Recruitment of a Population-Based Sample of Young Black Women with Breast Cancer through a State Cancer Registry.

Given that Black women remain underrepresented in clinical research studies, we sought to recruit a population-based sample of young Black women with breast cancer through a state cancer registry. Demographic and clinical information on all Black women diagnosed with invasive breast cancer at or below age 50 between 2009 and 2012 in Florida was obtained through the state cancer registry. Survivors were invited to participate in the study through state-mandated recruitment methods. Participant demographic and clinical characteristics were compared using Chi-squared tests for categorical variables and the two sample t-test for continuous variables to identify differences between: (i) consented participants versus all other eligible; and (ii) living versus deceased. Of the 1,647 young Black women with breast cancer, mean age at diagnosis was 42.5, with the majority having localized or regional disease, unmarried, privately insured, and employed. There were no significant differences in demographic and clinical variables between the 456 consented study participants versus the remaining 1,191 presumed eligible individuals. Compared to potential participants, women determined to be deceased prior to recruitment (n = 182) were significantly more likely to have distant disease and a triple-negative phenotype. They were also significantly more likely to be unemployed, and uninsured or have public insurance (i.e., Medicaid or Medicare). Our results demonstrate that recruitment of a population-based sample of breast cancer survivors through a state cancer registry is a feasible strategy in this underserved and underrepresented population. However, survival bias, which was observed due to the lag time between diagnosis and recruitment, is important to adjust for when generalizing findings to all young Black breast cancer patients.

Environmental influences on fighting versus nonviolent behavior in peer situations: a qualitative study with urban African American adolescents.

This qualitative study explored environmental factors that influence adolescents' responses to problem situations involving peers. Interviews were conducted with 106 middle school students (97% African American) from an urban school system. Participants were asked to describe factors that would make it easier and those that would make it more difficult for adolescents to make specific responses to problem situations. Two types of responses were presented: nonviolent responses identified as effective in a previous study, and fighting responses. Qualitative analysis identified 24 themes representing family, peer, school, and neighborhood and broader social factors that were related to both nonviolent behavior and fighting. The identification of environmental influences on fighting and nonviolent responses has important implications for efforts to reduce aggression and promote effective nonviolent responses to problem situations encountered by adolescents.