
shows
that
many

informational
sessions
and
workshops
by
Komen
Affiliates
are
also
available
in

Spanish.

The
Komen
organization
is
also
forging
partnerships
with
Asian

foundations
to
reach
their
communities.

The
website
also
shows
that
the
organization’s
2015
agenda
includes

contributing
to
and
supporting
breast
cancer
research
federal
funding
being

conducted
through
the
National
Institutes
of
Health,
the
Department
of
Defense,
and

for
the
Centers
for
Disease
Control
and
Prevention’s
National
Breast
and
Cervical

Cancer
Early
Detection
Program.

Another
one
of
its
stated
goals
for
2015
is
public

affairs
work
to
advocate
for
improved
insurance
coverage
that
addresses
all
breast

cancer-‐related-‐
needs
and
to
reduce
and
eventually
eliminate
out-‐of-‐pocket
medical

costs
for
a
mammogram.

21

22

• Interview
with
Gwen
Baker:
Susan
G.
Komen
Foundation:

An
interview
with
Gwen
Baker,
Director
of
Mission
Programs
for
the
Los

Angeles
affiliate
of
Susan
G.
Komen,
revealed
more
about
the
growth
of
the
largest

breast
cancer
advocacy
organization.

When
asked
if
the
Komen
organization
saw
a

difference
in
survivorship
between
women
of
different
ethnicities,
Baker
said
that

Caucasians
are
more
open
about
breast
cancer
especially
among
their
friends
and

family.

Many
Caucasian
women
find
that
breast
cancer
becomes
part
of
their
public

identity
as
a
survivor.

However,
she
said
the
Komen
Foundation
had
noted
that
Latinas
are
more

private
and
reserved
about
breast
cancer,
and
many
believe
that
there
is
shame
in

being
diagnosed.

Baker
revealed
that
she
personally
had
seen
close
Latina
family

members
who
were
unaware
of
other
family
members’
diagnoses
of
breast
cancer,

and
said
it
was
not
uncommon
for
a
Latina
to
not
know
that
an
aunt
or
cousin

currently
or
previously
had
breast
cancer.

In
her
opinion
this
outlook
hurts
the

Latina
community
because
it
makes
these
women
unaware
that
breast
cancer
is
in

their
family
and
they
can’t
take
the
necessary
preventative
measures.

Baker
said

Asian-‐American
women
were
also
more
private
about
breast
cancer
and
that
many

believed
that
if
they
didn’t
talk
about
their
condition,
it
was
not
really
happening.

Unfortunately,
Baker
said
she
had
seen
some
discrimination
in
the
Thai
community

toward
breast
cancer
in
general
because
they
believed
that
it
brought
negative

energy
to
their
community;
as
a
result,
women
who
have
breast
cancer
are
kept

separated.

23

Baker
said
that
while
many
women
prioritize
their
lives
similarly,
a
woman’s

financial
and
family
status
plays
the
biggest
role.

In
her
experience,
African-‐
American
women
seem
to
be
spread
more
thinly
and
have
less
time
to
dedicate
to

their
own
health.

She
reported
seeing
that
many
of
the
African-‐American
women

the
Komen
Foundation
works
with
are
single
mothers
with
limited
money,
time
and

resources.

“These
women
do
not
always
have
a
lot
of
support
so
all
responsibilities

falls
on
them.

Similarly,
Latinas
who
are
wives
and
mothers
also
tend
to
put
their

own
health
last.”

Many
Latinas
also
will
not
follow
through
with
treatment
if
their

children
are
young
enough
to
not
know
about
their
cancer
condition.

She
said
they

do
this
to
shield
their
children
from
witnessing
the
effects.

While
there
are
numerous
health
conditions
competing
for
a
woman’s
time

and
attention,
Baker
said
the
Komen
Foundation
has
recognized
that
women
are

more
likely
to
pay
attention
to
immediate
health
conditions
instead
of
long-‐term

illnesses,
like
breast
cancer.

Her
organization
teaches
women
that
breast
cancer

requires
attention
even
before
diagnosis
because
there
are
so
many
preventative

measures.

She
emphasizes
that
women
shouldn’t
wait
until
they
have
breast
cancer

to
worry
about
it.

When
it
comes
to
mammograms,
the
Komen
Foundation
notes

that
Latinas
have
more
resistance
to
treatment
than
to
getting
mammograms.

“Latina
women
tend
to
be
less
educated
about
mammograms
to
argue
over
its

positive
use,
but
they
question
treatment
processes
because
they
know
there
are

numerous
alternatives
like
homeopathic
traditions
that
are
kinder
on
the
body
and

don’t
cost
as
much.”

24

Baker
revealed
that
African-‐American
women
expressed
the
greatest

resistance
to
mammograms
because
of
their
historical
mistrust
in
the
government

and
the
health
care
system
in
general.

She
said
African-‐American
women
are
more

worried
about
radiation
because
they
believe
“the
health
care
system”
is
not
on

their
side.

There
is
also
mammogram
resistance
expressed
by
Asian
American

women
because
they
are
aware
of
their
likelihood
to
have
dense
breasts,
which

make
mammograms
less
effective.

“They
wonder
if
there
is
any
point
to
getting
a

mammogram
if
it
won’t
pick
up
breast
cancer
as
accurately,
and
many
can’t
afford

an
ultrasound
that
is
needed
for
their
breast
type.”

According
to
Baker,
the
biggest
obstacle
for
reaching
women
about

mammograms
is
that
it
is
harder
to
educate
those
with
language,
cultural
or

educational
barriers.

It
also
is
difficult
because
of
rumors
that
circulate
about

mammograms
and
that
radiation
treatment
does
more
harm
than
good.

These

rumors
especially
sway
the
women
who
are
already
questioning
whether
to
get

tested
for
breast
cancer
or
not.

Baker
reported
that
the
Komen
Foundation
is
currently
focusing
much
of
its

resources
toward
reaching
Latina
and
African-‐American
women.

The
four

recommendations
are:
to
be
healthy,
to
know
their
personal
risk,
to
get
a
yearly

screening,
and
to
be
aware
of
their
own
breasts
and
any
changes
that
may
occur

with
them.

The
Komen
National
group
focuses
on
all
research
and
current
breast

cancer
studies.

Local
Komen
affiliates
concentrate
more
on
providing
education
and

services
to
the
communities
they
target.

Of
the
money
raised
from
each
affiliate,

25

25%
goes
to
the
national
foundation
and
funding
research,
and
75%
goes
toward

educating
women
at
their
local
affiliate.

In
the
last
few
years,
the
Komen
Foundation
has
been
gathering
information

from,
and
providing
more
tailored
messaging
to
all
ethnicities.

Baker
noted
that
the

foundation
is
currently
trying
to
determine
whether
some
women
are
less
receptive

to
the
messages
that
are
currently
being
distributed
or
if
their
current
messages
are

not
properly
tailored
to
reach
more
women.

It
also
is
working
on
creating

educational
programs
for
each
ethnicity.

In
the
Komen
foundation
early
days,
it
was

considered
to
be
more
of
a
“white
women’s”
organization
because
that
was
the
main

ethnic
group
that
was
seeking
help
and
represented
at
their
events.

The
information
provided
by
Baker
indicates
that
the
foundation
is
now

focusing
on
becoming
more
inclusive
to
a
more
diverse
constituency
with
measures

such
as
becoming
very
active
on
Facebook
and
Twitter,
and
using
these
social
media

platforms
to
share
inspirational
quotes,
thoughts
and
educational
information.

Local
Komen
affiliates
post
about
their
current
goals
and
activities
and
also
about

studies
that
are
looking
for
volunteers.

Many
affiliates
have
their
own
Instagram

accounts
to
document
their
own
activities,
races
and
events.

The
future
goals
of
the
Komen
Foundation
are
to
reach
the
largest
group
of

women
with
accurate
information
about
breast
cancer
and
inform
them
about

current
risk
factors
and
research.

They
also
are
working
to
dispel
current
myths

about
breast
cancer
diagnosis.

For
example,
Baker
said
many
women
believe
that

an
injury
or
a
trauma
to
the
breast
or
that
breast-‐feeding
can
also
cause
breast

cancer,
both
of
which
are
untrue.

26

Their
greatest
challenge
in
reaching
more
women
is
language
barriers.

The

foundation
actively
recruits
volunteers
who
speak
multiple
languages
to
attend
as

many
events
as
possible
so
they
can
communicate
with
more
women
about
risk

factors.

Baker
believes
that
it
is
more
beneficial
to
target
ethnicities
separately
even

though
the
Komen
organization
embraces
and
represents
all
women.

She
believes

that
each
ethnicity
receives
messaging
differently
so
the
messages
need
to
be

tailored
specifically.

It
is
important
to
Komen
Foundation
officials
that
they
make

their
messages
as
catchy
and
informational
as
possible
because
of
the
amount
of

information
competing
for
women’s
attention
to
today.

• SIDEBAR:
Surviving
Breast
Cancer
-‐
Donna
Hartman:

Donna
Hartman
has
been
the
office
manager
and
scheduler
at
the
Orange

Coast
Memorial
Center
for
over
20
years.

While
the
author
was
interviewing

Hartman,
she
chose
to
disclose
that
in
addition
to
her
two
decades
of
professional

experience
working
at
the
breast
cancer
center
that
she
also
was
a
two-‐time
breast

cancer
survivor.

This
interview
was
obtained
via
email
in
October
of
2014.

Hartman
noted
that
in
her
personal
experience,
white
women
were
the
most

open
about
their
diagnosis.

She
believed
they
also
were
the
most
open
to
receiving

outside
support
from
family,
friends,
support
groups,
churches,
and
social
media.

Since
being
in
remission,
Hartman
said
she
herself
had
become
very
active
on
social

media,
offering
support
and
comfort
to
other
women
going
through
treatment.

She

commented
that
she
also
used
social
media
to
educate
women
on
breast
cancer

testing
and
to
offer
encouragement
to
those
who
have
been
diagnosed.

27

Hartman
also
noted
that
some
women
of
other
ethnicities,
such
as
Asian

women,
seemed
to
be
treating
a
breast
cancer
diagnosis
as
“a
very
shameful

disease.”

She
also
said
she
had
seen
first-‐hand
that
some
Hispanic
women
did
not

seek
screenings
or
treatment
because
of
lack
of
medical
insurance
or
fear
of
possible

deportation
due
to
their
immigration
status.

Hartman
believed
many
white
women

“treat
the
breast
cancer
battle
head-‐on”
because
they
were
more
aware
of

screenings,
treatment,
support
and
survivorship,
while
women
in
other
ethnic

groups
might
be
less
well-‐informed
of
what
resources
were
available.

Hartman
noted
that
how
a
woman
prioritized
her
personal
health
was

dependent
on
each
woman’s
situation.

For
some
women
like
herself,
married
with

health
insurance,
they
were
able
to
make
their
personal
health
more
of
a
priority,

whereas
for
some
other
women,
such
as
single
parents,
or
low
income
individuals

who
might
have
no
health
insurance
and
have
to
work
numerous
jobs,
personal

medical
care
“might
tend
to
fall
by
the
wayside.”

At
the
breast
cancer
center,
Hartman
reported
seeing
numerous
different

attitudes
toward
mammograms.

Some
women
avoided
screenings
because
they

were
afraid
of
the
pain
or
of
being
diagnosed,
while
others
didn’t
go
because
they

were
unaware
or
misinformed
about
breast
cancer.

She
said
many
such
women

expressed
misperceptions
that
they
could
only
develop
cancer
if
it
ran
in
their

family;
that
they
couldn’t
get
cancer
past
a
certain
age;
that
an
annual
mammogram

was
unnecessary,
or
that
the
costs
were
prohibitive.

She
noted
that
it’s
not

uncommon
for
women
to
give
in
because
of
their
doctor’s
insistence.

28

Hartman
expressed
a
belief
that
educating
women
about
mammograms
is

one
of
the
most
important
things
to
be
done,
and
reported
that
her
center
was
active

on
this
topic
through
social
media,
health
fairs,
insurance
companies,
physicians,

employers,
and
the
general
media.

The
center’s
main
objective
is
to
educate
women

about
breast
cancer
risks
and
the
importance
of
early
detection.

It
also
advises

women
that
anyone
can
get
breast
cancer
at
any
time.

Hartman
commented
that

she
used
her
personal
experience
with
breast
cancer
as
a
way
to
reach
more

women.

Even
though
both
of
her
breast
cancers
were
not
found
through
a

mammogram,
she
still
encouraged
women
to
seek
a
yearly
screening,
as
it
is
still
the

best
way
to
detect
a
diagnosis
early.

Hartman
said
that
education
is
the
most
important
in
a
breast
cancer

campaign
and
that
doctors
and
physicians
need
to
get
more
involved
with
outreach

because
women
tend
to
listen
more
to
a
medical
professional.

Although
she
thought

that
it
was
more
beneficial
for
public
education
campaigns
and
breast
cancer

advocacy
organizations
to
be
divided
by
ethnicity,
she
said
one
of
the
biggest

challenges
with
any
ethnicity
was
the
amount
of
women
in
denial
about
breast

cancer
and
who
didn’t
receive
mammograms
out
of
fear
of
the
results.

• SIDEBAR:
Surviving
Breast
Cancer
-‐
Shirley
Horn:

Shirley
Horn,
the
director
of
communication
and
marketing
for
the
Dr.
Susan

Love
Research
Foundation,
also
disclosed
during
her
interview
with
the
author
that

she
is
a
two-‐time
breast
cancer
survivor.

This
interview
was
conducted
via
email
in

October
2014.

29

While
Horn
said
she
doesn’t
see
much
of
a
difference
in
survivorship

between
different
ethnic
groups,
she
did
think
that
survivorship
varies
according
to

age
and
through
immigration
statuses,
specifically
noting
that
whether
the
woman

were
American-‐born
verse
acculturated
immigrants
could
have
an
impact
on
breast

cancer
survival.

Horn
believes
that
celebrating
survivorship,
which
occurs
more
often
with

white
women,
is
a
result
of
marketing
by
breast
cancer
advocacy
organizations,
and

that
such
groups
have
used
the
emotions
associated
with
breast
cancer
for

fundraising
and
product
sales.

However,
she
also
noted
survivorship
should
be

considered
a
badge
of
courage
for
many
women
who
want
to
show
others
that
a

breast
cancer
diagnosis
was
not
a
death
sentence.

Why
do
some
ethnicities
choose
to
not
disclose
their
breast
cancer
status?

“It
is
my
understanding
that
in
some
ethnic
groups,
such
as
Latinas,
the
women

perceive
themselves
as
the
strength
and
center
of
the
family.

As
such,
they
see

having
breast
cancer
as
a
sign
of
weakness
or
vulnerability-‐characteristics
that
they

do
not
want
to
portray.”

22

Horn
opined
that
many
women
place
their
medical
needs
after
their
families’

and
if
they
have
a
career
or
are
a
single
parent,
their
health
falls
to
third
priority.

She
said
she
had
seen
some
women
associate
guilt
with
having
breast
cancer,
as
it

required
more
time,
money
and
energy
that
would
be
taken
away
from
the
family.

The
added
stress
a
woman
experiences,
not
being
able
to
take
care
of
the
home
and

the
family
like
she
did
prior
to
breast
cancer
was
enormous
and
in
Horn’s
view,

usually
did
not
vary
according
to
a
woman’s
ethnicity.

30

Horn
said
that
Dr.
Susan
Love
Research
Foundation
recently
conducted
a

focus
group
with
Latina
breast
cancer
patients
and
learned
that
they
thought

negatively
about
mammograms
because
of
the
cost,
fear
and
modesty.

Many
women

didn’t
have
the
medical
insurance
to
cover
the
cost
of
breast
cancer
treatment,
and

they
were
unable
to
afford
the
expenses
themselves.

Fear
also
held
women
back

from
getting
a
mammogram;
they
were
afraid
of
the
pain
from
the
procedure,
and

also
fearful
of
the
results.

The
third
reason
why
Latinas
don’t
always
have

mammograms
was
their
embarrassment
over
having
to
show
their
breasts
to
so

many
doctors,
saying
they
prefer
to
keep
their
bodies
private.

Horn
said
the
Dr.
Susan
Love
Research
Foundation’s
current
campaign
is
to

find
the
cause
of
breast
cancer
and
ways
to
prevent
it.

While
a
cure
is
just
as

important,
the
Love
Foundation
investigates
the
cause
so
that
women
will
not
get

breast
cancer
in
the
future
at
all.

The
campaign’s
objectives
are
to
engage
the
public
as
much
as
possible
and

persuade
them
to
participate
in
research
to
help
find
what
causes
breast
cancer
and

what
they
could
do
to
prevent
it
from
occurring.

The
Love
Foundation
recently

started
two
programs
to
help
them
accomplish
these
goals.

The
first
is
Army
of

Women,
where
members
are
sent
emails
about
current
and
upcoming
studies
in

which
they
can
participate.

The
second
is
the
foundation’s
Health
of
Women
Study,

an
online
international
study
examining
women’s
personal
and
family
health

histories,
diet,
exercise,
environmental
exposures,
and
other
risk
factors
to
see
if

correlations
could
be
found.

31

According
to
Horn,
the
Love
Foundation
has
changed
its
outreach
campaigns

over
the
years
by
putting
more
effort
into
the
importance
of
community

engagement
and
research
participation.

Officials
believe
that
research
needs
to
be

conducted
more
on
real
women
instead
of
in
a
lab.

A
large
portion
of
outreach
is

done
through
social
media,
using
this
platform
to
make
the
public
more
aware
of

what
is
currently
being
done
in
the
breast
cancer
community,
and
providing

information
on
the
disease,
how
to
prevent
it,
and
how
women
can
personally

participate
in
finding
the
cure
and
cause
of
breast
cancer.

Horn
expressed
a
belief
that
there
was
too
much
emphasis
on
finding
the

cure
instead
of
finding
the
cause.

While
she
admitted
that
a
cure
needs
to
be
found

for
women
already
diagnosed,
there
also
needs
to
be
more
attention
on
finding
the

cause.

She
said
her
organization
informs
its
followers
about
the
diseases
that
have

already
been
eliminated
due
to
medical
research,
and
how
they
hoped
to
one
day

eliminate
breast
cancer
as
well.

Horn
noted
that
the
greatest
challenges
for
effective
outreach
vary
by

ethnicity.

For
reaching
Latinas,
she
explained
the
challenges
were
predominantly
in

the
cost
of
translating
education
materials
and
conducting
additional
campaigns
in

Spanish.

The
greatest
challenge
in
reaching
the
African
American
community
was

finding
a
way
to
be
trusted.

“The
African
American
community
has
a
very
strong

sisterhood
and
finding
access
into
it
is
very
difficult
for
medical
professionals
who

are
not
black.”

Horn
said
the
Love
Foundation
is
working
to
find
more
advocates

from
African
American
communities
to
speak
about
breast
cancer
awareness.

32

While
Horn
saw
the
benefits
of
segmenting
campaigns
by
ethnic
groups,
she

said
such
a
practice
also
creates
additional
challenges.

While
potentially
beneficial

and
necessary
because
segmented
campaigns
create
the
opportunity
of
giving

specific
breast
cancer
examples
to
each
ethnicity,
the
cost
behind
tailoring
each

campaign
to
a
specific
group
and
adding
additional
languages
was
considerable.

The
Love
Foundation,
like
many
other
breast
cancer
advocacy
groups,
is
a
nonprofit,

and
segmented
campaigns
would
require
allocation
of
very
limited
resources.

