Breast Reconstruction Awareness: Targeting Health Literacy through Community Engagement

Abstract

Background: After mastectomy, women of color undergo breast reconstruction at disproportionately lower rates than their Caucasian counterparts. In this study we address health literacy, a modifiable contributor to this disparity, through community engagement. Methods: In collaboration with a large church in West Philadelphia PA, the Abramson Cancer Center, the division of plastic surgery at the University of Pennsylvania, and with funding from the Plastic Surgery Foundation, the authors developed a health awareness symposium centered on breast reconstruction. This program, targeting women of color, included lectures, patient testimonials and a Q&A session. Participants completed pre and post-symposium surveys focusing on the availability, timing and options for breast reconstruction. Results: A total of 63 community members attended the symposium. Participants were mostly female (88.9%) and of African American descent (87.3%). Half were current breast cancer patients while 24% identified as family members/friends of a breast cancer patient. Prior to the session, 12.7% of participants were unaware of breast reconstruction as a treatment option after mastectomy, while 42.8% were unaware of insurance coverage for breast reconstruction and contralateral balancing procedures. There were statistically significant increases in the number of participants responding correctly to questions regarding insurance coverage, timing of reconstruction, and reconstruction options after the program as compared to before. Conclusions: The etiology of the existing disparity in breast reconstruction is complex and multifactorial. Partnerships between community groups and healthcare professionals from plastic surgery and breast surgery to create targeted interventions can improve community awareness in an effort to alleviate the current disparity.