Stigma plays a role in the health of many populations including cancer survivors. Stigma associated with cancer, its treatment, or other stigmatized identities may affect cancer survivor?s interactions with others, health behavior, healthcare processes (e.g., quality of patient-provider relationships), healthcare-seeking behavior, and health outcomes. Living in rural areas may exacerbate stigma due to factors such as less anonymity and privacy, poorer access to healthcare, and greater social isolation. In these ways, stigma can contribute to disparities in health and healthcare for cancer survivors, and its impact may differ for survivors of breast, prostate, and lung cancer, which are the cancers with the highest incidence and the top causes of cancer death in the U.S. Improving understanding of the role of stigma in the health of rural populations of breast, prostate, and lung cancer survivors is critical for developing effective intervention strategies to reduce stigma and its negative impacts for these populations. In this R03 application, our objective is to characterize the role of stigma in health behavior, healthcare, and health outcomes, as well as identify modifiable factors that could lessen stigma?s negative impact, from the perspective of rural survivors of breast, prostate, and lung cancer.
The specific aims are to (1) identify commonalities and differences in sources of stigma and perceptions and experiences of stigma across cancer types; (2) identify and compare how stigma influences health behavior, healthcare processes, healthcare-seeking behavior, patient-centered health outcomes, and social isolation across cancer types; and (3) identify resources that might ameliorate or buffer stigma?s negative health consequences.
These aims will be achieved by collecting and analyzing data from face-to-face, semi- structured, in-depth interviews with breast, prostate, and lung cancer survivors living in rural Oregon (N=50-60) recruited through the Oregon State Cancer Registry. In the process of achieving these aims, we will describe commonalities and differences across cancer types, examine multiple stigmatized identities, and explore how context matters for rural populations. The proposed project is expected to increase understanding of stigma, its outcomes, and factors that might lessen its negative effects from the perspective of rural breast, prostate, and lung cancer survivors. These outcomes will positively impact future research including the development of new measures of stigma and the design of a larger quantitative study to further characterize stigma among the target populations and to test hypothesized relationships between stigma and other variables. Ultimately, these outcomes will inform the development of effective intervention strategies to reduce stigma and its negative impacts for these populations.
Cancer survivors may be impacted by stigma associated with their disease, its treatment, or other characteristics. This research will examine the role of stigma in the health and well-being of survivors of breast, prostate, and lung cancer living in rural areas. This research will positively impact public health by improving understanding of stigma, its outcomes, and factors that might lessen its negative effects and improve the health and healthcare of rural survivors of breast, prostate, and lung cancer.