Horn
said
that
as
important
as
it
was
to
reach
each
ethnicity
individually,
it

also
was
important
to
put
as
much
funding
as
possible
toward
research,
stating:
“If

we
were
an
organization
that
was
disease-‐state
focused,
for
example,
triple

negative,
metastatic
or
young
survivors,
it
might
be
a
bit
easier
to
create
campaigns

that
are
more
general,
but
since
we
are
looking
at
all
breast
cancer,
we
have
to
be
all

inclusive
in
our
messaging.”
23

33

Section
II:
Breast
Cancer
Awareness
Outreach
to

African-‐American
Women

• Introduction:

An
African-‐American
woman
is
defined
as
“an
American
of
African
and

especially
of
black
African
descent.”

24

Even
though
white
women
are
more
likely
to

be
diagnosed
with
breast
cancer,
African
American
women
have
the
lowest
survival

rate
in
the
U.S.
compared
to
any
other
race
or
ethnic
group.

While
breast
cancer
is

the
most
commonly
diagnosed
cancer
for
African
American
women,
lung
cancer
has

higher
rates
of
mortality.

Death
from
breast
cancer,
however,
is
higher
in
African

American
women
under
the
age
of
45,
than
in
white
women
of
comparable
age.

A

major
reason
for
this,
according
to
the
Susan
G.
Komen
Foundation
Website,
is
the

likelihood
of
a
tumor
in
an
African
American
woman
being
larger
and
more

aggressive.

25

According
to
the
Susan
G.
Komen
Foundation
Website,
one
factor
leading
to

greater
mortality
among
young
African
American
women
may
be
that
fewer
get

early
breast
cancer
screenings
which
can
lead
to
a
later-‐stage
diagnoses.

“In
2004,

only
59%
of
African
American
women
over
40
years
of
age
reported
having
had
a

mammogram.”

26

Even
though
the
number
of
African
American
women
going
for

mammograms
is
lower
than
other
women
of
other
races,
death
rates
from
breast

cancer
have
decreased
since
1992
as
a
result
of
screenings,
early
detection
and

proactive
treatment.

Another
reason
that
African
Americans
are
more
likely
to
be
diagnosed
later

may
be
due
to
the
lack
of
education
and
a
higher
percentage
of
poverty
typically

34

seen
in
this
group.

According
to
the
Intercultural
Cancer
Council,
25%
of
African

Americans
live
below
the
poverty
line.

27

For
these
women,
health
insurance
and

paying
for
medical
needs
out
of
pocket
is
not
usually
a
possibility.

Also,
breast

cancer
awareness
and
education
may
not
be
as
accessible
for
women
living
with
so

few
financial
resources.

An
additional
factor
in
African
Americans
being
more
susceptible
to
dying

from
breast
cancer
and
having
a
higher
mortality
rate
is
a
higher
likelihood
of
being

overweight.

“During
the
period
1960-‐1962,
42%
of
African
American
women
were

overweight;
by
2004,
76%
of
African
American
adults
(over
the
age
of
20)
were

overweight.”

28

According
to
the
Intercultural
Cancer
Council,
being
overweight
or

obese
is
considered
a
possible
risk
factor
for
breast
cancer
as
well
as
make

treatment
for
breast
cancer
care,
including
surgery,
much
more
difficult.

As
a
result
of
these
factors,
“cancer
mortality
among
African
American

women
is
approximately
36%
higher
than
white
women.”

29

In
general,
the
time
frame
for
breast
cancer
reoccurrence
and
mortality
is

approximately
five
years.

If
a
woman
has
not
been
diagnosed
with
breast
cancer

again
after
five
years
of
being
in
remission,
her
chances
of
reoccurrence
drops

dramatically.

30

However,
African
American
women
diagnosed
with
breast
cancer

are
less
likely
to
survive
five
years
after
their
initial
diagnosis
when
compared
to

white
women.

The
survival
rate
for
African
American
women
after
five
years
is

77%,
while
white
women
are
90%.

31

Due
to
a
possible
lack
of
knowledge
regarding
breast
cancer,
there
may
be
a

misconception
among
younger
women
that
breast
cancer
is
only
hereditary
or

35

cannot
affect
them
until
an
older
age.

This
fallacy
leads
women
to
not
seek

screenings
and
take
other
preventative
measures.

Also,
“The
Impact
of
the

Detection
and
Diagnosis
of
Breast
Cancer
in
Black
and
Asian
Women,”
published
in

2012,
reported
that
because
African
American
women
are
not
as
educated
on
the

benefits
of
mammograms,
many
stop
getting
them
if
they
found
their
first
one

uncomfortable
or
painful.

32

Many
women
also
believe
that
if
breast
cancer
does

not
run
in
their
family,
then
they
are
not
at
risk.

According
to
Ethnicity
and
Inequalities
in
Health
and
Social
Care,
in
some

communities,
a
diagnosis
of
breast
cancer
may
be
seen
as
a
form
of
karma
and
that

the
woman
is
being
punished
for
bad
behavior
of
some
kind.

33

This
also
may
cause

women
to
be
ashamed
if
diagnosed
because
they
think
that
they
personally
did

something
to
cause
the
breast
cancer.

The
women
become
embarrassed
at
their

status
and
believe
people
will
think
they
did
something
immoral
to
deserve
the

disease.

The
Journal
of
Cancer
Education
notes,
“Incorporating
spirituality
and
social

support
strategies
have
been
utilized
to
increase
screening
and
treatment

adherence
and
reduce
breast
cancer
disparities
for
black
women.

Spirituality
has

been
found
to
play
an
important
role
in
mammography
utilization
and
has
been

related
to
breast
cancer
treatment
adherence
and
coping
at
various
stages
of

treatment.”

34

36

• The
Sisters
Network
Inc.:

The
Sisters
Network
Inc.
is
a
national
breast
cancer
organization
for
African

Americans.

Its
mission
is
“being
committed
to
increasing
local
and
national

attention
to
the
devastating
impact
that
breast
cancer
has
in
the
African
American

community.”

35

Started
in
1994,
this
foundation
has
over
3,000
members,
and

partners
with
over
40
other
breast
cancer
chapters
run
by
survivors.

It
is
assisted

by
health
professionals
on
an
advisory
board.

The
organization’s
focus
is
to
educate

African
American
women
on
the
breast
cancer
risks
that
affect
their
specific
race.

In
2011,
The
Sisters
Network
outreach
helped
over
3.9
million
families.

36

Its

awareness
campaign
begins
with
the
resources
that
are
on
their
website.

Aside

from
links
to
other
organizations
and
a
calendar
of
upcoming
events,
the
Sisters

Network
Inc.
webpage
also
provides
breast
cancer
facts
for
African
American

women
and
a
list
of
recommended
questions
for
women
to
ask
their
doctor
about

treatment,
surgery,
radiation
and
reconstruction.

According
to
the
organization’s
website,
The
Sisters
Network
hosted
the
first

national
Breast
Cancer
Conference
in
1999,
which
addressed
how
breast
cancer

affects
African
American
women;
the
conference
is
now
held
in
five
major
U.S.
cities.

In
2010,
the
Sisters
Network
Inc.
hosted
the
1
st

National
African
American
Breast

Cancer
5K
Walk/Run.

The
goal
with
this
now-‐annual
event
is
to
“Stop
the
Silence”

about
breast
cancer
in
the
African
American
community
and
to
“replace
the
fear
of

diagnosis
with
hope
for
a
cure.”

37

One
way
that
the
Sisters
Network
Inc.
keeps
its
resources
current
is
by

recruiting
women
to
review
their
website
and
then
take
part
in
a
survey.

These

37

women
then
advise
on
changes
that
should
be
made
and
what
they
think
is
a

positive
tool
for
reaching
other
women
in
African
American
communities.

The

foundation
also
started
a
door-‐to-‐door
program
called
“Gift
for
Life
Block
Walk,”

where
women
from
the
organization
walk
through
African
American
neighborhoods

providing
community
members
with
information
on
breast
cancer
awareness.

Also

associated
with
this
program
is
a
mobile
unit
that
offers
free
mammograms.

Taking

into
account
how
much
spirituality
is
an
important
factor
in
African
Americans’

lives,
the
Sisters
Network
Inc.
also
has
a
faith-‐based
education
program,
providing

churches
with
information
on
breast
cancer,
testing
and
resources.

• Social
Media
Use:

The
Sisters
Network
Inc.
is
currently
active
on
Facebook,
Twitter
and

YouTube.

Their
Twitter
account,
@sistersnetwork
has
1,055
followers
and
tweets

daily
about
upcoming
events
and
races
and
how
women
can
get
involved
with
the

organization.

One
of
the
biggest
issues
discussed
on
the
Twitter
page
is
the
“Stop

the
Silence”
event
with
information,
web
links
and
photos.

Aside
from
the
Sisters

Network
Inc.
headquarters
having
a
Facebook
page
with
over
8,241
“page
likes,”
the

affiliates
located
in
other
cities
also
maintain
their
own
Facebook
pages
so

individuals
can
follow
what
their
local
chapter
is
doing
to
further
promote
breast

cancer
awareness.

38

• Interview
with
Valerie
L.
Rochester:
The
Black
Women’s
Health

Imperative:

The
Black
Women’s
Health
Imperative
(BWHI)
focuses
on
“improving
all

health
issues
for
African
Americans”
with
breast
cancer
as
one
of
its
focal
areas.

According
to
its
website,
the
goals
of
this
foundation
include
increasing
access
to

medical
care,
training
the
younger
generation
about
awareness,
and
promoting

lifestyle
changes
to
decrease
breast
cancer
risks.

The
Black
Women’s
Health

Imperative
aims
to
improve
the
lives
of
black
women
physically,
emotionally,
and

financially.

In
addition
to
decreasing
the
number
of
breast
cancer
deaths
among
African

American
women
and
increasing
health
awareness
and
education,
the
organization

also
works
on
enhancing
access
to
health
insurance
and
medical
care.

Its
website

notes
that
BWHI’s
overall
goal
is
to
increase
the
current
number
of
healthy
black

women
from
9.5
million
to
12.5
by
2020
through
education
and
awareness.
Through

partnerships
and
funding,
BWHI
has
currently
invested
$20
million
in
an
attempt
to

prevent
unnecessary
deaths
through
all
the
health
disparities
that
African
American

women
face,
but
especially
cancer.

The
foundation
plans
to
invest
an
additional
$25
million
in
the
next
five
years

to
10
major
cities
in
the
U.S.

The
BWHI
wants
a
majority
of
this
money
to
go
toward

preventative
measures
in
health
care,
as
well
as
providing
more
women
with
health

insurance
and
the
understanding
of
how
to
use
their
coverage
wisely.

The

organization
believes
that
one
way
the
goals
will
be
accomplished
is
by
empowering

39

young
women
to
stay
in
school
and
receive
an
education
that
can
then
be
applied
to

helping
the
future
generations
of
African
American
women.

BWHI
Director
of
Programs
Valerie
L.
Rochester
has
over
25
years
of

experience
in
the
health
field
providing
training
and
technical
assistance.

Her
role
is

to
address
health
imbalances
impacting
African
American
women,
in
the
community

and
nationally.

Her
skills
include
strategic
planning,
staff
development,
creating

partnerships,
developing
education
programs,
and
engaging
with
communities.

In

2002,
Rochester
was
awarded
the
Congressional
Black
Caucus
Healthcare
Hero

Award.

In
January
2015,
the
author
conducted
an
interview
via
email
with
Rochester,

in
which
she
reported
that
breast
cancer
treatment
and
its
effectiveness
is
more

difficult
among
black
women
because
they
are
often
diagnosed
at
a
later
stage
of
the

disease.

She
also
said
that,
Tamoxifen,
one
of
the
leading
drug
treatments
for

malignant
breast
cancer,
is
less
effective
for
treating
African
American
women.

Other
problems
that
her
organization
has
found
are
an
overall
sense
of
mistrust
in

the
community
toward
providers
and
that
many
women
have
such
a
great
fear
of

cancer
that
they
would
prefer
to
ignore
the
possibility
of
a
diagnosis.

According
to
Rochester,
many
African
American
women
tend
to
put
their

personal
health
last.

Women
are
usually
the
primary
caregivers
in
their
families
and

communities
and
they
tend
to
set
their
cancer
diagnosis
aside
to
remain
as
the
glue

holding
their
families
together.

Rochester
said
these
women
don’t
believe
that
they

have
the
time
or
the
resources
to
become
sick
with
something
as
serious
as
breast

cancer;
there
is
pressure
to
remain
strong
and
resilient.

She
also
said
many
black

40

women
keep
their
diagnosis
a
secret
from
family
and
friends
because
they
are

embarrassed;
they
consider
breast
cancer
to
be
a
very
sexual
disease,
having
to
do

with
many
private
areas
of
the
body,
so
they
want
to
remain
very
tight-‐lipped.

Even
though
there
are
other
diseases
such
as
obesity,
diabetes
and

cardiovascular
disease
prevalent
in
black
communities,
many
of
these
conditions

may
be
more
preventable
by
leading
a
healthier
lifestyle
and
remaining
active.

Due

to
the
lack
of
available
information
or
knowledge
about
breast
cancer,
Rochester

says
many
women
are
afraid
of
mammograms.

Their
fear
develops
from
not

understanding
the
full
process
of
a
mammogram,
the
effects
of
radiation
exposure

during
the
screening
and
the
amount
of
discomfort
associated
with
the
test.

Currently,
the
Black
Women’s
Health
Initiative’s
campaign
is
promoting

overall
breast
health
for
everything
from
screenings
to
survivorship.

The

organization
stresses
how
important
early
detection
and
a
timely
diagnosis
are,
by

working
to
increase
access
to
preventative
testing,
including
standard

mammograms
and
3D
mammography,
which
is
needed
for
women
with
dense

breast
tissue.

One
of
BWHI’s
main
objectives
is
to
focus
more
research
on
why
black

women
under
40
are
being
diagnosed
with
breast
cancer
that
is
progressing
rapidly

and
aggressively.

One
of
the
most
significant
ways
that
BWHI
changed
its
communications

campaign
in
recent
years
is
the
attention
and
focus
on
educating
women
under
40

about
the
high
breast
cancer
risks
and
encouraging
them
to
find
out
about
their

family
health
history.

By
knowing
their
family
history,
these
women
can
assess

their
risks
for
developing
breast
cancer,
whether
at
a
young
age
or
later
in
life.

The

41

foundation
also
is
working
to
educate
women
on
the
importance
of
genetic
testing

by
explaining
about
BRCA
testing
for
gene
mutations.

By
using
social
media

platforms
such
as
Facebook
and
Twitter,
BWHI
is
able
to
get
their
messages
out
to
a

larger
audience
of
women.

Rochester
says,
with
BWHI’s
focus
on
the
health
of
African
American
women,

she
believes
it
is
beneficial
to
segment
breast
cancer
awareness
campaigns
by

ethnicities,
noting
that
because
black
women
are
affected
by
breast
cancer

differently
when
compared
to
other
races,
it
is
valuable
to
target
them
specifically
so

that
the
messages
and
education
tactics
can
be
fitted
to
their
community.

• Future
Goals:

In
mid-‐2015,
The
Sisters
Network
Inc.
was
planning
to
host
a
10-‐city
tour

about
breast
cancer
awareness.

The
tour
was
designed
to
bring
medical
experts
to

African
American
communities
to
educate
them
on
risks,
prevention,
testing,

treatment
and
survivorship.

The
Black
Women’s
Health
Imperative’s
future
goals
include
women’s

understanding
of
their
personal
risks
for
breast
cancer
and
having
access
to
the

latest
preventative
measures.

One
of
the
greatest
challenges
in
breast
cancer

awareness
is
getting
women
to
see
the
connection
between
their
sexual
and

reproductive
health
with
their
overall
health
and
well-‐being.

42

Section
III:
Breast
Cancer
Awareness
Outreach
to

Hispanic/Latina
Women

• Introduction:

The
term
“Hispanic”
is
defined
as
a
person
“coming
from
an
area
where

Spanish
is
spoken
and
especially
from
Latin
America;
of,
relating
to,
or
being
a

person
of
Latin
American
descent
living
in
the
United
States,
especially
of
Cuban,

Mexican,
or
Puerto
Rican
origin.”

The
term
“Latina”
is
defined
as
“a
woman
or
girl

who
is
a
native
or
inhabitant
of
Latin
America
is
of
Latin-‐American
origin
living
in

the
United
States.”

38

Hereafter,
the
author
will
use
the
terms
Latina
and
Hispanic

interchangeably.

According
to
the
Journal
of
Cancer
Education,
cancer
is
often
seen
as
an

automatic
death
sentence
in
many
Latin
countries
and
this
misconception
is
relayed

to
women
when
considering
and
pursuing
tests
and
treatment
for
breast
cancer.

A

study
published
in
2011
in
The
Journal
of
Cancer
Education
found
that
“the
word

cancer
was
often
equated
with
death
in
their
home
countries.

Among
Latinos
the

word
cancer
means
that
your
life
is
coming
to
an
end
already.”

39

Even
though
breast

cancer
rates
are
lower
for
Latina
women
when
compared
to
women
of
other

ethnicities,
cancer
is
the
leading
cause
of
death
among
the
Latina
community
in
the

U.S.
overall.

Breast
cancer
is
in
the
top
five
most
common
types
of
cancer
diagnosed

for
Latina
women,
as
well
as
the
top
five
most
common
types
of
cancer
to
cause

death.

40

According
to
The
Journal
of
Cancer
Education,
“one
in
three
Hispanic
women

will
be
diagnosed
with
cancer
during
their
lifetime.”

41

In
the
U.S.,
the
Hispanic

43

population
is
growing
faster
than
any
other
minority
group
and
is
currently
the

largest
minority
group
in
the
country.

“Based
on
research
conducted
by
MD

Anderson
Cancer
Center,
it
is
estimated
that
over
the
next
20
years,
cancer
cases
in

the
Hispanic
population
will
increase
by
142%,
compared
to
a
42%
increase

projected
for
the
total
U.S.
population.”

42

Breast
cancer
is
the
most
commonly
diagnosed
cancer
among
Latina
women,

yet
many
may
find
their
only
resource
for
information
about
breast
cancer

treatment
and
prevention
to
be
family
and
friends.

This
can
lead
to
dissemination
of

inaccurate
information
or
opinions
based
on
personal
experiences.

Not
all
women

experience
breast
cancer
the
same
way
mentally,
emotionally
or
physically,
but

many
experiences,
struggles,
and
feelings
may
be
similar
for
women
of
similar

cultural
heritage
or
ethnic
upbringing.

• Community
Outreach
Organizations:

Organizations
like
ALAS
Wings,
The
Fred
Hutchinson
Cancer
Research
Center

and
the
Intercultural
Cancer
Council
are
among
those
aiming
to
educate
Hispanic

women
about
what
breast
cancer
resources
are
available
to
them
and
how
to
obtain

the
proper
care
with
minimal
financial
resources.

These
foundations
also
focus
on

educating
women
on
the
risk
factors
due
to
their
Hispanic
heritage,
as
well
as

possible,
treatment
options
and
support
during
and
after
breast
cancer.

One
notable
organization
is
ALAS
(English
translation:
“Latina
Assistance
and

Breast
Cancer
Prevention
Association”)
Wings
located
in
Chicago,
IL.

