A Geo-Social-Cultural-Ecological Approach to Breast Cancer Screening Among Black Women: A Qualitative and Descriptive Study

Abstract

Introduction:

Early breast cancer detection is essential to reducing disproportionately high mortality among Black women. This study aimed to explore multilevel, place-based barriers to breast cancer screening among Black women living in a low-income community and examine how geo-social-cultural-ecological systems contribute to the barriers.

Methods:

This qualitative study used focus group approach and recruited Black women with and without breast cancer, health care providers, and community leaders (N = 22) from a low-income community in the United States. Bronfenbrenner’s ecological framework guided an iterative and inductive method to analyze data.

Results:

Eleven themes emerged across the individual, microsystem, macrosystem, exosystem, and mesosystem levels, illuminating barriers and interconnected pathways of barriers that limited breast cancer screening. Participants also identified facilitators that helped Black women manage multilevel system challenges to breast cancer screening.

Discussion:

Findings support a geo-social-cultural-ecological approach to systematically identifying barriers and discerning the pathways of barriers across multilevel systems within a geolocation.