Evaluating the quality of care for women with breast cancer is an important research priority in the United States as there are concerns about the quality of treatment delivery. Latina women may be particularly vulnerable to access and quality of care issues related to culture, context and access. Unfortunately, there are no population-based studies that simultaneously evaluate determinants of treatment processes and outcomes of care for Latina women with breast cancer in the United States. We propose a population-based study in Los Angeles County to examine a broad array of determinants (predisposing/enabling factors, clinical factors, external influences and patient knowledge and attitudinal factors) that may be associated with four outcomes for Latina women recently diagnosed with breast cancer: (1) definitive surgical treatment (mastectomy vs. lumpectomy) and complementary treatment options (radiation therapy post-lumpectomy and reconstruction post-mastectomy); (2) patient satisfaction with the treatments received; (3) patient satisfaction with the process by which treatment decisions were made; and (4) health-related quality of life. All Latina women (identified using a validated U.S. Census-based surname strategy) and a 20% random sample of non-Latina women recently diagnosed with breast cancer (N=2,200) will be selected prospectively from the Los Angeles Surveillance, Epidemiology and End Results (SEER) catchment areas of a 12-month period using the registries' rapid case ascertainment process. Women will be invited to complete a standardized self-administered survey questionnaire in the mail with an invitation to complete the survey by telephone if preferred. We expect that 75% of eligible patients will complete the questionnaire (N=1,545 respondents) of whom 35% will self-designate as Latina.
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