According
to

its
website,
ALAS
is
“dedicated
to
empowering
Hispanic
women
about
breast
cancer

44

awareness
through
education
and
support
for
all
women
faced
with
breast
cancer

diagnosis.”

43

Although
the
organization’s
main
focus
is
on
the
Hispanic
community

throughout
Chicago,
its
webpage,
which
includes
numerous
breast
cancer
facts
and

resources,
is
available
to
all.

ALAS
Wings
wishes
to
enhance
the
quality
of
life
for

their
community
by
providing
them
with
awareness,
education,
and
support.

The
nonprofit
ALAS
Wings
was
started
in
2011
by
breast
cancer
survivor

Judy
Guitelman
who
is
originally
from
Argentina.

Before
starting
ALAS-‐Wings,
she

was
the
Latino
Outreach
Coordinator
from
2007
to
2010
for
the
Y-‐ME
National

Breast
Cancer
Organization.

According
to
the
organization’s
website,
one
of
the

greatest
gifts
to
the
Latina
breast
cancer
community
was
the
start
of
“ALAS
On

Wheels-‐The
Mobile
Salon.”

This
program
provides
mastectomy
bras,
prostheses

and
wigs
to
breast
cancer
patients
who
can’t
afford
them.

Guitelman
has
found
that

enhancing
a
woman’s
self
esteem
and
physical
appearance
can
have
positive
effects

on
their
prognosis.

The
organization
also
has
partnered
with
several
hospitals
and

organizations
in
Chicago
to
make
the
salon
possible.

With
her
vast
knowledge
and
experience
with
breast
cancer,
Guitelman
is
the

community
co-‐principal
investigator
of
Breast
Cancer
Disparities
in
the
Hispanic

Community
in
Chicago.

She
also
has
become
a
researcher
and
participant
in
a
study

being
conducted
by
the
Feinberg
School
of
Medicine
at
Northwestern
University.

The
purpose
of
the
study
is
to
uncover
ways
that
technology
and
related
devices
can

be
used
to
provide
information
for
breast
cancer
survivors.

ALAS
Wings
offers
support
groups
at
six
different
locations
in
Chicago.

These

groups
are
open
to
patients,
survivors,
and
their
family
and
friends
to
share
their

45

experiences,
concerns,
and
accomplishments.

The
meetings
are
given
in
Spanish

and
provide
attendants
with
support,
education,
and
advice.

This
makes
breast

cancer
awareness
personal
and
allows
women
to
ask
questions.

The
foundation
also
offers
educational
workshops
to
teach
women
about

prevention
and
awareness.

The
employees
teach
women
how
to
do
a
proper
self-‐
examination
and
assist
those
currently
going
through
breast
cancer
with

information,
guidance,
and
encouragement
on
the
treatment
process.

ALAS
Wing’s
website,
which
is
available
in
both
English
and
Spanish,
lists

numerous
links
to
other
breast
cancer
awareness
organizations
as
well
as
blogs

from
survivors
offering
support
and
sharing
their
personal
experience.

The

organization
also
provides
a
calendar
with
upcoming
events
and
workshops.

Although
is
not
as
active
on
social
media
as
some
of
the
other
organizations

assessed
by
the
author,
it
does
provide
website
visitors
with
a
link
to
the

foundation’s
Facebook
page,
and
links
to
the
most
recent
breast
cancer
discoveries

and
articles
currently
in
the
news.

• Challenges:

According
to
the
Journal
of
Cancer
Education,
a
high
number
of
Hispanic

women
do
not
speak
English
well,
so
they
may
not
know
what
breast
cancer

resources
are
available
to
them.

Also,
due
to
language
barriers,
concerns
over

immigration
status
and
lack
of
access
to
regular
health
care,
many
Hispanic
women

do
not
have
a
regular
physician
and
instead
resort
to
using
clinics
or
emergency

rooms
when
they
become
concerned.

As
the
Intercultural
Cancer
Council
notes,
“the

46

probability
of
having
a
screening
mammogram
is
greater
in
women
who
have

personal
physicians,
who
seek
health
care
at
their
physician’s
offices,
and
who
have

health
care
coverage.”

44

The
Intercultural
Cancer
Council
reports
that
testing
and
treatment
for

breast
cancer
in
Hispanic
communities
are
less
available
than
resources
available
to

white
women.

The
purpose
of
Hispanic
breast
cancer
organizations
is
to
provide

women
with
the
knowledge
of
what
is
available
for
them
and
how
to
find
additional

resources.

These
organizations
explain
how
to
perform
monthly
self-‐breast
exams,

when
they
should
be
going
for
a
mammogram
and
how
to
get
one
with
limited
or
no

health
insurance.

Breast
cancer
carries
such
a
high
mortality
rate
for
Hispanic

women
because
most
don’t
seek
testing
or
treatment
until
much
later.

Compared
to

white
women,
breast
cancer
is
more
likely
to
be
found
in
Hispanic
women
when
it
is

in
a
more
advanced
stage
because
of
a
delay
in
screenings.

When
breast
cancer
is
found
in
later
stages,
treatments
become
less

successful
and
the
chance
of
death
increases.

The
Intercultural
Cancer
Council

reports
that,
due
to
the
time
delay
of
being
tested
for
breast
cancer
and
receiving
a

later
diagnosis,
“Hispanic/Latino
women
presenting
with
breast
cancer
are
more

likely
to
have
Stage
IV
disease,
to
have
poorly
differentiated
tumors,
larger
tumors,

and
to
have
estrogen
receptor-‐negative
tumors
compared
to
non-‐Hispanic/Latino

white
women.”

45

By
getting
diagnosed
at
later
stages
breast
cancer
tumors
are

given
more
time
to
grow
to
an
untreatable
point.

The
cancer
also
has
the

opportunity
to
spread
into
a
woman’s
liver,
lungs,
bones
and
brains,
the
four
main

47

parts
of
the
body
in
which
Stage
IV
breast
cancer
develops
after
the
breast
tissue.

These
factors
all
contribute
to
a
greater
chance
of
a
woman’s
mortality.

A
lack
of
health
insurance
can
also
affect
accessibility
to,
certain
forms
of

treatment,
such
as
adjuvant
therapy,
which
is
“additional
cancer
treatment
given

after
the
primary
treatment
to
lower
the
risk
that
the
cancer
will
come
back;
this

may
include
chemotherapy,
radiation
therapy,
hormone
therapy,
targeted
therapy,

or
biological
therapy.”

46

According
to
the
Susan
G.
Komen
Website,
women
should
begin
receiving

yearly
mammograms
at
the
age
of
40
regardless
of
their
ethnicity.

The
Intercultural

Cancer
Council
found
that
in
2003,
only
two-‐thirds
of
Hispanic
women
age
40
and

older
received
a
regular
mammogram,
while
70.8%
of
white
women
got
one

annually.

47

• Disparities/Poverty:

“While
many
racial
minorities
are
seeing
improvements
in
disparities
in

access
to
care,
disparities
for
most
Hispanics
are
worsening.”

48

According
to
the

Journal
of
Cancer
Education,
poverty
is
very
common
among
the
Hispanic

population
in
the
U.S.

It
is
especially
hard
for
those
immigrating
to
the
U.S.
to
find

secure
employment,
steady
health
insurance
and
stable
housing
due
to
their
lower

levels
of
education,
language
barriers
and
immigration
status.

The
Journal
of
Cancer

Education
reports,
“compared
with
whites,
Hispanics
live
in
poverty,
lack
health

insurance,
have
fewer
years
of
formal
education,
and
have
higher
employment
rates,

all
factors
that
contribute
to
inadequate
medical
care
and
poor
cancer
outcomes.”

49

48

From
2005
to
2009,
the
median
wealth
of
Hispanics
in
the
U.S.
fell
by
66%,

while
the
household
income
of
African
Americans
dropped
by
53%
and
white

households
fell
only
a
mere
16%.

o Interpreters:

To
Hispanic
women,
family
is
a
strong
foundation.

However,
with
breast

cancer,
family
can
be
a
support
system,
but
also
a
restraint
when
a
woman
tries
to

discuss
the
topic.

Many
women
in
this
culture
experience
pudor
or
embarrassment

from
going
through
breast
cancer.

Pudor,
defined
as
a
sense
of
humility,
modesty,

or
reserve
related
to
self,
has
been
linked
with
feelings
of
discomfort
in
exposing

one’s
body
during
physical
exams.”

50

Prevention,
diagnosis,
and
treatment
for
breast
cancer
can
become
very

invasive
physically
and
emotionally.

Breast
cancer
requires
women
to
become
very

exposed
physically,
to
talk
about
numerous
private
matters,
and
ask
potentially

embarrassing
questions
of
physicians.

As
a
result,
many
women
may
refrain
from

asking
certain
questions
or
avoid
obtaining
information.

This
phenomenon
is

especially
true
with
Hispanic
women
who
rely
on
an
interpreter.

51

If
the
patient
is

using
a
family
member
to
communicate
with
the
doctor
due
to
her
own
language

barrier,
she
may
refrain
asking
questions
or
divulging
personal
information
because

saying
this
through
a
family
member
is
mortifying,
especially
if
the
interpreter
is
a

child,
a
common
occurrence
in
large
metropolitan
areas.

One
woman
in
a
focus
group
conducted
in
2011
by
the
Lombardi

Comprehensive
Cancer
Center
at
Georgetown
University
in
Washington
D.C.,

49

described
her
shame
and
embarrassment
about
using
her
daughter
as
a
translator.

She
described
situations
where
she
would
refrain
from
asking
questions
about
her

personal
sexual
functioning
because
she
didn’t
want
her
daughter
to
know
this
part

of
her.

52

The
same
is
true
if
the
female
patient
is
depending
on
a
translator
provided

by
the
medical
facility.

It
may
be
considered
humiliating
enough
to
speak
to
a

doctor
directly
about
these
issues,
but
having
to
do
so
through
a
stranger
can
cause

women
to
keep
the
information
or
questions
to
themselves.

Again,
this
can
result
in

devastating
consequences
such
as
delaying
treatment,
not
seeking
the
right
cancer

management
and
not
receiving
adequate
after
care.

According
to
“Quality
of
Life

Among
Immigrant
Latina
Breast
Cancer
Survivors,”

53

the
women,
who
understood

some
English,
but
not
enough
to
communicate
with
a
health
professional,
sensed

that
the
interpreter
was
not
expressing
their
questions
and
concerns
accurately.

This
greatly
increased
the
emotions
and
frustrations
that
the
women
were
already

feeling
and
led
to
them
delaying
follow-‐up
care
just
to
avoid
facing
the
process

again.

o Family:

In
Hispanic
culture,
women
are
taught
to
be
reliant
on
others,
especially

family
members.

This,
however,
is
a
double-‐edged
sword
for
breast
cancer
patients.

Women
may
feel
guilty
and
weak
for
having
to
be
so
reliant
on
others,
especially

while
no
longer
being
able
to
be
relied
upon
themselves.

Also,
many
women
may

not
discuss
their
diagnosis,
treatment
or
feelings
with
their
family,
so
as
to
not
pass

50

on
the
burden
of
what
they
are
going
through.

In
many
cases,
families
may
not
want

to
be
as
deeply
involved,
as
they
need
to
be
and
avoid
the
subject
and
diagnosis
of

breast
cancer.

Women
begin
to
feel
like
a
burden
to
their
family
and
friends
and

hold
back
about
their
illness,
emotions,
and
fears.

Many
men,
whether
husbands,
sons,
brothers
or
fathers,
also
may
feel

emasculated
when
their
female
loved
one
is
diagnosed
with
breast
cancer
because

they
can’t
cure
them,
make
them
feel
better
or
do
more
for
them.

Study
after
study

indicates
that
men
of
any
race/ethnicity
don’t
know
how
to
act
around
the
women

or
react
to
the
news
and
instead
try
to
remain
brave,
strong,
and
stoic.

This
is
even

more
prevalent
in
the
Hispanic
community.

According
to
“Quality
of
Life
Among

Immigrant
Latina
Breast
Cancer
Survivors,”
many
women
also
reported
that
breast

cancer
affected
their
marriage
due
to
their
loss
of
sexual
drive
and
insecurities

about
their
physical
appearance.

One
woman
in
the
study
added
that
her
husband

accused
her
of
not
loving
him
anymore
because
of
her
reduced
libido.

54

The
authors
also
found
that
numerous
women
reported
they
would
keep

upsetting
information
from
their
families
back
in
their
home
countries
to
not
add

extra
anxiety.

o Self
Reliance:

It
is
natural
for
independent
women
to
be
reluctance
to
relinquish
common

tasks
that
used
to
come
easily
to
them,
such
as
lifting
heavy
boxes
or
carrying

groceries.

The
Journal
of
Cancer
Education
reported
research
in
which
“several

women
agreed
that
their
mental
toughness
may
be
due
to
learning
how
to
be
self-‐

51

reliant
and
“fighting”
for
themselves
back
in
their
home
countries.”

55

One
woman

expressed
that
her
goal
during
recovery
from
breast
cancer
was
“to
be
completely

self-‐reliant.”

Many
women
also
agreed
that
they
pushed
themselves
to
keep

working
through
their
treatment
because
it
would
help
to
distract
them
from
the

breast
cancer.

56

o Elements
Affecting
Women
in
the
U.S.:

Some
women
also
found
that
living
in
the
U.S.
was
at
times
a
negative
to
their

diagnosis
and
treatment.

While
the
medical
care
is
generally
much
better
in
the
U.S.

than
in
their
home
countries,
the
Journal
of
Cancer
Education
reports
that
many

women
felt
the
fast-‐paced
lifestyle
of
Americans
caused
them
to
feel
rushed
when

making
medical
decisions.

Also,
women
felt
intense
pressure
to
find
and
keep
their

jobs,
to
contribute
to
their
family
finances.

If
they
are
unable
to
work
and
make
adequate
income,
they
also
lack
family

financial
support
because
they
are
no
longer
in
their
original
countries
where
most

of
their
family
still
resides.

The
geographic
distance
between
them
and
their

families
created
additional
challenges
because
they
didn’t
have
their
most
reliable

support
system
close
by.

“Separation
from
family
is
a
significant
stressor
for
many

immigrants
and,
results
indicate
that
a
breast
cancer
diagnosis,
along
with
language

barriers
and
changes
in
social
habits,
may
exacerbate
this
stressor
for
some
Latina

survivors.”

57

52

o Social
Life:

The
Journal
of
Cancer
Education
reports
that
it
is
common
for
Hispanic

women
to
seclude
themselves
during
breast
cancer
because
of
personalismo
or
“the

secrecy
and
shame
related
to
their
diagnosis
and
its
impact.”

58

One
reason
was
that

they
don’t
want
to
face
the
stares
caused
by
their
baldness
after
chemotherapy
or

not
being
able
to
wear
feminine
clothing
after
a
mastectomy.

Another
common

reason
was
they
didn’t
want
to
answer
questions
about
their
treatment
or
illness

and
didn’t
want
to
continually
explain
it
to
people.

These
social
concerns
caused

women
to
isolate
themselves
during
and
after
breast
cancer
diagnosis/treatment

and
to
believe
that
they
were
alone
because
they
could
not
talk
comfortably
about

their
condition.

Other
women
felt
isolated
not
only
because
of
their
breast
cancer,

but
also
because
of
their
immigration
status.

They
feel
that
they
had
nowhere
to

turn
for
support
or
help.

o Religion:

Religion
and
spirituality
is
a
huge
part
of
the
Hispanic
culture.

The
Journal
of

Cancer
Education
reports
that
most
women
expressed
their
deep
commitment
to

God
during
and
after
their
diagnosis
of
breast
cancer
and
remarked
that
the
disease

actually
strengthened
their
devotion.

Others,
but
not
as
many,
had
the
opposite

feelings
toward
religion
after
being
diagnosed.

Some
became
very
angry
with
God

for
allowing
this
to
happen
to
them.

They
questioned
their
religion
and
whether

their
diagnosis
was
a
punishment
from
God.

53

Faith
and
religion
are
a
source
of
comfort
for
many
women,
especially
those

in
the
Latino
community.

Many
found
that
they
recommitted
their
lives
to
God
after

going
through
breast
cancer
and
others
said
they
had
used
their
religion
and

spirituality
to
help
them
cope
with
the
sickness
and
mental/emotional
strain.

Some

women
even
allowed
their
view
of
God
to
impact
their
medical
decisions
during
and

after
breast
cancer.

According
to
“Quality
of
Life
Among
Immigrant
Latina
Breast

Cancer
Survivors,”
one
woman
noted
that
she
opted
not
to
have
reconstructive

surgery
after
her
mastectomy
because
she
viewed
it
as
unnatural
and
would
be

going
against
God
and
his
plan
for
her.

59

o Fatalism
and
Fear:

Fatalism
is
“a
doctrine
that
events
are
fixed
in
advance
so
that
human
beings

are
powerless
to
change
them;
also:

a
belief
in
or
attitude
determined
by
this

doctrine.”

60

Many
religious
people
believe
in
fatalism
and
in
God’s
plan
for
them.

This
fear
of
fatalism,
however,
may
cause
many
women
to
not
be
tested
due
to
fear

of
finding
out
the
results
of
a
mammography.

The
thinking
goes,
if
they
don’t
hear
a

doctor
tell
them
they
have
breast
cancer
then
they
can
continue
to
live
in
ignorant

bliss.

To
Latina
women,
the
word
“cancer”
may
be
synonymous
with
death
and

because
of
this
they
don’t
investigate
into
the
levels
of
severity
or
types
and
stages

of
breast
cancer.

61

Many
women
found
that
their
feelings
of
fatalism
started
to

dissipate
the
more
they
became
informed
and
educated
on
breast
cancer,
their

options
and
their
condition.

They
began
to
see
that
with
early
detection
and
the

54

right
follow
up
treatment,
breast
cancer
didn’t
necessarily
have
to
be
a
death

sentence.

However,
some
women
allowed
their
feelings
of
fatalism
and
past

experiences
with
testing
and
pain
to
hold
them
back
from
future
treatment
or

examinations.

Some
women
explained
that
if
their
breast
cancer
were
to
reoccur,

they
would
not
go
through
chemotherapy,
radiation
or
surgery
again
because
it
was

such
a
painful
process
the
first
time.

Unfortunately,
these
painful
experiences
and

challenges
caused
women
to
avoid
treatment
in
the
event
of
a
future
diagnosis.

• Social
Media
Use:

At
the
time
of
this
writing,
the
Fred
Hutchinson
Cancer
Research
Center

(FHCRC),
a
leading
cancer
and
disease
research
center
in
Seattle,
Washington,
did

not
have
an
active
Facebook
page.

It
did,
however,
offer
an
“About”
page
with
an

extensive
overview,
what
its
foundation
does,
its
future
goals
and
how
a
person

could
become
involved.

While
an
interview
with
a
representative
from
FHCRC

indicated
that
the
foundation
did
not
believe
that
Twitter
was
the
best
way
to
reach

their
community,
the
Twitter
account,
@fredhutch,
had
1,779
followers
and
posts

throughout
the
day
with
updates
of
research
findings
and
current
upcoming
events.

Its
Twitter
page
also
included
links
to
resources
and
other
web
pages
with

information
on
breast
cancer.

ALAS
Wings
did
not
have
a
Twitter
page
at
all
and

was
very
inactive
on
their
Facebook
page.

With
only
180
“page
likes,”
the
Facebook

page
consisted
of
pictures
from
past
events,
links
to
breast
cancer
articles
and

55

motivational
messages.

