Determinants of breast cancer knowledge among newly diagnosed, low-income, medically underserved women with breast cancer

Cancer. 2008 Mar 1;112(5):1153-61. doi: 10.1002/cncr.23262.


Background: Among women with breast cancer (BC), greater BC knowledge has been associated with greater participation in treatment decision-making, patient satisfaction, and survival. The objective of this study was to identify modifiable determinants associated with BC knowledge.

Methods: Data were collected from a telephone survey of medically underserved women with BC in California (n = 909). The dependent variable for analysis was BC knowledge. The modifiable determinants that were assessed included 1) physician-patient discussion of BC topics, 2) receipt of written BC-related material, 3) self-efficacy in interacting with physicians, 4) physician emotional support, 5) discussions with a BC survivor, and 6) office visit support by relatives/friends. Multivariate linear regression was used to examine the effect of those determinants on BC knowledge while controlling for socioeconomic factors, clinical characteristics, and treatment received.

Results: The average knowledge score was 6.9 (standard deviation, 2.3; range, 0-10). In multivariate analyses among women with less physician emotional support, those with the greatest self-efficacy had higher knowledge scores than those with the least self-efficacy (8.2 vs 5.4; P < .001). For women with low self-efficacy, those with more physician emotional support had higher knowledge scores than those with less physician emotional support when the analysis was controlled for confounding factors (6.3 vs 5.4; P < .001); physician information-giving had no effect on BC knowledge.

Conclusions: The study findings suggested significant associations of patient self-efficacy and physician emotional support with BC knowledge; physician emotional support appeared to be more important than physician informational support. Further research will be needed to investigate whether interventions that target these 2 domains may be effective in increasing BC knowledge in disadvantaged populations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms / psychology*
  • Cohort Studies
  • Female
  • Health Care Surveys
  • Health Services Accessibility*
  • Humans
  • Middle Aged
  • Patient Education as Topic*
  • Physician-Patient Relations
  • Self Efficacy
  • Social Class*
  • Social Support