The newest grant received by UA researchers Chris Segrin and Terry Badger focuses on Latinas with breast cancer who live in rural areas.
Chris Segrin, the Steve and Nancy Lynn Endowed Professor and the director of the University of Arizona Department of Communication, calls himself a relationship scientist and has published studies on marriage, loneliness, depression, and parenting. Segrin believes that communication and our relationships are inextricably intertwined with our quality of life. Nowhere is that more apparent than when we are sick.
For several years, Segrin, in collaboration with UA Nursing Professor Terry Badger, has been studying the role of communication on the health and well-being of cancer patients and their partners.
This summer, the V Foundation for Cancer Research donated $65,000 to the Arizona Cancer Center to fund Segrin’s and Badger’s research aimed at recruiting rural Latinas with breast cancer and their family partners into clinical trials that deliver interventions to manage and improve quality of life.
This grant will expand on Segrin’s and Badger’s $1.5 million grant from the American Cancer Society that focuses on Latinas with breast cancer and their partners, which replicates their previous study with primarily Anglo women. They are currently in year three of the five-year grant.
Segrin says that Latinas are an underserved population, who are often not seen by a doctor until their breast cancer has progressed to Stage III or IV. They are also usually younger—in their 30s and 40s—than the Anglo women in Segrin’s and Badger’s previous study.
Patients and their partners in the study each receive either a health education intervention or an interpersonal counseling intervention over the telephone for 30 minutes once a week for eight weeks. Measurement of quality-of-life and health indicators occurs at four times over six months.
Providing the intervention to the patient’s partner is a key part of the study. According to Segrin, healthcare professionals have historically overlooked the experience of the partner of the cancer patient. However, partners also experience emotional distress such as depression, helplessness, anxiety and exhaustion. And patients who have a partner who is emotionally distressed do worse, both emotionally and physically.
“Major health problems are family health problems,” Segrin said. “It doesn’t just affect one person. And the other person may be a very important player in the wellness of the patient.”
Segrin said that one of the key differences between the Anglo women and the Latina women they have studied is who they named as their “supportive partner.”
“We found that with Anglo women, almost to the person, most of their helpers were their husbands,” Segrin said. “In the Latina women, not so. We were surprise by how many were married but did not nominate their husbands as their partner in the study. Their helper was almost always a female, such as a sister or mother.”
Segrin thinks that the concept of marianismo, a cultural ideal for females to be selfless caregivers, may be playing a role in how Latino families deal with illness.
“It helps to have counselors who are Latina and speak Spanish and have kids themselves,” Segrin said. “They directly relate to the patient. That is a big part of how we structure the intervention. We want to be culturally competent. The counselor has to match the values of the people they are speaking to.”
So far, the patients and their partners have responded well to the intervention, with decreased symptoms of depression, anxiety, and fatigue. The phenomenon of “emotional contagion” that the researchers found in previous studies—that the emotional state of the patient and partners are related—was found in all relationship types, not just with spouses.
The researchers did predict that the patients and partners receiving the counseling would have better outcomes than those receiving just the health education. They were surprised to discover that both groups improved about the same amount.
With the new grant from the V Foundation, Segrin and Badger are beginning to specifically target Latinas who live in rural areas, who often have limited access to healthcare services.
“They are doubly at risk,” Segrin said. ‘This is a population that seems custom tailored for our telephone intervention.”
According to Segrin, many Latinas with breast cancer live in rural areas and one-third of all women in the United States live in rural areas. “It is important that these women be represented in our clinical trial,” he said.
Adding patients who live in rural areas to the study is a challenge, since the researchers typically get their referrals from the large cancer centers in Tucson and Phoenix. To recruit patients, the research team will travel to rural communities to meet with providers and community health workers; develop relationships with community groups that serve Latinas; and use traditional marketing strategies, such as advertising, flyers and brochures.
Segrin predicts they will see even more powerful effects with the rural patients and partners. Whereas patients in populated areas have access to support groups and are probably visiting doctors and specialists on a regular basis, patients in rural areas are much more isolated.
Segrin hopes that their research draws attention to the need to provide health information and counseling to both the patient and their partner throughout the cancer experience. He also is excited to be extending his research to tackle the health disparities found in minority populations.
“Given that Arizona has such a large Latina population, the UA is a fantastic place to be doing this type of research,” Segrin said. “Hopefully, our research can have a real regional impact on healthcare.”