Its
Facebook
page
was
mainly
in
Spanish
with
some
English

translations
available.

Many
Hispanic
health
organizations
are
becoming
more
active
on
social

media
to
try
to
reach
a
larger
portion
of
the
public.

With
respect
to
breast
cancer

awareness,
this
may
be
very
important
to
help
address
some
of
the
low
levels
of

accurate
information
that
are
available.

By
using
Facebook
and
Twitter,
these

foundations
could
potentially
reach
larger
audiences
continuously
and
allow
their

followers
to
become
more
involved
with
others
as
well.

In
2009,
LIVESTRONG
piloted
a
national
outreach
campaign
targeting

Hispanics
using
increased
social
media
activities.

This
campaign
became
one
of
the

first
started
by
a
national
cancer-‐related
organization
and
used
different
marketing

techniques
other
than
the
traditional
resources
of
community
centers
and
radio.

The
campaign
showed
that
radio
was
one
of
the
most
reliable
forms
of

communication
for
reaching
the
Hispanic
community.

“This
campaign
led
to

increased
awareness
and
utilization
of
resources,
including
a
238%
increase
in

traffic
over
traditional
marketing
campaigns,
which
focused
on
radio
alone.

The

success
of
this
campaign
highlights
the
use
of
social
media
as
a
cost-‐effective

method
to
raise
awareness
of
cancer
resources
among
Hispanics.”

62

LIVESTRONG
created
a
webpage
about
resources
and
awareness
in
Spanish

and
its
print,
radio,
and
social
media
outreach
directed
Hispanics
to
this
website.

It

not
only
provided
information
on
cancer
services,
prevention,
testing,
treatment,

and
after
care,
but
it
also
provided
support
for
those
affected
by
a
family
member

going
through
cancer.

56

Researchers
looking
into
how
Hispanics
obtain
information
through
media

found
that
most
use
radio
to
find
out
about
medical
issues
because
the
channels

operated
in
Spanish;
English
language
comprehension
issues
kept
them
from

seeking
out
information
from
other
resources.

“These
cultural
and
linguistic

barriers
often
keep
Hispanics
from
seeking
health
care
or
cancer-‐related
services,

and
result
in
Hispanics
having
limited
knowledge
about
cancer-‐related
risk
factors

and
cancer
preventative
services.”
63

However,
it
was
discovered
that
not
only
was
this
media
resource
and
others

not
being
utilized
for
cancer
awareness,
but
that
the
Hispanic
community
was
not

aware
of
resources
that
did
exist.

It
had
been
theorized
that
social
media
would

not
be
a
good
format
for
reaching
Hispanics
because
of
low
numbers
of
computer

ownership
in
this
group.

However,
with
the
use
of
smartphones
continuing
to
grow,

more
Hispanics
have
begun
accessing
the
Internet
than
ever
before.

In
fact,
a
study
sponsored
by
the
Pew
Hispanic
Foundation
and
the
Robert

Wood
Johnson
Foundation
found
that
equal
numbers
of
Hispanics
gathered
their

health
information
from
doctors
as
they
did
through
social
media.

At
89%,

Hispanics
have
the
highest
percentage
of
mobile
Internet
usage,
compared
to
83%

for
African
Americans
and
84%
for
whites.

“According
to
the
National
Alliance
for

Hispanic
Health,
50%
of
Hispanics
are
on
the
Internet
with
recent
growth
quantified

as
2
million
new
Hispanic
Internet
users
a
year.”

64

The
Journal
of
Cancer
Education
reports,
“Internet
usage
among
the
Hispanic

population
is
increasing,
and
social
media
use
is
rapidly
being
adopted
by
Hispanic

users
to
communicate
and
facilitate
relationships
with
family
and
friends,
and
get

57

information.”

65

Hispanics
have
become
big
users
of
social
media
because
it

provides
a
communication
platform
that
is
not
hindered
by
language.

It
also
is

popular
because
it
provides
a
way
to
stay
in
constant
touch
with
family
and
friends

back
in
their
home
countries
without
making
international
phone
calls.

“Twenty-‐
seven
percent
of
Spanish
language
preferring
Hispanics
and
36%
of
English

language
preferring
Hispanics
visit
a
social
networking
site
at
least
two
to
three

times
per
month;
this
is
higher
than
the
18%
of
non-‐Hispanic
whites
with
Facebook

reaching
close
to
10.55
million
Hispanics
per
month.”

66

From
2006
to
2008,
Internet
use
among
Hispanics
adults
increased
from

54%
to
64%.

67

During
the
initial
campaign,
LIVESTRONG
saw
almost
5,000
visitors

to
their
Spanish
webpage.

One
way
they
directed
so
much
traffic
to
their
webpage

was
to
place
an
advertisement
for
LIVESTRONG
on
their
Facebook
page.

If
the
user

clicked
on
the
advertisement,
they
were
immediately
directed
to
the

LIVESTRONG.org/Espanol.

The
foundation
also
sent
messages
about
the
Spanish
webpage
on
its
Twitter

page
and
had
celebrity
athlete
Lance
Armstrong
post
about
it
as
well
on
his
own

personal
Twitter
account.

Using
a
celebrity
or
someone
with
a
strong
public

presence
can
be
a
great
way
to
draw
people
to
a
website.

By
joining
forces
with

someone
famous
who
has
a
large
presence
in
the
community,
people
can
be
made

aware
of
resources
through
their
social
media
activity.

By
trafficking
the
website
visits
that
came
through
Facebook
and
Twitter
and

comparing
those
results
to
the
summary
of
visits
from
the
year
before
that
only

used
print
and
radio,
the
campaign
attributed
the
increase
in
awareness
to
the
use

58

of
social
media.

The
results
of
the
LIVESTRONG
campaign
were
that
in
the
first
six

days,
the
Spanish
cancer
webpage
saw
a
total
of
1,700
visitors
through
Facebook

and
hundreds
through
Twitter.

Another
reason
using
social
media
for
cancer
awareness
and
education
is
a

great
tool
is
the
cost.

The
LIVESTRONG
campaign
reported
using
only
10%
of
its

total
budget
for
social
media,
yet
these
activities
drove
a
significant
increase
in

traffic.

While
print
and
radio
are
still
good
tools
for
reaching
many,
especially
the

elderly
who
are
not
common
users
of
social
media
and
the
Internet,
the
cost
of
using

such
traditional
channels
is
drastically
higher.

“The
evaluation
of
this
social
media

outreach
strategy
provides
preliminary
evidence
that
the
addition
of
social
media

when
compared
to
radio
and
print
alone
can
be
a
cost-‐effective
method
for
reaching

a
larger
segment
of
the
Hispanic
population,
and
driving
awareness
of
existing

cancer
resources.”

68

Figure
5:
Comparison
of
Social
Media
Campaigns
to
Print
and
Radio:

69

The
chart
above
shows
the
difference
in
people
reached
in
a
cancer
campaign.

It
compares
the
use
of

traditional
media,
only
print
and
radio
in
2008
to
the
number
of
people
reached
in
2009
when
the

use
of
social
media
was
added
in
the
outreach
campaign.

59

• Interview
with
Katherine
Briant:
Fred
Hutchinson
Cancer
Research

Center:

According
to
an
interview
the
author
conducted
in
December
2014
with

Katherine
Briant,
the
Community
Health
Education
Manager
for
the
Fred

Hutchinson
Cancer
Research
Center,
her
organization
mainly
works
with
rural

Hispanic
women.

Because
Hispanic
women
are
primarily
diagnosed
at
later
stages

of
breast
cancer,
she
said
they
require
more
severe
levels
of
surgery,
chemotherapy

and
radiation.

This
intense
treatment
impacts
their
attitude
toward
survivorship
because
it

is
so
difficult
to
hide
the
side
effects
of
hair
loss,
lymphoma,
fatigue
and
nausea.

However,
the
Fred
Hutchinson
organization
is
finding
that
there
has
been
an

increase
in
survivors
wanting
to
share
their
personal
stories
and
experience.

These
women
are
choosing
to
share
their
cancer
journey
to
raise
awareness

for
other
women
about
the
importance
of
breast
cancer
screenings,
prevention,
and

treatment.

The
Hispanic
survivors
want
other
women
to
know
that
they
survived

breast
cancer
and
that
with
the
right
diagnosis
and
treatment,
breast
cancer
doesn’t

have
to
lead
to
death.

Briant
says
her
organization
believes
this
outreach
toward

other
women
is
because
Hispanic
women
are
raised
to
be
caregivers
and
it
is
in

their
nature
to
help
others.

Briant
said
it
is
hard
for
Hispanic
women
to
make
their
health
a
top
priority

when
compared
to
their
other
responsibilities.
Hispanic
women
typically
put
their

family,
job,
and
their
contribution
to
the
family
finances
before
their
own

healthcare.

Also,
due
to
the
high
number
of
Hispanics
with
lower
paying
or
hourly

60

jobs
and
lack
of
health
insurance,
they
may
not
be
able
to
take
the
time
off
that
is

necessary
to
battle
breast
cancer.

Although
breast
cancer
is
a
leading
cause
of
death
in
Hispanic
women,
Briant

says
conditions
such
as
diabetes,
obesity
and
cardiovascular
disease
are
also

competing
for
the
women’s
attention.

Because
more
is
known
about
these
diseases,

Hispanic
community
members
are
more
likely
to
know
about
their
preventative

measures
and
treatments.

These
diseases
also
don’t
carry
the
same
death
sentence

and/or
social
stigma
associated
with
cancer.

Briant
said
that
while
more
information
about
mammograms
is
becoming

available
to
the
Hispanic
community,
there
hasn’t
been
as
much
of
an
increase
in

receiving
screenings.

Although
women
may
know
about
mammograms
and
that

they
should
be
getting
screened
annually,
their
lack
of
healthcare,
and
limited

financial
resources
to
pay
out
of
pocket
restrict
them
from
doing
so.

Briant
says
that

it
has
taken
a
lot
of
awareness
raising
and
providing
education
for
Hispanic
women

to
understand
the
importance
of
having
a
mammogram.

In
2013
the
Fred
Hutchinson
Research
Center
implemented
a
breast
cancer

promotion
project
to
educate
women,
but
also
have
women
educate
each
other.

Spokespeople
from
the
cancer
center
attended
community
events
to
provide
women

there
with
information
on
breast
cancer.

These
spokespeople
would
then
offer

women
the
opportunity
to
host
a
“home
health
party”
in
their
own
home
for
their

friends
and
family.

Women
who
were
interested
would
host
a
get
together
their
homes
and
a

promotora
or
community
health
worker
from
the
cancer
center
would
provide

61

education,
awareness,
statistics,
and
facts
for
these
women
using
a
simple
flip
chart

with
numerous
pictures
and
graphics.

Sending
a
bilingual
spokesperson
helped
to

avoid
language
barriers.

The
information
included
an
overview
of
how
breast

cancer
develops,
risk
factors,
explanations
on
screenings
and
mammograms
that
are

available,
treatment
options
in
the
event
that
breast
cancer
occurred
and
material

on
survivorship
and
quality
after-‐care.

Briant
says
the
foundation
uses
the
strategy
of
building
on
its
success.

If

something
doesn’t
work,
then
members
meet
again
with
their
community
advisory

board
to
address
the
problems,
design
solutions
to
fix
them,
and
think
of
new
ideas

on
how
to
reach
Hispanic
women
in
the
community.

At
the
time
of
this
writing,

social
media
did
not
play
a
large
role
in
their
outreach.

Briant
said
they
had
found

that
some
of
their
followers
were
on
Facebook,
but
were
not
that
active
on
Twitter.

She
said
family
finances
might
play
a
part
in
this
because
many
didn’t
have

the
financial
resources
to
buy
a
smartphone
or
computer.

Also,
older
generations

especially
those
with
language
barriers
are
not
very
active
on
social
media
because

of
a
lack
of
technology
understanding.

Briant
said
the
organization
considers
it

beneficial
to
segment
campaigns
by
ethnicity,
because
there
is
no
“one
size
fits
all”

approach
to
breast
cancer
awareness.

Briant
advises
that
for
an
organization
to
be

successful,
it
needs
to
tailor
its
messaging
to
fit
the
intended
audience.

62

• Future
Goals:

At
the
time
of
this
writing,
the
Fred
Hutchinson
Cancer
Research
Center
had

just
started
year
four
of
a
five-‐year
grant
toward
cancer
research.

In
2015,
it
is

focusing
on
cervical
cancer
and
HPV,
with
the
future
goal
of
obtaining
more
funding

to
do
more
extensive
breast
cancer
research
and
community
outreach.

If
the

funding
came
through,
then
the
outreach
process
proposal
included
a
needs

assessment
of
the
target
community
to
then
plan
an
intervention.

Another
future

goal
was
for
FHCRC
to
establish
more
partnerships
with
providers
and
clinics

willing
to
perform
free
or
low-‐cost
screenings.

The
foundation
uses
its
current

partnerships
to
reach
Hispanic
individuals
who
do
not
have
health
insurance
or
the

means
to
pay
for
a
screening.

Current
projects
include
raising
awareness
about
its

cancer
website
and
the
services
that
are
offered,
increasing
knowledge
about
risk

factors,
and
persuading
women
to
seek
breast
cancer
screenings.

63

Section
IV:
Breast
Cancer
Awareness
Outreach
to

Asian
American
Women

• Introduction:

“Asian
American”
is
defined
as
“an
American
who
was
born
in
Asia
or
whose

family
is
from
Asia.”

70

According
to
the
Intercultural
Cancer
Council
fact
sheet,
the

term
Asian
American
women
includes
Asian
Indian,
Bangladeshi,
Bhutanese,

Burmese,
Cambodian,
Chinese,
Filipino,
Hmong,
Indonesian,
Japanese,
Korean,

Laotian,
Malayan,
Mien,
Nepalese,
Pakistani,
Sri
Lankan,
Thai,
and
Vietnamese.

71

The
Journal
of
Cancer
Survivorship
reports
that,
although
the
chance
of

breast
cancer
is
lower
in
Asian
American
women
when
compared
to
white
and

African
American
women,
it
is
still
the
leading
cancer
diagnosed
in
Asian
American

women.

It
is
also
higher
in
Asian
American
women
who
have
lived
in
the
U.S.
for
a

long
period
of
time
as
opposed
to
Asians
who
have
moved
to
the
U.S.
more
recently.

The
risk
for
Asian
American
women
who
have
lived
in
the
U.S.
for
many
years
or

who
were
born
in
the
U.S.
is
approximately
60%
higher
than
in
women
who
were

born
in
Asia.

72

Even
though
the
Asian
population
in
the
U.S.
has
one
of
the
fastest
growing

first
generations,
immigrants
tend
to
dominate,
which
leads
to
different
beliefs

about
cancer,
language
difficulty
with
medical
services,
and
economic
problems.

According
to
“Breast
Cancer
Experience
and
Survivorship
Among
Asian
Americans,”

there
are
many
variables
that
can
impact
an
Asian
American’s
feelings
of

survivorship.

These
factors
include
socio-‐economic
status,
social
support,
health

beliefs,
language
barriers,
spirituality,
health
care
access,
and
level
of

64

communication
and
comfort
with
a
health
care
provider.

This
results
in
a
low
level

feeling
of
emotional
stability
and
smaller
chance
of
seeking
support
from
family,

friends
or
medical
professionals.

“Acculturation
is
used
to
define
an
immigrant’s
process
of
adaption
to
a
new

home
country
in
which
varying
elements
of
the
newcomer
and
dominant
cultures

are
retained
and
internalized.”

73

Acculturation,
then,
can
affect
a
women’s
ability
to

access
health
care,
how
they
handle
their
diagnosis
in
a
new
country,
and
finding

social
support
in
a
new
society.

• Challenges:

o “Asian
Women
Don’t
Get
Breast
Cancer”

One
of
the
biggest
medical
misconceptions
in
the
Asian
community
is
that

Asian
women
do
not
get
breast
cancer,
when,
in
reality,
more
Asian
American

women
are
diagnosed
with
breast
cancer
than
any
other
cancer.

This
is
not
just
a

misconception
by
Asian
women,
but
also
by
many
medical
professionals
who
then

pass
this
fallacy
on
to
Asian
women.

“Rates
for
invasive
breast
cancer
for
Asian

women
have
actually
increased
every
year
from
1988
to
2005
and
have
yet
to

decline.”

74

By2010,
breast
cancer
was
the
third
leading
cause
of
death
among
Asian

American
women,
surpassed
only
by
lung
cancer
and
heart
disease.

While
incidence
of
breast
cancer
in
Asia
is
very
low,
Asian
women
increase

their
odds
of
being
diagnosed
with
breast
cancer
by
80%
after
living
in
the
U.S.
for

more
than
10
years.

75

Aside
from
the
health
risk
increase
associated
with
being

Asian-‐born
compared
to
an
Asian
immigrant,
Asian
Americans
born
in
the
U.S.
are

65

likely
to
not
face
as
much
difficulty
with
socioeconomic
status,
education,
income,

health
insurance,
and
language
as
people
of
other
ethnicities.

All
of
this
affects
a

woman’s
emotional
well-‐being.

Social
support
is
essential
for
any
woman
going
through
breast
cancer.

It

helps
in
recovery
and
coping,
but
Asian
American
women
have
been
found
to
be
less

likely
to
seek
support
from
other
people
and
have
a
smaller
social
network
as
well

as
support
group
opportunities.

76

The
Journal
of
Cancer
Survivorship
reports
that

in
general,
Asian
American
women
who
are
more
acculturated
received
a
greater

amount
of
emotional
support,
while
foreign-‐born
Chinese
women,
more
than
U.S.

born
Chinese
women,
reported
that
their
financial
security
determined
their

emotional
well-‐being.

In
the
U.S.
there
appears
to
be
some
lack
of
education
and
knowledge
among

Asian
American
women
regarding
breast
cancer.

The
author
was
unable
to
find

substantial
campaigns
targeting
women
of
this
specific
group
of
ethnicities.

This

may
lead
Asian
American
women
to
have
a
lack
of
knowledge
and
understanding

about
their
breast
cancer
risks,
the
importance
of
screenings,
treatment
options

available
and
how
to
manage
survivorship.

It
has
also
been
found
that
Asian

American
women
are
less
assertive
when
meeting
with
a
medical
professional
about

breast
cancer.

77

They
tend
to
be
more
shy
and
reserved
and
rely
on
their
doctors
to

make
the
medical
decisions
instead
of
advocating
for
themselves.

Many
recently
immigrated
Asian
women
are
unaware
of
what
health

treatments
and
resources
are
available
to
them
through
the
government
due
to
their

difficulty
with
the
language.

78

The
Journal
of
Cancer
Survivorship
reports
that

66

follow
up
treatment
is
very
low
with
Asian
American
women
because
of
their
lack
of

understanding
on
how
to
navigate
the
medical
system
and
language
barriers
keep

them
from
contacting
medical
providers
with
questions.

79

o Family
Influence:

“Asian
cultural
and
gender
socialization
dictates
that
Asian
American
women

be
self-‐sacrificing
and
nurturing
of
their
husband
and
family,
serving
as
caregivers

with
obligations,
not
as
dependents.”

80

Being
the
main
caregiver
of
others
also
may

lead
Asian
American
women
to
become
very
self-‐conscious
about
a
breast
cancer

diagnosis
and
be
less
likely
to
discuss
the
issue
with
family-‐members.

Many
women

engage
in
self-‐sacrificing
behavior
including
not
discussing
their
health
issues,
so
as

to
not
upset
their
family
harmony.

