Work accommodations described by a racially and socioeconomically diverse sample of women undergoing treatment for breast cancer

Abstract

Background

Receiving work accommodations is associated with job retention among women at high-risk of job loss during cancer treatment. However, there is a lack of consensus on what constitutes an accommodation. Understanding accommodations relevant to cancer is essential to creating inclusive patient-centered interventions.

Objective

We aimed to better understand patient perceptions of work accommodations relevant to cancer diagnosis and treatment.

Methods

As part of a survey pilot, we interviewed a diverse cohort of women undergoing treatment for stage 0-III breast cancer at five New York City cancer centers. We asked participants to list examples of what they considered to be work accommodations when completing the survey. Content analysis was used to describe accommodation types listed. Associations between participant characteristics and accommodation types were explored using significance tests.

Results

Sixty-one women (79% non-White race/ethnicity; 41% employed in service, manufacturing, or transportation industries) described nine accommodation types. Accommodations included leave time, schedule flexibility, social support, benefits, employer expectations, working from home, job security, physical accommodations, and confidentiality; 63% described more than one accommodation type. Women from groups at high risk of job loss described accommodation types not commonly assessed in cancer-employment research including job security (non-White race/ethnicity, less educated) and social support (low self-efficacy in approaching employers).

Conclusions

Work accommodations provided to women during breast cancer treatment vary. A multi-item instrument is needed to assess accommodations relevant to cancer. Women at high risk of job loss (non-White, less education) consider novel accommodations and therefore must be included in instrument development.