Psychosocial protective interventions for African American female breast cancer survivors: A systematic integrative review

Abstract

BACKGROUND: Despite the higher incidence rate of breast cancer among African American women compared to their White counterparts, this populations’ five-year survival rate has increased in recent years. The growing number of African American breast cancer survivors highlights the need for culturally appropriate psychosocial interventions to improve survivors’ quality of life and psychological wellbeing. OBJECTIVE: This systematic integrative review provides an overview of the current research-based psychosocial interventions for African American breast cancer survivors supplemented by an overview of the qualitative studies focusing on psychosocial wellbeing. METHODS: Utilizing the evidence-based PEO framework, a search of five databases was conducted for English-language articles published between 2013–2020: Pubmed, Academic Search Ultimate, CINAHL, PsycINFO, and Web of Science. Studies were excluded if there was a lack of primary data collection or if the population in the study was not identified as African American female breast cancer survivors. The seven interventions and twenty-one qualitative studies included in the final analysis underwent data extraction, critical appraisal using SRQR and STROBE checklists, and thematic analysis. RESULTS: Twenty-eight studies were identified in the search, including seven interventions and twenty-one qualitative studies. Analysis of the interventions revealed the importance of alleviating structural barriers and including peer support for African American breast cancer survivors. Analysis of the qualitative studies revealed five main themes: 1) spirituality and religion as a protective factor, 2) social support as a protective factor, 3) cultural perceptions of breast cancer, 4) negative impacts of treatment, and 5) healthcare system experience. CONCLUSION: While study designs differed in the interventions, this review showed the critical need for culturally competent psychoeducational interventions for African American breast cancer survivors to improve this population’s psychological wellbeing. The qualitative research highlighted the importance of spirituality and social support as protective factors for African American breast cancer survivors’ psychological wellbeing. Further research using rigorous methodologies and transparent reporting practices is needed to further evaluate how to most effectively alleviate structural barriers that African American breast cancer survivors face.