For
unmarried
women,
families
may
believe
that
a
breast
cancer
diagnosis

can
deter
someone
from
choosing
to
marry
their
daughter.

According
to
“The

Impact
of
the
Detection
and
Diagnosis
of
Breast
Cancer
in
Black
and
Asian
Women,”

for
some
Asian
cultures
that
still
practice
arranged
marriages,
many
advertise

themselves
as
having
no
diseases.

In
fact,
a
cancer
diagnosis
can
deter
someone

from
marrying
their
daughters
now
that
cancer
is
in
the
family.

81

One
place
that
many
Asian
women
find
support
is
in
spirituality
and
religious

practices.

Many
use
religion,
prayer,
spiritual
rituals
and
Asian
traditions
as
a

source
of
resource
and
comfort
during
breast
cancer.

67

o Mammograms/Dense
Breasts:

Even
though
Asian
American
women
are
being
diagnosed
with
breast
cancer

at
younger
ages
when
compared
to
women
of
other
ethnicities,
they
continue
to
be

the
lowest
ethnic
group
receiving
a
mammogram.

Anatomically,
Asian
women
are

more
likely
to
have
“dense
breasts,”
which
is
more
fibrous
(connective
tissue)
or

glandular
tissue
(also
called
lobules
tissue
because
of
milk
production)
instead
of

fatty
tissue.

82

For
most
women,
age
causes
breast
density
to
decrease,
but
not
for

all
Asian
women.

Women
with
the
highest
levels
of
breast
density
have
a
lower
chance
of

having
a
successful
mammogram
when
screening
for
lumps
and
tumors.

This
is

because
dense
tissue
appears
white
on
a
mammogram,
while
a
tumor
also
looks

white,
whereas
fatty
tissue
appears
black
during
a
mammogram
so
any
white
tumor

stands
out
in
contrast.

Even
though
it
is
harder
to
see
a
tumor
on
a
woman
with

dense
breasts,
it
does
not
mean
that
it
is
impossible.

It
is
still
important
for
a

woman
to
have
a
mammogram
to
determine
her
level
of
density
and
screen
for

tumors
and
lumps.

Women
with
dense
breasts,
however,
are
more
likely
to
need
an

ultrasound
or
MRI
when
looking
for
breast
cancer,
which
is
much
more
costly
than
a

mammogram
and
not
available
through
most
clinics
or
mobile
screening
units.

83

An
MRI
or
ultrasound
is
recommended
more
when
a
woman
also
has
a
family

history
of
breast
cancer,
shows
gene
mutations
or
has
previously
had
chest

radiation.

84

This
breast
density
issue
is
what
leads
many
medical
professionals
and
Asian

women
themselves
to
mistakenly
believe
that
Asian
women
don’t
get
breast
cancer.

68

The
National
Asian
Breast
Cancer
Initiative
reports
that
mammograms
are

not
as
effective
on
Asian
women
because
there
is
the
likelihood
of
missing
up
to

60%
of
breast
cancer.

The
idea
that
mammograms
so
often
miss
breast
cancer
in

Asian
women
leads
many
to
believe
that
they
can’t
have
cancer,
instead
of
knowing

that
they
may
need
a
different
kind
of
breast
screening.

There
are
many
other

factors
in
diagnosing
breast
cancer
including
age,
family
history,
age
while
pregnant,

and
menstrual
cycle.

A
woman’s
overall
risk
of
breast
cancer
is
determined
by
how

many
factors
a
woman
possess
all
together.

85

• National
Asian
Breast
Cancer
Initiative:

The
National
Asian
Breast
Cancer
Initiative
(NABCI)
is
a
nonprofit

organization
designed
to
educate
Asian
women
on
a
national
level.

This
foundation

is
comprised
of
influencers,
connectors,
and
activists
who
want
to
address
the

unique
problems
of
breast
cancer
that
affect
Asian
American
women.

NABCI
calls
its
breast
cancer
awareness
campaign
“Asian
women
don’t
get

breast
cancer,”
to
draw
attention
to
the
misconceptions
about
the
disease.

The

organization
aims
to
make
Asian
women
aware
that,
contrary
to
belief,
Asian

women
are
very
susceptible
to
breast
cancer,
especially
if
they
have
been
living
in

the
U.S.
for
over
10
years.

According
to
the
organization’s
website,
after
assessing
what
was
needed
the

most
to
reach
the
target
audience,
NABCI
prioritized
building
a
resource
directory
in

multiple
languages
on
their
webpage,
and
printing
multi-‐language
brochures
and

fliers
about
breast
cancer
in
Asian
American
women.

69

Another
goal
was
to
enhance
communication
between
U.S.
and
Asia-‐based

doctors
so
that
information
could
be
distributed
to
the
greatest
number
of
Asian

women.

NABCI’s
website
notes
that
doctors
can
then
work
together
to
determine

the
greatest
testing
and
screening
processes
for
Asian
women.

NABCI
focused
its

campaign
to
reach
mainly
immigrants
from
Asia
to
the
U.S.

• Survivorship
Among
Asian
American
Women:

As
we’ve
learned
in
both
the
African
American
and
Hispanic
communities,
it

is
customary
in
many
Asian
cultures
for
women
to
put
their
personal
health
last.

There
is
also
the
potential
for
shame,
stigma
and
embarrassment
that
comes
with

breast
cancer
because
it
is
such
an
invasive
and
exposing
disease.

86

According
to
the
Journal
of
Cancer
Survivorship,
Asian
women
are
less
likely

than
women
of
other
ethnicities
to
participate
in
survivorship
celebrations,
and
are

more
reserved
about
the
process
and
treatment.

Many
women
decide
to
not
talk

about
breast
cancer
at
all
and
instead
ignore
what
is
actually
happening
to
them
and

their
bodies.

Once
again,
they
try
to
make
themselves
believe
that
if
they
don’t

acknowledge
the
breast
cancer,
then
it
isn’t
actually
happening
to
them.

According

to
Ethnicity
and
Inequalities
in
Health
and
Social
Care,
many
Asian
women
reported,

that
their
family
pressured
them
into
not
telling
anyone
of
their
cancer
status

because
it
revealed
the
fact
that
cancer
was
in
the
family.

This
brought
great
shame

and
guilt
to
many
women,
who
were
convinced
that
they
brought
breast
cancer
into

their
family.

87

70

Due
to
the
lack
of
communication
and
support
resources
for
members
of
the

Asian
American
community,
there
is
a
greater
likelihood
of
having
a
poorer
quality

of
life
following
breast
cancer
diagnosis
and
treatment.

Based
on
her
secondary

research,
the
author
believes
there
is
not
as
much
offered
to
this
specific
ethnicity,

and
what
is
offered
may
not
be
apparent
to
the
target
audience.

• Social
Media
Use:

Compared
to
all
other
ethnicities,
Asian
Americans
have
the
highest
rate
of

Smartphone
use;
therefore
there
is
great
potential
to
use
technology
to
reach
Asian

Americans
about
breast
cancer
management,
risk,
testing,
and
treatment.

88

NACBI
notes
on
its
website
that
“in
October
2013,
NABCI,
along
with
Asian

Breast
Cancer
Advocates,
implemented
a
national
social
media
campaign
and

fundraising
event
designed
to
bring
awareness
about
the
unique
issues
of
breast

cancer
as
it
relates
to
Asian
women.”

This
included
bringing
on
numerous
Asian

American
social
media
influencers.

Through
these
advocates,
the
NABCI
set
a
goal

of
reaching
at
least
1
million
Asian
women
using
various
social
media
channels

including
Facebook,
Twitter,
Instagram,
and
various
Asian
breast
cancer
blogs.

The

blogs
include
“Angry
Asian
Men,”
“Thick
Dumpling
Skin,”
and
“Bag
Snob.”

NABCI

also
created
a
multi-‐language
YouTube
channel
for
Asian
breast
cancer
survivors
so

they
could
educate
and
inspire
their
peers.

Although
the
NABCI
reports
its
attempts

to
be
extremely
active
on
social
media,
its
Facebook
page
at
the
time
of
this
writing

only
had
457
“page
likes”
and
it
had
not
posted
anything
new
throughout
the
year

2014.

They
also
did
not
have
a
Twitter
account.

NABCI,
however
was
a
popular

71

hashtag
for
Privy.net
(@privy1),
which
is
one
of
the
main
supporters
and
funders
of

the
NABCI
and
have
over
3,833
followers.

• Future
Goals:

According
to
its
website,
NABCI’s
future
goals
include
more
research
on
how

Asian
American
women
are
affected
by
breast
cancer.

The
foundation
is
constantly

looking
for
new
and
improved
ways
to
reach
Asian
women
to
educate
them
on
the

risks.

Another
main
goal
is
to
eliminate
the
myth
that
Asian
women
do
not
get

breast
cancer.

This
fallacy
is
preventing
many
women
from
seeking
screenings
and

treatment.

• Interview:

The
author
made
numerous
attempts
to
secure
an
interview
with
a

representative
from
an
Asian
American
breast
cancer
advocacy
organization

through
phone
calls
and
emails.

Unfortunately,
only
secondary
research
has
been

included
in
this
section.

72

Section
V:
Multiethnic
Organizations

While
the
author
researched
multiple
breast
cancer
advocacy
organizations

that
focus
on
one
targeted
ethnic
group
as
well
as
The
Susan
G.
Komen
Foundation

that
aims
to
assist
all
women
regardless
of
their
ethnicity,
the
following

organizations
focus
primarily
on
the
underserved
and
underrepresented
ethnic

population
including
Hispanics,
African
Americans
and
Asian
Americans.

• The
National
Cancer
Institute:

The
federal
National
Cancer
Institute
(NCI)
developed
the
Multicultural

Media
Outreach
(MMO)
campaign
in
2008
to
educate
ethnic
communities
on
cancer

awareness
by
using
traditional
and
social
media.

The
MMO
developed
a
cancer

education
series
entitled
Lifelines
to
discuss
the
issues
of
prevention,
treatment,

clinical
trials,
and
survivorship.

They
created
a
separate
series
for
African

Americans,
Hispanic,
Asian
American,
Alaska
Natives
and
American
Indians.

The

MMO
distributes
their
information
through
radio,
print,
television,
webpages,

Twitter
and
YouTube.

“Ethnic
media”
currently
reaches
approximately
57
million

people
in
the
U.S.
with
tailored
campaigns
for
each
ethnic
group.

89

NCI’s
Office
of
Communications
and
Education
established
the
MMO
program

as
the
central
hub
for
media
outlets
seeking
information,
education,
news,
and

resources
dedicated
to
reaching
ethnic
communities
about
cancer.

According
to
the

Journal
of
Cancer
Education,
NCI
provides
minority
researchers
to
act
as

spokespeople
on
the
radio,
give
interviews
on
television,
and
answer
numerous

questions
about
cancer.

Lifelines
was
originally
a
bimonthly
newsletter
for
the

73

African
American
and
Hispanic
communities,
but
has
now
grown
to
include
video

and
audio
segments
and
content
to
be
distributed
at
venues.

90

Lifelines
includes
new
research
findings,
cancer
statistics,
published

literature
and
lists
of
community
representatives
who
provide
the
organization
with

information/news
about
their
respective
communities’
needs.

The
videos
feature

members
of
the
same
communities
that
NCI
is
trying
to
reach
with
cancer
advocacy

messages.

The
videos
and
audio
recordings
are
distributed
through
social
media,

links
throughout
articles,
postings
on
their
webpage
and
emails
to
their
mailing
list.

MMO
hosts
numerous
workshops
each
year
to
educate
participating
organizations

about
how
to
reach
their
audience
and
how
to
distribute
cancer
awareness
material.

From
the
MMO’s
beginning
in
2008,
only
282
media
placements
had
been

secured.

By
the
end
of
2012,
the
number
of
media
placements
rose
to
3,390.

MMO

defines
a
media
placement
as
“a
measure
of
coverage
is
operationally
defined
as
a

cancer
story
or
segment-‐in
article,
video,
or
audio
format-‐which
is
posted
online,

broadcast
on
radio
and
television
or
printed
in
different
newspapers.”

91

From

2008-‐12,
a
total
of
10,684
media
placements
had
been
distributed
to
the
public.

Of

the
engagements,
59%
were
to
African
Americans,
37%
went
to
the
Hispanics
and

4%
went
to
the
remaining
ethnic
audiences
including
Asian
Americans.

By
moving
MMO
from
only
traditional
media
to
include
social
media,
NCI

demonstrated
its
dedication
to
staying
current,
relevant
and
reaching
the
largest

audience
possible
in
the
quickest
fashion.

The
organization
has
embraced
the
fact

that
a
large
number
of
people
of
varying
ethnicities
are
using
social
media
to
locate

information
and
education
on
medical
and
health
issues.

By
effectively
using
social

74

media
channels,
MMO
is
able
to
provide
up-‐to-‐date
information
on
cancer
statistics

and
facts.

Even
though
other
organizations
studied
for
this
thesis
found
that
outreach

through
social
media
wasn’t
as
prevalent
for
some
ethnic
community
cancer

advocacy
groups,
the
MMO’s
demonstrates
it
is
possible
to
use
social
media
to
an

advantage
by
drawing
in
members
of
minority
communities
and
using
them
as
a

source.

“In
a
recent
survey,
a
large
majority
of
African
Americas
(71%)
and

Hispanics
(72%)
reported
using
social
networking
sites,
and
Twitter
use
was
found

to
more
popular
among
African
American
and
Hispanics,
both
reporting
higher

usage
than
whites.”

92

Figure
6:
Media
Placements
Graph
2008-‐12

93

From
the
Multicultural
Media
Outreach
study
conducted
by
The
National
Cancer
Institute,
this
graph

demonstrates
the
percentage
of
media
placements
that
reached
the
above
target
ethnic
groups.

The

Caucasian
ethnic
group
was
not
included
in
this
graph
and
Asian
Americans
were
included
in
the

“additional
audience”
section.

75

• Interview
with
Jennifer
Metz:
The
California
Health
Collaborative:

According
to
its
website,
“The
California
Health
Collaborative
(CHC)
is
a

nonprofit
organization
committed
to
enhancing
the
quality
of
life
and
health
of
the

people
of
California,
particularly
the
underserved
and
underrepresented.”

94

The

organization’s
main
goal
is
to
help
those
who
have
limited
access
to
health

insurance
and
resources,
including
those
who
are
negatively
affected
by
language

barriers,
restricted
income,
and
education
level
or
immigration
status.

Throughout

over
25
years
of
service,
many
of
the
over
50
programs
have
been
implemented

throughout
the
state.

Founded
in
Fresno,
California
in
1982,
The
California
Health
Collaborative

currently
has
six
offices
and
is
active
in
42
of
California’s
58
counties.

In
addition
to

promoting
health
awareness
and
disease
prevention,
it
partners
with
other

foundations,
including
the
Susan
G.
Komen
organization,
to
reach
a
broader

audience.

Jennifer
Metz,
CHC
project
coordinator
and
health
educator,
participated
in

an
email
interview
with
the
author
for
this
thesis.

She
believes
that
the
level
at

which
a
woman
prioritizes
her
health
depends
on
her
economic
status,
as
well
as

having
the
time
and
finances
to
make
their
medical
needs
a
top
priority.

For
women

who
are
the
sole
providers
and
caregivers
for
their
family
or
work
numerous

minimum-‐paying
jobs,
for
example,
she
said
it
is
more
difficult
for
them
to
take
the

time
to
care
for
themselves.

They
also
can’t
afford
to
take
time
off
of
work
if
their

job
does
not
provide
them
with
sick
leave
or
health
coverage.

76

Metz
said
that
the
main
diseases
that
are
competing
for
the
attention
of

women
regardless
of
their
ethnicity
are
cardiovascular
disease,
obesity
and

diabetes.

She
also
has
seen
that
many
women
in
the
lower
income
areas
that
her

organization
serves
have
negative
attitudes
toward
mammograms.

Many
believe

that
they
are
uncomfortable
and
are
not
worth
the
amount
of
pain
that
it
causes.

Metz
also
indicated
that
many
women
have
been
misinformed
about
the

harmful
effects
of
the
radiation
exposure
from
a
mammogram,
and
consequently

believe
that
the
screening
will
do
more
harm
than
good.

Many
of
the
women,

especially
those
who
are
immigrants,
don’t
trust
the
government
and
question
the

health
care
system.

She
believes
that
if
women
were
more
educated
about
the
risks

of
not
having
a
mammogram
and
the
benefits
of
having
a
screening,
more
would
go

for
preventative
mammograms
instead
of
waiting
until
there
was
a
problem.

Her

organization
is
trying
to
educate
women
on
breast
cancer
awareness,
risks,
and

treatment.

Through
the
“Every
Woman
Counts”
program,
the
CHC
offers
free
breast
and

cervical
screenings
for
those
who
are
underinsured
or
have
no
insurance,
as
well
as

educational
workshops
in
numerous
languages
throughout
ethnic
communities.

It

currently
uses
community
organizations,
low-‐income
housing
units,
PTAs,
schools,

churches,
and
senior
citizen
centers
to
reach
women
in
over
13
languages.

For
Metz
and
CHC,
the
greatest
deterrent
in
the
campaigns
has
been
funding.

It
is
very
costly
to
reach
so
many
different
communities
in
numerous
languages
and

it
constantly
has
to
choose
between
health
campaign
priorities.

Lack
of
funding
also

prevents
the
organization
from
using
social
media
to
build
awareness.

The
CHC
has

77

also
found
that
individuals
in
the
low-‐income
areas
that
it
serves
do
not
have
the

financial
means
of
affording
a
smartphone
or
computer
to
access
social
media.

English
language
literacy
also
creates
numerous
barriers
when
reaching
out
to

people
on
social
media.

Another
restraint
is
that
because
it
is
a
nonprofit,
the

foundation
has
to
meet
specific
screening
guidelines.

Metz
said
that
CHC’s
current
and
future
campaign
goals
are
to
educate
as

many
people
as
possible
about
breast
cancer
awareness
through
health
workshops

that
include
discussion
and
question-‐and-‐answer
sessions.

It
uses
a
lot
of
its

funding
to
provide
people
with
transportation,
child-‐care,
and
help
at
home
so

women
can
go
for
cancer
screenings
and
treatments.

Metz
says
that
the
CHC
wants

to
eliminate
the
obstacles
that
keep
people
from
receiving
medical
care.

Its
greatest
challenges
are
finding
the
funding
to
tailor
its
campaigns
to
reach

multiple
ethnicities.

The
more
funding
it
has,
the
more
people
the
organization
can

reach.

While
Metz
thinks
it
is
beneficial
for
campaigns
to
be
divided
by
ethnicity,

especially
when
it
comes
to
language
barriers,
she
also
believes
that
it
is
equally
as

important
to
divide
campaigns
by
community,
geographical
location
and
economic

status.

She
considers
that
there
are
more
important
factors
in
a
successful
outreach

campaign
than
just
the
race
or
ethnicity
of
its
target
audience
members.

• Intercultural
Cancer
Council:

According
to
its
website,
the
Intercultural
Cancer
Council
(ICC)
“promotes

policies,
programs,
partnerships,
and
research
to
eliminate
the
unequal
burden
of

cancer
among
racial
and
ethnic
minorities
and
medically
underserved
populations

78

in
the
United
States
and
its
associated
territories.”

95

The
ICC
includes
members
of

all
minority
groups,
and
focuses
on
bringing
more
attention
and
research
to

minorities
and
the
medically
underserved
in
the
U.S.

