Partners in Action: A UM/ Little Haiti Collaborative United Against Breast Cancer

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DESCRIPTION (provided by applicant): "Partners in Action," or Patne an Aksyon in Haitian Creole, represents a campus-community partnership between the University of Miami Sylvester Comprehensive Cancer Center (UM SCCC) and key Haitian American community-based organizations in Miami, Florida. This partnership aims to alleviate the excess burden of breast cancer morbidity and mortality experienced by Haitian American women living in the Miami metropolitan area. When compared to other racial/ethnic minorities and immigrant populations in Miami, Haitian women are more likely to suffer disability and death from breast cancer, largely as a function of their stage of disease at diagnosis. Haitian women are typically diagnosed with late-stage breast cancer (Stages III and IV) when the prognosis for survival is poor. Previous research has not examined why Haitian American women present with late-stage breast cancer, despite the growing importance of this population sub-group within South Florida. Thus, the Community Advisory Board (CAB) for Patne an Aksyon decided to undertake research toward this end. We propose a two-year study to identify the determinants that may account for the exaggerated late-stage presentation of breast cancer among Haitian American women. We will identify such determinants using three complementary methodologies. Ethnography, the first methodology, will be used to map the social and geographic boundaries of "Little Haiti," a predominately Haitian neighborhood in Miami. We will use this information to develop sampling frames for the rapid assessment surveys and in-depth interviews, the other two methodologies to be employed in the proposed study. The rapid assessment surveys will be used to document the prevalence of mammography use within Little Haiti, as well as to identify characteristics of women who have never been screened in their lifetime or are screened less frequently than every one to two years as is recommended by national guidelines. The in- depth interviews, in turn, will provide information about barriers to screening and follow-up for breast abnormalities within the South Florida Haitian community. All data will be collected by Community Health Workers (CHWs) who are indigenous to Little Haiti, fluent in Haitian Creole, and trained to perform ethnographic community mapping, rapid assessment surveys and in-depth interviews. Using CHWs to collect data will help ensure the study's success. These individuals have intimate knowledge of Little Haiti, community customs, and cultural norms. Our primary objective is to inform understanding of why Haitian women experience excess breast cancer mortality, and to use such understanding to direct future research and intervention initiatives to attenuate this disparity.