It
believes
that
by
recruiting

survivors,
minorities,
and
culturally
diverse
individuals
to
share
their
personal

experiences,
it
can
build
and
promote
new
educational
programs
and
awareness.

By
doing
this,
the
ICC
aims
to
greatly
decrease
fear,
fatalism,
denial,
and

ignorance
associated
with
health
issues.

Because
minorities
comprise
the
majority

of
the
medically
underserved,
ICC
treats
cancer
research
for
minorities
as
a
higher

priority.

The
ICC
wants
to
bring
preventative
health
education
and
medical
care

including
cancer
prevention,
detection,
diagnosis,
treatment,
rehabilitation,
mental

health,
and
long-‐term
care
services
to
a
variety
of
health
care
settings
in
numerous

communities.

By
highlighting
persons
from
various
racial,
ethnic
or
culturally

diverse
groups,
ICC
seeks
to
discover
new
and
better
ways
of
reaching
the
rest
of
the

communities.

Also,
by
featuring
people
from
the
ethnic
communities
that
it
is
trying

to
reach,
it
can
learn
new
insights
as
well
as
become
even
more
sensitive
and

culturally
aware
of
minority
women’s
needs.

The
Intercultural
Cancer
Council
website
includes
a
homepage
with

upcoming
events
and
the
latest
news
on
the
work
it
is
doing.

The
website
also

contains
cancer
fact
sheets
divided
by
ethnicity,
as
well
as
fact
sheets
for
rural
and

poor
communities,
the
elderly,
children
and
pain
management.

These
fact
sheets

provide
individuals
with
cancer
statistics
based
on
ethnicity,
as
well
as
awareness

and
educational
content,
and
links
to
other
organizations
that
can
provide
more

information
and
insight.

The
ICC
also
partners
with
foundations
such
as
the

79

American
Cancer
Society,
CANCERcare,
Lance
Armstrong
Foundation,

CancerPlan.org
and
C-‐Change:
Collaborating
to
Conquer
Cancer
and
provides
access

and
links
to
these
organizations.

o Outreach/Future
Goals:

The
ICC’s
main
outreach
is
through
the
“Biennial
Symposium
on
Minorities
&

Cancer,”
a
symposium
series
that
was
originally
started
in
Houston,
TX
in
1987.

This
conference’s
debut
coincided
with
the
launch
of
National
Minority
Cancer

Awareness
Week.

When
the
Intercultural
Cancer
Council
was
started
in
1995,
the

Symposium
Series
was
moved
to
Washington
D.C.
and
was
renamed
“The
Biennial

Symposium
on
Minorities,
the
Medically
Underserved
&
Cancer”
to
sharpen
focus
on

the
issue
of
health
care
disparities
for
minorities.

This
symposium
regularly
unites

citizens
from
different
racial/ethnic
groups,
as
well
as
health
care
professionals,

academicians
and
students
to
come
up
with
new
ideas
and
solutions
for
these

issues.

ICC
also
offers
educational
workshops
for
the
community
to
learn
more

about
finding
and
using
the
cancer
resources
that
are
available
to
them.

Through

grass-‐roots
communications
means
such
as
lectures,
PowerPoint
presentations,

panel
discussions,
question
and
answer
sessions
and
networking,
the
ICC
intends
to

discover
new
methods
of
awareness
and
have
participants
introduce
community

resources,
find
available
funding,
and
advocate
for
cancer
awareness.

80

Section
VI:
Conclusion

Every
breast
cancer
advocacy
organization
researched
for
this
work

ultimately
has
the
same
goal:
to
save
the
lives
of
women.

All
of
the
foundations
are

working
to
educate
women
on
breast
cancer
diagnosis
and
treatment
to
prevent
as

many
cancer
deaths
as
possible.

Each
organization
informs
women
about
their

personal
risks,
family
history,
screenings,
treatment,
and
survivorship.

While
a

woman’s
affiliation
with
a
particular
ethnic
group
may
result
in
different
statistics

and
facts
about
breast
cancer
risks,
members
of
every
ethnicity
still
need
to
take
the

same
preventative
measures
to
ultimately
achieve
the
same
outcome.

“Since
the
introduction
of
breast
screening
in
1988,
the
incidence
of
breast

cancer
has
increased
without
a
reciprocal
increase
in
mortality.”

96

Women
of
each

ethnicity,
while
all
in
need
of
diagnostic
screenings
such
as
mammograms,
may

require
them
for
different
reasons
and
at
different
times.

For
example,
Asian

American
women
differ
in
their
mammogram
screening
needs
because
of
their

likelihood
of
dense
breasts,
while
African
Americans
need
to
be
receiving
screenings

earlier
because
of
higher
risk
for
developing
larger
tumors.

With
early
detection

and
treatment,
survival
from
breast
cancer
can
increase,
but
women
from
each

differing
ethnicity
may
need
a
different
kind
of
messaging
that
speaks
directly
to

them.

“Health
messages
often
contain
two
key
components:
a
recommendation
to

adopt
a
specific
behavior,
and
a
description
of
the
benefits
associated
with

behavioral
change.”

97

The
women
in
the
ethnic
groups
that
were
assessed
for
this

work
may
have
more
similarities
than
differences,
but
it
is
the
author’s
opinion
that

81

it
is
still
is
more
beneficial
for
the
organizations
to
be
segmented
according
to
race,

and
that
the
outreach
methods
need
to
be
different
and
tailored
for
women
of
each

ethnicity.

According
to
the
secondary
and
primary
research
conducted
for
this
thesis,
it

appears
that
one
of
the
areas
where
women
share
the
most
in
common
is
the

emotional
and
inner
struggles
that
come
with
having
breast
cancer.

All
women,

regardless
of
ethnicity,
age,
income,
immigration
status
or
education,
have
some
fear

of
breast
cancer.

The
research
indicated
that
most
are
afraid
of
having
a

mammogram
and
receiving
the
results.

For
those
who
are
diagnosed,
they
may
be

afraid
of
treatments,
side
effects,
and
breast
cancer
reoccurrence.

Women
also
may

be
concerned
about
how
breast
cancer
will
affect
their
families,
friends,
and
jobs.

They
also
may
be
afraid
of
being
different,
talking
about
their
feelings,
and
being
a

burden
to
others.

Just
the
screening
process
for
breast
cancer
alone
is
very
invasive
for
women.

It
requires
women
to
remove
their
clothing
in
front
of
strangers
and
be
touched
in
a

way
that
may
make
them
feel
very
uncomfortable
and
embarrassed,
especially
for

women
of
certain
cultures.

Women
of
all
ethnicities
also
seem
to
feel
guilt
when
going
through
breast

cancer
treatment,
whether
it
stems
from
no
longer
being
a
strong
caregiver,
not

maintaining
the
same
job
performance,
using
the
family
finances,
or
not
being
able

to
contribute
as
much
to
their
family,
breast
cancer
causes
many
women
to
lose

their
independence.

As
a
result,
they
feel
guilty
about
being
a
burden
to
their
family

and
friends
and
having
to
rely
so
much
on
others
for
daily
functioning.

82

Chemotherapy,
radiation
and
surgery
can
cause
women
to
become
weak

both
physically
and
emotionally.

Treatments
and
the
strain
of
having
breast
cancer

can
lead
to
severe
exhaustion
for
the
woman
and
her
loved
ones.

Also,
if
a
woman

has
a
mastectomy
(the
surgical
removal
of
a
breast),
she
may
feel
shame
and

embarrassment
about
her
physical
appearance.

Many
women
also
become
self-‐
conscious
after
losing
their
hair,
eyebrows
and
eyelashes
during
chemotherapy,
and

this
may
lead
to
many
losing
their
feelings
of
femininity.

Anger
is
also
a
very
common
emotion
in
breast
cancer
patients.

Understandably,
women
are
livid
that
this
is
happening
to
them
and
that
they’ve
lost

control
over
their
own
bodies
and
health.

They’re
furious
that
something
they
are

going
through
is
affecting
their
lives
and
families
so
destructively,
and
they
feel

responsible.

For
many
women,
especially
those
who
have
strong
religious
beliefs,

their
spirituality
may
play
a
major
role
in
their
diagnosis,
whether
positive
or

negative.

The
research
indicates
that
some
women
turn
to
God
in
prayer
while

others
question
whether
they
are
being
punished
in
some
way,
and
feel
angry
with

God
for
allowing
this
disease
to
happen
to
them.

It
seems
universally
that
all
women
feel
overwhelmed
upon
receiving
a

diagnosis
of
breast
cancer.

The
choices
and
decisions
that
are
needed
are

enormous,
need
to
be
made
quickly,
and
are
often
life-‐or-‐death.

Understanding
the

diagnosis
and
treatment
options
is
very
difficult
no
matter
what
the
language,

income
or
education
barriers
may
exist.

Newly
diagnosed
patients
may
wonder
if

they
are
being
misled
and
if
they’re
getting
the
best
care
available.

Factor
in
medical

insurance
coverage
and
the
financial
aspects
of
receiving
extended
care,
and
many

83

women
may
break
under
the
pressure
and
begin
to
question
whether
it
would
be

better
for
everyone
if
they
avoided
or
stopped
treatment.

Some
women
feel
extremely
isolated
because
people
may
not
know
what

they’re
going
through.

This
is
why
support
groups
are
so
important
for
women,

both
during
and
after
breast
cancer
treatment.

This
disease
also
puts
strain
on

women’s
relationships
and
personal
lives.

The
insecurities
that
women
have
about

their
bodies
during
and
after
breast
cancer
treatment
can
impact
their
intimacy
and

sex
drive,
and
their
loved
ones
also
may
feel
overwhelmed
and
fearful.

The
research
reviewed
by
the
author
for
this
thesis
suggests
that
the

majority
of
women
who
experience
breast
cancer
describe
the
same
emotions

regardless
of
their
ethnicity,
and
would
benefit
from
more
information
and
support.

Even
though
there
are
many
similarities
between
the
women
and
the

organizations
assessed
for
this
work,
the
author
maintains
it
is
still
ultimately
more

beneficial
for
breast
cancer
advocacy
organizations
to
segment
their
communication

according
to
their
target
audience’s
respective
ethnicities.

This
allows
tailoring
of

messaging
that
best
fits
targets’
lives
and
culture.

In
addition,
many
women
want
to

hear
about
experiences
from
women
in
their
peer
group,
individuals
with
whom

they
can
relate
personally
and
culturally.

Many
of
the
women
of
the
same

ethnicities
face
the
same
obstacles
and
difficulties,
and
messaging
from
women
of

other
ethnicities
may
be
considered
irrelevant
to
them
or
unwelcomed.

When
going

through
something
as
difficult
as
breast
cancer,
women
want
to
feel
like
they
are

being
treated
personally,
not
as
one
mass
group,
which
is
what
is
accomplished
with

broad-‐based
general
messaging.

84

Section
VII:
Overall
Recommendations

“Pew/Internet
survey
reports
about
113
million
Americans,
accounting
for

80%
of
American
Internet
users
have
searched
for
health
related
information

online.”
98

This
statistic
shows
that
web
use
is
growing
among
all
Americans.

While

there
is
still
value
in
outreach
through
such
traditional
channels
as
print,
radio,
and

television,
the
Internet
is
the
leading
source
of
consumer
information.

People
are

already
online,
but
they
need
targeted
messaging
to
drive
them
to
the
right
location

with
the
content
that
they
are
looking
for
and
need.

While
many
advocacy
organizations
have
the
same
goals
of
educating
women

about
breast
cancer,
the
methods
they
are
using
to
accomplish
this
differ.

For
some,

like
the
Intercultural
Cancer
Council,
it
focuses
on
hosting
grass-‐roots
seminars
to

educate
ambassadors
who
will
then
educate
their
respective
communities.

Other

organizations,
like
the
California
Health
Collaborative,
use
mainly
traditional
media

because
the
majority
of
the
people
it
is
trying
to
reach
can’t
readily
afford
the

technologies
to
use
the
Internet,
or
possess
strong
language
barriers
that
prohibit

them
from
using
the
Internet.

Grass-‐roots
approaches
also
dominate
other
foundations,
such
as
ALAS

Wings,
which
offers
workshops
in
numerous
languages
for
women
to
learn
about

breast
cancer
and
to
hear
about
others’
experiences.

The
Sisters
Network
Inc.
has
a

door-‐to-‐door
program
to
educate
the
women
in
their
community
about

preventatives
and
risks,
and
has
introduced
a
mammogram
mobile
unit
to
offer

women
free
screenings
if
they
have
limited
or
no
health
insurance.

But
how
do

women
find
out
about
the
mobile
units,
workshops
and
seminars?

While
the

85

information
is
posted
on
the
organizations
websites,
along
with
other
numerous

resources,
these
women
also
need
to
be
directed
to
these
webpages
and
be
given

regular
updates
about
breast
cancer.

Organizations
need
to
focus
on
areas
that
women
frequently
congregate.

These
are
the
locations
where
the
foundation’s
website,
resources
and
outreach

programs
should
be
advertised.

These
places
should
include
schools,
salons,

grocery
stores,
gyms
and
churches.

These
are
high
traffic
areas
for
females
and/or

their
family
members
that
should
be
targeted
with
outreach
messages
to
direct

women
to
the
proper
resources.

Conversely,
The
Susan
G.
Komen
Foundation,
the
biggest
of
the
breast

cancer
advocacy
organizations
assessed
for
this
work,
has
forcefully
tackled
the

social
media
platform
opportunity.

Komen
dominates
heavily
on
Twitter
and

Facebook,
and
its
numerous
affiliates
have
started
their
own
city-‐focused
Instagram

pages
to
document
5K
races
and
hosted
events.

Komen
uses
social
media
to

motivate
others
and,
share
personal
stories,
while
also
educating
women
on
breast

cancer
facts
and
risks
factors.

“Information
transmitted
through
social
networks

can
both
reinforce
patients’
positive
attitudes
toward
cancer
screenings
and
convey

other’s
experiences
with
barriers,
which
may
include
lack
of
knowledge,
fear,

mistrust
of
health
care
providers,
and
fatalism.”

99

More
of
the
ethnically
centric
advocacy
organizations
need
to
follow

Komen’s
examples
of
media
messaging.

While
Komen
makes
an
effort
to
reach
out

to
all
women,
those
of
a
particular
ethnicity
are
more
receptive
to
information
from

someone
of
their
own
race
and
culture.

“In
computer-‐mediated
communication

86

there
also
exists
a
body
of
evidence
which
suggests
that
information-‐seekers
are

more
likely
to
rely
on
advice
from
an
agent
whose
ethnicity
is
similar
to
their

own.”
100

Each
organization
would
benefit
by
not
only
targeting
its
ethnicity
but
also

tailoring
its
messages
specifically
to
meet
the
needs
of
those
women.

“According
to

the
similarity-‐attraction
hypothesis,
individuals
are
more
attracted
to
others
who

display
a
similar
personality
along
with
other
characteristics.”

101

While
traditional
media
is
still
needed
for
those
who
are
of
an
older
age
or

have
a
severe
English
language
barrier,
social
media
is
still
needed
to
touch
the

younger
generations.

Social
media
is
a
great
resource
for
reaching
the
younger
ages

and
having
them
absorb
the
information
and
pass
it
on
to
the
older
generations
in

their
life.

It
is
extremely
important
in
particular
to
influence
the
younger
Hispanic

and
Asian
generations,
where
the
older
generations
are
more
set
in
their
ways
and

may
have
more
of
a
language
difficulty,
thus
relying
on
their
younger
family

members,
who
can
educate
them
on
the
breast
cancer
information
that
they
have

received
via
social
media
and
the
Internet.

Social
media
is
not
only
growing
rapidly
and
can
be
changed
and
tailored

accordingly
on
a
day-‐to-‐day
basis,
but
it
is
also
very
inexpensive
to
operate
and
use.

Web
platforms
not
only
give
a
large
audience
the
opportunity
to
find
information

and
resources,
but
it
also
gives
people
the
opportunity
to
support
one
another
and

share
their
personal
experiences.

Key
for
two
of
the
studied
groups
–
Hispanic
and

Asian
American,
is
the
reduced
burden
of
having
to
understand
English
–
or
worse,

rely
on
a
translator.

87

While
representatives
of
each
of
the
organizations
interviewed
for
this
thesis

expressed
strongly
believes
that
awareness
campaigns
should
be
segmented

according
to
ethnicity,
another
strategy
that
should
be
considered
is
the
California

Health
Collaborative’s
method
of
dividing
the
campaigns
by
geographic
community.

According
to
CHC’s
model,
reaching
an
African
American
woman
living
in
the
inner

city,
for
example,
is
going
to
require
different
messaging
than
reaching
an
African

American
in
a
rural
area.

The
more
tailored
and
direct
messages
can
be,
the
better

women
can
be
educated
on
their
specific
breast
cancer
risks
and
needs.

After
all,

every
organization
is
after
the
same
goal:
saving
lives
and
preventing
unnecessary

death
due
to
lack
of
information.

88

Section
VIII:
Appendix

• Charts
and
Graphs:

Figure
1:
Susan
G.
Komen
Foundation
Breast
Cancer

Incidence
and
Mortality
Graph

The
above
graph
is
comparing
the
higher
rate
of
breast
cancer
incidence
in
white

women
to
black
women,
in
contrast
to
the
higher
mortality
rate
in
black
women
to

white
women
in
breast
cancer.

89

Figure
2:
Susan
G.
Komen
Foundation
Breast
Cancer
Incidence
Graph

The
graph
above
from
The
Komen
Foundation,
is
comparing
the
incidence

rates
to
breast
cancer
among
different
ethnicities.

This
graph
shows
that
although

one
ethnic
group
may
have
a
high
breast
cancer
diagnosis
rate,
its
mortality
rate

may
be
lower
than
other
ethnic
groups.

90

Figure
3:
Susan
G.
Komen
Mortality
Graph

This
graph,
also
from
The
Komen
Foundation
shows
that
while
African
American

women
have
the
second
highest
incidence
rate,
shown
in
the
previous
graph,
it
has

the
highest
mortality
rate.

91

Figure
4:
Komen
Foundation
Mammogram
Graph

This
chart
is
comparing
the
rate
of
receiving
of
mammogram
in
women
over
40

years
of
age
in
the
ethnic
groups
Caucasian,
African
American,
Hispanic/Latina,

Asian
American
and
American
Indian
and
Alaska
Native,
which
was
not
an
ethnic

group
studied
in
this
paper.

92

Figure
5:
Comparison
of
Social
Media
Campaigns
to
Print
and
Media

The
chart
above
shows
the
difference
in
people
reached
in
a
cancer
campaign.

It

compares
the
use
of
traditional
media,
only
print
and
radio
in
2008
to
the
number
of

people
reached
in
2009
when
the
use
of
social
media
was
added
in
the
outreach

campaign.

Figure
6:
Media
Placements
Graph
2008-‐12

From
the
Multicultural
Media
Outreach
study
conducted
by
The
National
Cancer

Institute,
this
graph
demonstrates
the
percentage
of
media
placements
that
reached

the
above
target
ethnic
groups.

The
Caucasian
ethnic
group
was
not
included
in
this

graph
and
Asian
Americans
were
included
in
the
“additional
audience”
section.

93

• Interview
Transcripts:

Name:
Gwen
Baker

Organization:
Susan
G.
Komen
LA
county
affiliate

Title
in
organization:
Director
of
Mission
Programs

1)
How
do
you
think
survivorship
is
different
between
ethnic
groups
(white,
African

American,
Asian
and
Latina)?
Why
do
you
believe
that
some
ethnic
groups
prefer
to

celebrate
the
fight
while
other
ethnic
groups
choose
to
hide
it?

• Latinas
don’t
like
to
share
cancer
news
with
their
family

• Common
in
Latina
families
for
one
to
not
know
that
a
cousin
or
aunt
had

gone
through
breast
cancer
and
that
it
is
now
considered
“in
the
family”

• Caucasians
are
more
open
about
breast
cancer
with
their
family;
breast

cancer
becomes
a
part
of
their
“public
identity”
as
a
survivor

• More
celebrated
in
Caucasian
culture
where
in
Latina
culture
it
is
much
more

private
and
carries
some
shame

• Variations
in
response
to
breast
cancer
through
different
ethnicities

• Asian
is
more
reserved
and
private;
if
you
don’t
talk
about
it,
it’s
not

happening

• In
Thai
community
there
is
discrimination
with
breast
cancer,
they
believe
it

brings
negative
energy
to
their
community

94

1A)
Why
do
you
believe
the
majority
of
women
treat
the
battle
of
breast
cancer
this

way?
No
answer

2)
How
do
women
with
breast
cancer
prioritize
their
care
verse
their
other
daily
life

commitments?
Do
you
believe
this
varies
according
to
ethnic
group?
(ex:
family,

work,
etc.)

• African
American
women
are
invested
in
more
and
have
less
time;
many
that

they
work
with
are
single
mothers
so
there
is
only
so
much
time
and
money

that
they
can
put
toward
their
health;
don’t
have
the
support
to
spend
a
lot
of

time
on
themselves

• Latina
women
who
are
moms
and
wives
put
themselves
last

• For
Latina
women,
if
their
children
are
young
enough
not
to
know
about

their
condition,
there
is
more
of
a
chance
for
them
to
not
go
through

treatment
so
that
their
kids
don’t
find
out.

• Depends
on
each
woman’s
financial
status

• How
a
woman’s
health
is
prioritized
depends
heavily
on
their
family

situation
and
so
cultures
have
more
single
moms
and
less
time,
help
and

money

2A)
What
other
diseases/health
conditions
are
competing
for
a
women’s
attention

in
per
target
ethnic
group?

• In
general
people
think
of
immediate
health
conditions
verse
long
term

illnesses
like
breast
cancer

• For
African
Americans,
breast
cancer
is
a
more
likely
way
to
die
than
lung

cancer

95

3)
What
is
the
attitude
toward
mammograms
per
ethnic
group?

• Latina
women
don’t
have
much
resistance;
they
have
more
issues
with
breast

cancer
treatment
possibly
because
there
are
more
alternatives
for
treatment

like
homeopathic
traditions
that
are
kinder
on
the
body
and
cheaper

• African
American
women
have
a
large
resistance
to
mammograms;
they

don’t
trust
or
believe
in
the
government;
mistrust
is
due
to
past
health

treatment
from
the
government

• African
Americans
are
worried
about
the
radiation
and
if
the
doctors
can’t
be

trusted;
the
system
isn’t
on
their
side

• Mammograms
don’t
work
well
for
Asian
women
and
they
more
likely
need

an
ultrasound

• Caucasians
doesn’t
have
much
resistance,
same
with
Latinas

3A)
For
the
women
where
the
attitude
is
negative,
what
do
you
consider
being
the

primary
reason
these
women
avoid
getting
them?
For
the
women
where
the

attitude
is
positive,
what
do
you
believe
was
the
best
way
of
reaching
women
to
be

positive
about
mammograms?

• Harder
to
educate
women
of
ethnicity
because
of
language
and
cultural

barriers

• Many
women
are
scared
of
the
radiation
but
the
rumors
about
mammograms

being
more
harmful
don’t
seem
to
sway
many
women
unless
they
are
already

on
the
fence
about
being
tested

96

4)
How
would
you
describe
your
current
breast
cancer
campaign
objective
and

activities?

• Been
trying
to
put
more
time
and
money
toward
reaching
Latina
and
African

American
women

• Trying
to
focus
on
disparities

• The
four
recommendations
that
they
are
trying
to
tell
women
to
be
healthy,

know
their
risk,
get
yearly
screening,
and
breast
awareness
instead
of
self

breast
exam

• Komen
National
does
all
research
and
is
focused
on
current
studies

• Local
affiliates
concentrate
more
on
the
communities
education
and
services

• 25%
of
money
raised
goes
to
national
foundation
and
research

• 75%
of
money
raised
goes
to
educating
women
at
their
local
affiliate

4A)
Have
there
been
ways
that
your
campaigns
have
changed
in
the
last
3-‐5
years?

Does
social
media
play
a
part
in
your
breast
cancer
activities
today?
How?

• Komen
attempting
to
speak
broadly
to
all
ethnicities

• Trying
to
tailor
their
messaging
toward
more
ethnicities

• Don’t
know
if
some
women
are
less
receptive
or
if
their
messages
just
aren’t

properly
tailored
to
them

• Create
educational
programs
for
each
ethnicity

• Komen
used
to
be
strongly
Caucasian
and
considered
to
be
a
“white
woman’s

organization”

• Komen
uses
Facebook
and
Twitter
heavily
to
share
inspirational
thoughts

and
educational
information;
put
up
posts
about
Komen’s
current
goals
and

97

activities;
also
posts
about
research
volunteers
for
studies;
try
to
be
as

engaging
and
informative
as
possible

• Different
affiliates
have
their
own
Instagram
for
races
and
fundraisers

5)
What
goals
do
you
have
for
breast
cancer
awareness
in
the
future?

• Reaching
women
with
accurate
information

• Informing
women
with
risk
factors
and
research

• To
eliminate
myths
for
example
some
believe
that
a
trauma
or
injury
to
the

breast
can
cause
breast
cancer
or
that
breast
feeding
causes
breast
cancer

5A)
Where
do
you
see
the
greatest
challenges
in
reaching
women
about
breast

cancer
awareness
per
ethnic
group?

• Greatest
challenge
is
language
barrier,
they
have
the
responsibility
to
reach

all
women
through
their
organizations

• Try
to
bring
in
volunteers
who
speak
multiple
languages
for
events
so
they

can
assist
in
speaking
with
more
people

6)
Do
you
think
it
is
beneficial
to
divide
campaigns
by
ethnicities
or
is
it
better
to

make
one
campaign
for
the
general
woman?

• Targeting
each
ethnicity
separately
is
better

• Ethnicities
receive
messages
differently
so
messages
need
to
be
tailored

• There
is
so
much
people
need
to
pay
attention
to
so
it
is
more
important
to

make
their
messages
as
strategic
and
catching
as
possible

98

Name:

Donna
Hartman

Organization:

Orange
Coast
Memorial
Breast
Center

Title
in
organization:
Scheduler

Experience/qualifications:

Over
20
years
experience
as
an
Executive

Assistant/Office
Manager

1)
How
do
you
think
survivorship
is
different
between
ethnic
groups
(white,

African
American,
Asian
and
Latina)?
Why
do
you
believe
that
some
ethnic

groups
prefer
to
celebrate
the
fight
while
other
ethnic
groups
choose
to
hide

it?

Because
I
am
white,
I
mostly
know
about
that
ethnic
group.

In
my
experience,

white
women
with
breast
cancer
are
very
open
about
their
diagnosis
and
seek

support
in
many
ways;
family,
social
media,
support
groups,
church,
etc.

I
believe
for
some
ethnic
groups,
cancer
is
a
shameful
thing,
namely
the
Vietnamese.

I
have
witnessed
this
first
hand.

I
think
Hispanic
women
either
lack
insurance

and/or
are
afraid
that
if
they
seek
treatment,
they
will
be
deported.

1A)
Why
do
you
believe
the
majority
of
women
treat
the
battle
of
breast

cancer
this
way?

I
believe
the
majority
of
white
women
treat
the
battle
head
on
because
they
are

aware
of
the
support
that
is
out
there
and
they
see
that
many
women
are
surviving.

99

2)
How
do
women
with
breast
cancer
prioritize
their
care
verse
their
other

daily
life
commitments?
Do
you
believe
this
varies
according
to
ethnic
group?

(ex:
family,
work,
etc.)

I
believe
this
depends
on
their
marital
status,
insurance,
qualifying
for
disability,

financial
status,
etc.

I
am
married
and
have
great
insurance
and
was
able
to
go
on

disability
for
an
entire
year
which
was
very
helpful.

2A)
What
other
diseases/health
conditions
are
competing
for
a
women’s

attention
in
per
target
ethnic
group?

I
think
cancer
in
general
and
possibly
Alzheimer's

3)
What
is
the
attitude
toward
mammograms
per
ethnic
group?

I
work
in
a
breast
center
so
in
my
ethnic
group
I
see
varying
attitudes.

Some
women

only
come
because
their
doctor's
make
them,
some
are
uneducated
in
breast
cancer

awareness
and
think
that
they
can
only
get
it
if
it
runs
in
the
family
or
that
they
do

not
need
one
every
year
or
that
they
no
longer
need
them
after
a
certain
age.

Some

are
afraid
of
the
pain
it
causes
and
don't
come
at
all
and
some
don't
come
for
follow-‐
up
appointment
because
their
insurance
does
not
pay
100%.

3A)
For
the
women
where
the
attitude
is
negative,
what
do
you
consider
being

the
primary
reason
these
women
avoid
getting
them?

For
the
women
where

the
attitude
is
positive,
what
do
you
believe
was
the
best
way
of
reaching

women
to
be
positive
about
mammograms?

Fear
that
cancer
will
be
found.

Educating
women
through
the
media,
social
media,

health
fairs,
insurance
companies,
employers,
physicians.

100

4)
How
would
you
describe
your
current
breast
cancer
campaign
objective

and
activities?

My
main
objective
is
to
educate
women
and
to
let
them
know
that
anybody
can
get

breast
cancer
at
any
time
and
to
create
awareness
about
early
detection.

4A)
Have
there
been
ways
that
your
campaigns
have
changed
in
the
last
3-‐5

years?
Does
social
media
play
a
part
in
your
breast
cancer
activities
today?
How?

Since
my
second
breast
cancer
diagnosis
three
years
ago,
I
have
the
experience
of

getting
cancer
again
even
though
I
had
annual
mammograms
since
my
first

diagnosis
in
1996.

I
encourage
them
to
have
further
testing
if
there
is
a
problem.

Neither
of
my
cancers
were
found
with
a
mammogram,
but
I
let

them
know
that

mammograms
are
still
the
best
way
for
most
women
to
find
cancer.

Absolutely,
I
use
social
media
to
educate
my
friends
but
also
to
comfort
and

encourage
those
who
are
going
through
treatment.

5)
What
goals
do
you
have
for
breast
cancer
awareness
in
the
future?

My
hope
is
that
doctors
will
be
more
instrumental
in
educating
women
about
breast

cancer.

People
typically
trust
what
their
doctors
have
to
say.

5A)
Where
do
you
see
the
greatest
challenges
in
reaching
women
about
breast

cancer
awareness
per
ethnic
group?

A
lot
of
women
would
rather
not
know
about
it
due
to
fear
and
possibly
denial.

6)
Do
you
think
it
is
beneficial
to
divide
campaigns
by
ethnicities
or
is
it
better

to
make
one
campaign
for
the
general
woman?

I
believe
it
may
be
better
to
divide
campaigns
due
to
the
varying
cultural
differences

in
each
group.

101

Name:
Shirley
Horn

Organization:
Dr.
Susan
Love
Research
Foundation

Title
in
organization:
Director,
Communications
&
Marketing

Experience/qualifications:
40
years
in
communications/marketing
for
consumer

products,
business-‐to-‐business,
agriculture,
and
nonprofit.
I
am
also
a
two-‐time

breast
cancer
survivor.

1)
How
do
you
think
survivorship
is
different
between
ethnic
groups
(white,

African
American,
Asian
and
Latina)?

I
do
not
perceive
that
survivorship
is
all
that
different
ethnically,
though
I
do
believe

there
are
differences
based
on
age,
and
within
ethnic
groups,
based
on
immigration

status
(e.g.,
American-‐born
vs.
acculturated
immigrants)

Why
do
you
believe
that
some
ethnic
groups
prefer
to
celebrate
the
fight
while

other
ethnic
groups
choose
to
hide
it?

It
is
my
understanding
that
in
some
ethnic
groups,
such
as
Latinas,
the
women

perceive
themselves
as
the
strength
and
center
of
the
family.
As
such,
they
see

having
breast
cancer
as
a
sign
of
weakness
or
vulnerability—characteristics
that

they
do
not
want
to
portray.

1A)
Why
do
you
believe
the
majority
of
women
treat
the
battle
of
breast

cancer
this
way?

I
believe
that
the
celebration
of
survivorship
(which
is
predominant
amongst

whites)
arose
as
a
result
of
marketing
campaigns
to
raise
funds
and
has
morphed

into
a
cult-‐like
movement.
Many
women
wear
their
breast
cancer
survivorship
like
a

badge
of
courage…having
breast
cancer
is
a
life-‐defining
event
and
it
is
easy
to
have

it
become
an
ingrained
part
of
one’s
identity.
The
hype
and
celebration
of

survivorship
for
marketing/fundraising
and
product
sales
purposes
has
played
on

those
emotions.

2)
How
do
women
with
breast
cancer
prioritize
their
care
verse
their
other

daily
life
commitments?
Do
you
believe
this
varies
according
to
ethnic
group?

(ex:
family,
work,
etc.)

For
most
women,
especially
those
with
families,
their
own
care
always
comes

second
to
the
care
of
their
family
members,
and
if
they
also
have
a
career/are

breadwinners,
their
own
care
usually
takes
third
place
after
earning
money.

Reprioritizing
is
one
of
the
most
difficult
transitions
a
woman
with
breast
cancer

has
to
make
and
for
many,
the
guilt
associated
with
being
sick
and
not
being
able
to

take
care
of
family,
job,
house,
etc.,
adds
more
stress
and
anxiety
to
an
already-‐
stressful
situation.
I
do
not
believe
these
emotions
and
reactions
differ
between

102

ethnic
groups,
but
I
do
believe
that
the
overall
responsibilities
for
family
care,

earning
money,
and
household
care
are
much
greater
for
the
woman
(and
less

evenly
balanced
between
a
woman
and
her
partner—if
she
has
one)
for
Latinas
and

African
American
women.

2A)
What
other
diseases/health
conditions
are
competing
for
a
women’s

attention
in
per
target
ethnic
group?

I
don’t
know
how
to
answer
this.

3)
What
is
the
attitude
toward
mammograms
per
ethnic
group?

I
have
no
data
on
this.

3A)
For
the
women
where
the
attitude
is
negative,
what
do
you
consider
being

the
primary
reason
these
women
avoid
getting
them?

For
the
women
where
the
attitude
is
positive,
what
do
you
believe
was
the
best
way

of
reaching
women
to
be
positive
about
mammograms?
We
recently
conducted

focus
groups
with
Latinas.
The
negatives
associated
with
mammograms
were
1)

cost,
2)
fear
of
being
diagnosed
with
breast
cancer,
and
3)
modesty.

4)
How
would
you
describe
your
current
breast
cancer
campaign
objective

and
activities?

Our
foundation’s
mission
is
to
find
the
CAUSE
of
breast
cancer
and
ways
to
prevent

it.
Our
campaign
objectives
are
to
engage
the
public
to
participate
in
breast
cancer

research
so
we
can
learn
more,
faster,
about
what
is
causing
breast
cancer
and
how

to
stop
it.
Two
key
programs
are
our
Army
of
Women®,
where
women
can

volunteer
to
receive
emails
about
new
breast
cancer
studies
looking
for
participants

that
they
might
participate
in,
and
the
Health
of
Women
Study™,
an
international

online
breast
cancer
study
looking
at
family
and
personal
health
history,
diet
and

exercise,
environmental
exposures,
and
other
issues
that
are
associated
with
breast

cancer
risk.

4A)
Have
there
been
ways
that
your
campaigns
have
changed
in
the
last
3-‐5

years?

We
have
put
much
more
emphasis
on
public
engagement
and
participation
in

research
over
the
past
five
years.
We
need
to
move
research
out
of
the
lab
(and
off

of
mice)
to
the
clinic
where
real
women
are
being
studied.

Does
social
media
play
a
part
in
your
breast
cancer
activities
today?
How?
Social

media
plays
a
very
large
role
in
our
outreach.
Part
of
our
mission
in
engaging
the

public
is
to
translate
science
into
digestible
information
so
women
can
be
better

informed
about
the
disease,
ways
to
prevent
it,
and
how
they
can
participate
in

finding
the
cause
and
ending
breast
cancer.

5)
What
goals
do
you
have
for
breast
cancer
awareness
in
the
future?

There
is
too
much
emphasis
on
the
CURE…which
means
that
someone
already
has

breast
cancer.
Yes,
we
need
good/better
treatments
for
people
with
breast
cancer,

but
more
research
needs
to
be
done
to
find
the
cause
so
we
can
end
it. From
an

103

awareness
standpoint,
our
foundation
is
focused
on
making
people
aware
that
other

diseases
have
been
eliminated
when
research
was
done
to
find
the
cause
and

prevention
(e.g.,
Hep
B,
HPV/cervical
cancer,
etc.)
We
can
do
this
with
breast
cancer,

too.

5A)
Where
do
you
see
the
greatest
challenges
in
reaching
women
about
breast

cancer
awareness
per
ethnic
group?

For
Latinas,
it
is
cost
constraints
to
translate
our
communications
and
research
into

Spanish.
For
African
Americans,
it
is
finding
the
social
‘entry
points’
to
their

sisterhoods,
finding
individuals
who
are
willing
to
be
the
advocates
and
voices
to

their
sisters.

6)
Do
you
think
it
is
beneficial
to
divide
campaigns
by
ethnicities
or
is
it
better

to
make
one
campaign
for
the
general
woman?

It
is
much
more
beneficial
to
divide
campaigns
and
messages
by
ethnicities,
when

we
can
use
specific
examples
that
relate
to
that
ethnicity.
The
challenge
is
the
cost
to

do
targeted
campaigns
and
we,
like
many
nonprofits,
are
resource-‐constrained.
Our

focus
and
precious
dollars
need
to
be
on
research
into
the
cause,
so
it
is
challenging

to
create
broad-‐based
messages
that
resonate
with
ethnic
groups.
If
we
were
an

organization
that
was
disease-‐state
focused
(e.g.,
Triple
Negative,
Metastatic,
or

even
Young
Survivors),
it
may
be
a
bit
easier
to
create
campaigns
that
are
more

general,
but
since
we
are
looking
at
ALL
breast
cancer,
we
have
to
be
all-‐inclusive
in

our
messaging.

Name:
Valerie
L.
Rochester

Organization:
Black
Women’s
Health
Imperative

Title
in
organization:
Director
of
Programs

Experience/qualifications:
Bio
attached

Work
that
you
personally
have
done
and
are
doing
for
your
organization:

1)
What
is
survivorship
like
for
the
primary
ethnic
group
you
serve?
Is

survivorship
celebrated
or
hidden?
Do
the
women
in
the
target
ethnic
group

you
serve
prefer
to
celebrate
or
hide
the
cancer
fight?

The
breast
cancer
fight
in
the
African
American
community
has
many
challenges.

Often
times,
Black
women
are
diagnosed
at
later
stages
of
the
disease,
which
can

make
treatment
difficult
and
limit
the
effectiveness
of
treatment
options.

Other

times,
the
treatment
options,
such
as
Tomoxifan
are
not
shown
to
be
effective
in
the

104

treatment
of
breast
cancer
in
Black
women.

And
in
some
cases,
there
still
resides
an

overall
mistrust
of
the
provider
community
and
fear
of
cancer,
so
ignoring
the

severity
of
the
diagnosis
is
the
preferred
approach.

1A)
Why
do
you
believe
the
majority
of
women
treat
the
battle
of
breast

cancer
this
way?

Due
to
the
role
of
primary
caregiver
within
their
families
and
communities,
we

found
many
Black
women
who
are
breast
cancer
survivors
tended
to
downplay
the

fact
that
they
had
cancer,
in
order
to
continue
in
the
“backbone
of
the
family”
role.

Also,
the
tradition
of
putting
others
needs
before
their
own
is
prevalent.

In
addition,
many
Black
women
do
not
want
other
family
members
or
friends
to

know
about
having
breast
cancer
because
of
the
sexualization
of
the
breasts
and
it

can
be
an
embarrassment.

2)
How
would
a
typical
woman
with
breast
cancer
in
the
primary
ethnic
group

you
serve
prioritize
their
care
verse
their
other
daily
life
commitments?
(ex:

family,
work,
etc.)

As
mentioned
in
the
previous
paragraph,
as
the
primary
head
of
household
in
many

cases,
there
is
added
pressure
of
being
strong
and
the
sole
breadwinner
so
there
isn’t

time
to
be
sick
or
have
something
as
serious
as
cancer
happen.

Their
own
health
needs

receive
last
priority
compared
to
everyone
else.

2A)
What
other
diseases/health
conditions
are
competing
for
a
women’s

attention
in
your
target
ethnic
group?

Often
they
are
preventable,
obesity-‐related
health
conditions
such
as
diabetes,
or

cardiovascular
disease.

3)
What
is
the
attitude
toward
mammograms
in
the
primary
ethnic
group
you

serve?

Not
a
very
favorable
attitude;
due
to
lack
of
awareness,
there
is
fear
of
the
level
of

radiation
that
comes
from
mammography;
as
well
as
the
level
of
discomfort.

Additionally,
some
women
feel
they
would
just
rather
not
know.

105

3A)
If
the
attitude
is
negative,
what
do
you
consider
to
be
the
primary
reason

these
women
avoid
getting
them?
If
it
is
positive,
what
do
you
believe
was
the

best
way
to
have
your
target
ethnic
group
be
positive
about
mammograms?

Again,
fear
of
knowing
her
results,
discomfort
and
exposure
to
radiation
are
some
of
the

key
reasons
cited
for
avoidance

4)
How
would
you
describe
your
current
breast
cancer
campaign
objective

and
activities?

Our
current
breast
cancer
efforts
focus
on
these
main
issues:

• Promoting
overall
breast
health

• Increased
access
to
latest
screening
technologies
(i.e.,
3-‐D
mammography

which
is
more
effective
in
finding
tumors
in
dense
breast
tissue,
which
Black

women
and
younger
women
tend
to
have)

• Importance
of
early
detection
and
timely
diagnosis

• Increased
focus
on
research
on
why
younger
Black
women,
under
age
40,
are

being
diagnosed
more
often
with
a
more
aggressive
form
of
breast
cancer

4A)
Have
there
been
ways
that
your
campaigns
have
changed
in
the
last
3-‐5

years?
Does
social
media
play
a
part
in
your
breast
cancer
activities
today?

How?

We
have
changed
our
campaigns
to
have
our
messages
focus
more
on
Black
women

under
age
40
and
encouraging
them
to
know
their
family
history,
and
their
personal

risk
for
developing
breast
cancer;
the
role
of
genetic
testing
–
BRCA
testing
–
to

determine
level
of
personal
risk.

We
use
social
media
platforms
to
push
out
our

messages
including
Twitter
and
Facebook

5)
What
goals
do
you
have
for
breast
cancer
awareness
in
the
future?

That
more
Black
women
will
know
and
understand
their
personal
risk
for

developing
breast
cancer;
and
be
familiar
with
and
have
access
to
the
latest

screening
technologies

106

5A)
Where
do
you
see
the
greatest
challenges
in
reaching
women
about
breast

cancer
awareness
in
your
target
ethnic
group?

Getting
them
to
make
the
connection
between
their
sexual
and
reproductive
health

(which
include
breast
health)
and
their
overall
health
and
wellness

6)
Do
you
think
it
is
beneficial
to
divide
campaigns
by
ethnicities
or
is
it
better

to
make
one
campaign
for
women?

When
it
comes
to
sensitive
health
issues
such
as
breast
cancer,
the
messages
and

campaigns
need
to
be
focused
on
specific
concerns,
issues
and
needs
of
the

populations
most
impacted
in
order
for
them
to
be
effective,
so
yes,
I
feel
it
is

beneficial

Name:

Katherine
Briant

Organization:

Fred
Hutchinson
Cancer
Research
Center

Title
in
organization:

Community
Health
Education
Manager

Experience/qualifications:

Master’s
of
Public
Health
(MPHS)
and
Certified
Health

Education
Specialist
(CHES).

1) What
is
survivorship
like
for
the
primary
ethnic
group
you
serve?

In
our
projects,
we
work
primarily
with
rural
Hispanic
women.

If
you
are
asking

about
breast
cancer
survivorship,
in
general,
Hispanic
women
tend
to
be
diagnosed

at
a
later
stage,
which
can
result
in
higher
morbidity
and
mortality.

Is
it
celebrated

or
hidden?
Cancer
is
not
celebrated.

If
people
have
had
surgery,
or
are
going

through
radiation
or
chemotherapy,
it
is
also
difficult
to
hide
the
diagnosis
due
to

the
side
effects
(fatigue,
hair
loss,
lymphedema,
etc.)

Do
the
women
in
the
target

ethnic
group
you
serve
prefer
to
celebrate
or
hide
the
cancer
fight?

In
the

communities
we
work
with,
we
have
heard
people
say
that
cancer
is
a
death

107

sentence.

That
being
said,
we
are
meeting
survivors
who
want
to
share
their
cancer

journey
story
with
others
to
raise
awareness
about
screening,
and
to
let
people

know
it’s
not
a
death
sentence...and
that
others
have
gone
through
the
cancer

experience.

1A)
Why
do
you
believe
the
majority
of
women
treat
the
battle
of
breast

cancer
this
way?

I
think
that
because
Hispanic
women
are
usually
the
caregivers
in
their
families,
it’s

in
their
nature
to
want
to
share
information
about
the
experience.

2)How
would
a
typical
woman
with
breast
cancer
in
the
primary
ethnic
group

you
serve
prioritize
their
care
verse
their
other
daily
life
commitments?
(ex:

family,
work,
etc.)

Typically,
Hispanic
women
put
their
family,
work,
etc.
before
their
own
healthcare.

2A)
What
other
diseases/health
conditions
are
competing
for
a
women’s

attention
in
your
target
ethnic
group?

Other
diseases
competing
for
attention
in

the
communities
we
work
in
are
diabetes,
obesity,
and
cardiovascular
disease.

3)
What
is
the
attitude
toward
mammograms
in
the
primary
ethnic
group
you

serve?

Women
know
about
them
and
the
fact
that
they
should
be
getting
them,

however,
they
don’t
always
have
healthcare
or
the
financial
resources
to
pay
for

them
out
of
pocket.

108

3A)
If
the
attitude
is
negative,
what
do
you
consider
to
be
the
primary
reason

these
women
avoid
getting
them?
If
it
is
positive,
what
do
you
believe
was
the

best
way
to
have
your
target
ethnic
group
be
positive
about
mammograms?

I
think
it
has
taken
a
lot
of
awareness
raising
and
education
for
women
to
have
an

understanding
about
why
mammograms
are
important.

4)
How
would
you
describe
your
current
breast
cancer
campaign
objective

and
activities?

Last
year
we
implemented
a
project
around
breast
cancer.

We
provided

information
at
community
events.

At
those
events,
we
recruited
women
who

wanted
more
information,
to
participate
in
a
home
health
party.

If
a
woman
agreed,

she
would
host
friends/family
at
her
home
and
a
promotora
would
go
to
the

woman’s
house
to
provide
small
group
education
about
breast
cancer
using
a

flipchart.

Information
included
overview
of
how
cancer
develops,
statistics
about

breast
cancer
incidence
and
mortality,
risk
factors,
explanation
of
screening

available,
brief
overview
of
treatment
options
used
for
breast
cancer
treatment
in

general,
and
ended
with
information
on
survivorship.

4A)
Have
there
been
ways
that
your
campaigns
have
changed
in
the
last
3-‐5

years?

We
try
to
build
on
successes.

If
something
doesn’t
work,
we
go
back
to
our

community
advisory
board
to
talk
about
it
and
brainstorm
new
ideas.

Does
social

media
play
a
part
in
your
breast
cancer
activities
today?
No.

We
find
that
some

people
may
be
on
Facebook,
but
twitter
is
not
used
as
much.

109

5)
What
goals
do
you
have
for
breast
cancer
awareness
in
the
future?

We
have

just
started
year
4
of
our
five-‐year
cancer
grant.

This
year
we
are
focusing
on
HPV

and
cervical
cancer.

If
we
get
future
funding
for
breast
cancer
awareness,
then
we

will
likely
do
a
needs
assessment
to
plan
an
intervention.

5A)
Where
do
you
see
the
greatest
challenges
in
reaching
women
about
breast

cancer
awareness
in
your
target
ethnic
group?

Our
projects
usually
focus
on

raising
awareness
about
a
cancer
site,
increasing
knowledge
about
risk
factors
and

screening,
and
looking
for
ways
to
influence
screening
behavior.

That
can
be
tricky

when
the
population
we
are
reaching
might
not
have
health
insurance,
or
the

financial
resources
to
pay
for
screening.

We
try
to
address
this
by
establishing

partnerships
with
providers
and
clinics
who
offer
screening
for
free
,
at
low-‐cost,
or

on
a
sliding
scale.

6)
Do
you
think
it
is
beneficial
to
divide
campaigns
by
ethnicities
or
is
it
better

to
make
one
campaign
for
women?

You
cannot
go
with
a
‘one
size
fits
all’

approach
for
a
campaign.

You
have
to
adapt
your
messages
so
that
they
are

culturally
relevant
to
your
audience.

Name:
Jennifer
Metz

Organization:
California
Health
Collaborative

Title
in
organization:

Project
coordinator
and
health
educator

Experience/qualifications:

110

1)
How
do
you
think
survivorship
is
different
between
ethnic
groups
(white,

African
American,
Asian
and
Latina)?

Unable
to
answer

Why
do
you
believe
that
some
ethnic
groups
prefer
to
celebrate
the
fight
while

other
ethnic
groups
choose
to
hide
it?

Unable
to
answer

1A)
Why
do
you
believe
the
majority
of
women
treat
the
battle
of
breast

cancer
this
way?

Unable
to
Answer

2)How
do
women
with
breast
cancer
prioritize
their
care
verse
their
other

daily
life
commitments?
Do
you
believe
this
varies
according
to
ethnic
group?

(ex:
family,
work,
etc.)

• Economic
status,
what
responsibilities
they
have
to
continue
to
do
and
don’t

do

• Only
some
women
have
the
luxury
of
committing
their
lives
to
breast
cancer

• If
the
women
with
breast
cancer
have
numerous
minimum
wage
jobs
that

their
families
depend
on,
they
don’t
have
sick
leave
and
they
don’t
get
paid
if

they
don’t
work,
they’ll
choose
to
work
over
their
well
being
and
health

2A)
What
other
diseases/health
conditions
are
competing
for
a
women’s

attention
in
per
target
ethnic
group?
What
is
the
attitude
toward

mammograms
per
ethnic
group?

• Cardiovascular,
obesity,
diabetes,
heart
disease
and
lung
cancer

111

• They
are
painful,
uncomfortable,
similar
concern
from
low-‐income
about

radiation
exposure,
general
health
care
system
is
questioned,
misconception

about
treatment

• Concerned
the
mammograms
will
do
more
harm

• They
don’t
trust
the
government

3A)
For
the
women
where
the
attitude
is
negative,
what
do
you
consider
being

the
primary
reason
these
women
avoid
getting
them?

• Need
to
understand
the
risk
ratio,
the
whys
and
the
concerns,
need
to
be

educated
about
them
and
that
they
can’t
wait
until
there’s
a
problem

• The
good
outweighs
the
bad

3B)
For
the
women
where
the
attitude
is
positive,
what
do
you
believe
was
the

best
way
of
reaching
women
to
be
positive
about
mammograms?

• Educational
programs
and
clinics

2) How
would
you
describe
your
current
breast
cancer
campaign
objective

and
activities?

• Free
breast
and
cervical
screenings
for
the
no
insured
and
underinsured,

outreach
and
education
to
the
“every
women
counts
program”,
reach
out=

teach
classes
and
workshops
in
different
languages,
work
with
community

organizations,
low
income
housing,
PTAs,
schools,
churches,
elderly
homes,

to
get
word
out
13
different
languages

• Divide
by
community
and
ethnicity

• Wealthier
ethnicities
are
likely
more
educated
and
are
already
aware
of

many
risks
and
have
better
health
care

112

4A)
Have
there
been
ways
that
your
campaigns
have
changed
in
the
last
3-‐5

years?

• Funding
decreases,
campaigns
based
on
screening
guidelines,

4B)
Does
social
media
play
a
part
in
your
breast
cancer
activities
today?
How?

• They
don’t
have
the
funding

• Language
barriers
and
money
barriers

5)
What
goals
do
you
have
for
breast
cancer
awareness
in
the
future?

• Reach
as
many
people
as
possible,
education
is
goal,

• Host
workshops
for
questions
and
answer
sessions,
make
workshops

discussion
based

• CHC
helps
with
transportation
and
childcare

• Help
them
to
overcome
barriers
that
keep
them
from
getting
treatment

5A)
Where
do
you
see
the
greatest
challenges
in
reaching
women
about
breast

cancer
awareness
per
ethnic
group?

• Culturally
tailored
and
language
tailored,
if
there
were
more
funding
they

could
reach
more
people
with
more
help

6)
Do
you
think
it
is
beneficial
to
divide
campaigns
by
ethnicities
or
is
it
better

to
make
one
campaign
for
the
general
woman?

• Needs
to
be
tailored
to
community
not
ethnicity

• Each
community’s
needs
are
different,
geographic
and
cultural
backgrounds,

economic
differences

113

• Interview
Contacts:

Interview)Contacts)
Organization Name) Email Title
Ethnicity)
Representation
Susan&G.&Komen:&Los&Angeles Gwen&Baker GBarker@komenlacounty.org&
Director&of&
Mission&Programs&
Caucasian
California&Health&Collaborative& Jennifer&Metz jmetz@healthcollaborative.org&
Project&Coordinator&&&
Health&Educator
Multi&Ethnic
Orange&Coast&Memorial&Center&Donna&Hartman donnahartmanhb@yahoo.com& Office&Manager/&Survivor Caucasian&
Dr.&Susan&Love&
Research&Foundation
Shirley&Horn SHorn@drsusanloveresearch.org
Director&of&Communication&
and&Marketing/&Survivor
Caucasian
The&Black&Women's&
Health&Imperative
Valerie&L.&Rochester& VRochester@bwhi.org& Director&of&Programs& African&American
Fred&Hutchinson&Cancer&
Research&Center&
Katherine&Briant kbriant@fredhutch.org&
Community&Health&
Education&Manager&
Hispanic/Latina&

114

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VIIII:
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Section
X:
Endnotes

1

Susan
G.
Komen
Foundation
Website,
January
2015,
Komen
Fact
Sheet

2

Susan
G.
Komen
Foundation
Website,
January
2015,
Komen
Fact
Sheet

3

Susan
G.
Komen
Foundation
Website,
January
2015,
Incidence
and
Mortality
Graph

44

Merriam-‐Webster
Dictionary,
December
2014,
Caucasian
Definition

5

Susan
G.
Komen
Foundation
Website,
January
2015,
Mammograms

6

Susan
G.
Komen
Foundation
Website,
January
2015,
Incidence
Graph

7

Susan
G.
Komen
Foundation
Website,
January
2015,
Mortality
Graph

8

Susan
G.
Komen
Foundation
Website,
January
2015,
Ashkenazi
Jewish
Heritage

9

Susan
G.
Komen
Foundation
Website,
January
2015,
Ashkenazi
Jewish
Heritage

10

Susan
G.
Komen
Foundation
Website,
January
2015,
About
Us

11

Susan
G.
Komen
Foundation
Website,
January
2015,
About
Us

12

Susan
G.
Komen
Foundation
Website,
January
2015,
About
Us

13

Susan
G.
Komen
Foundation
Website,
January
2015,
Timeline
of
Events

14

Susan
G.
Komen
Foundation
Website,
January
2015,
Komen
Fact
Sheet

15

Susan
G.
Komen
Foundation
Website,
January
2015,
Quick
Guide

16

Susan
G.
Komen
Foundation
Website,
January
2015,
Mammogram
Chart

17

Susan
G.
Komen
Website,
January
2015,
Fact
Sheet

18

Susan
G.
Komen
Foundation
Website,
January
2015,
Media
Kit

19

Susan
G.
Komen
Foundation
Website,
January
2015,
Media
Kit

117

20

Susan
G.
Komen
Foundation
Website,
January
2015,
Risk
Factors

21

Susan
G.
Komen
Foundation
Website,
January
2015,
2015
Advocacy

22

“Breast
Cancer
Interview
with
Shirley
Horn,”
Email,
November
2014

23

“Breast
Cancer
Interview
with
Shirley
Horn,”
Email,
November
2014

24

Merriam-‐Webster
Dictionary,
January
2015,
African
American
Definition

25

Susan
G.
Komen
Foundation
Website,
January
2015,
Komen
Fact
Sheet

26

Intercultural
Cancer
Council,
November
2014,
African
American
Cancer
Fact

Sheets

27

Intercultural
Cancer
Council,
November
2014,
African
American
Cancer
Fact

Sheets

28

Intercultural
Cancer
Council,
November
2014,
African
American
Cancer
Fact

Sheets

29

Intercultural
Cancer
Council,
November
2014,
African
American
Cancer
Fact

Sheets

30

Intercultural
Cancer
Council,
November
2014,
African
American
Cancer
Fact

Sheets

31

Intercultural
Cancer
Council,
November
2014,
African
American
Cancer
Fact

Sheets

32

Ethnicity
and
Inequalities
in
Health
and
Social
Care,
“The
Impact
of
the
Detection

and
Diagnosis
of
Breast
Cancer
in
Black
and
Asian
Women,”
2012.
Pg
135

33

Ethnicity
and
Inequalities
in
Health
and
Social
Care,
“The
Impact
of
the
Detection

and
Diagnosis
of
Breast
Cancer
in
Black
and
Asian
Women,”
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Abstract (if available)

Abstract This thesis compares the similarities and differences between the Caucasian, African American, Asian American and Hispanic ethnicities when reaching their target and intended audience with breast cancer awareness campaigns and education. It researches the traditional media used and as well as social media and the new ideas used to influence and educate women about breast health and if tailoring messaging about breast cancer awareness and education to individual ethnicities is best.

Linked assets

University of Southern California Dissertations and Theses

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