The Nurse’s Role in Overcoming Barriers to Cancer Screening of African Americans An Integrative Review of the Literature Wendy Marie Clayton and Dr. Joseph Tariman MENP for Non-Nurse (MS), College of Sciences and Health, DePaul University Background Framework Results Patient Nurse Cues to Action Cancer Screening Behaviors   Perceived Barriers Perceived Threat Perceived Benefit Self-Efficacy Cultural Care Preservation/Maintenance Cultural Care Accommodation/Negotiations Cultural Care Repatterning/Restructuring Cancer mortality disadvantage experienced by African Americans increases as cancers become more amenable to medical interventions1 Not identifying cancer at an early stage can lead to advanced cancer stage, possible metastasis, and unfortunate death that has the potential to be avoided2 Nursing personnel have an opportunity and responsibility to impact the overall incidence and mortality of cancers3 Patient Education Four of the studies (30%) focused on targeted patient education Educational interventions reflected cultural care repatternning and restructuring’s effect on patient increased perceived benefits, increased self-efficacy, reduced perceived barriers, and reduced perceived threat Continuing Nurse Education Three of the studies (21%) suggest continuing nurse education Educational intervention for the nurses was met with increasing knowledge of cancer screening of the providers themselves Shared Decision Making Three of the studies (21%) used decision aids and shared decision making Provider and patient discussions surrounding cancer screening decisions would promote cues to action leading to cancer screening Focus Groups One of the studies (7%) incorporated focus groups to develop intervention Recruitment of ethnically diverse populations for focus groups is important for research into cancer interventions Engaging in Multidisciplinary Teams Three studies (21%) involved multidisciplinary teams for outreach strategies Outreach strategies are imperative to reach the African American population Purpose Purposes of this investigation into the literature were to: identify various barriers to early cancer detection and screening behaviors among African Americans Evaluate the nursing interventions and the nurse’s role in combating these barriers to improve on the health disparity associated with this population Conclusions Due to many factors such as personal, structural, and clinical barriers, African Americans face various obstacles to obtaining appropriate screening methods Continuing nurse education, the use of specially selected focus groups, patient education, shared decision making, and involvement in multidisciplinary teams have the potentials to decrease morbidity and mortality rates associated with cancer screening disparities among American Americans Methods The following steps were followed: specifying the purpose of the review, systematic literature search process, data evaluation, data synthesis and analysis, and results presentation4 Conceptual framework for this integrative literature review, combining the Cultural Care Diversity and Universality Theory and the Health Belief Model. Through the use of Cultural Care Repatterning and Restructuring, Cultural Care Accommodation and Negotiations, and Cultural Care Preservation and Maintenance from the Cultural Care Diversity and Universality Theory, Nurses are able to impact the Patient’s Perceived Benefits and Self-Efficacy components of the Health Belief Model. Constructed Summer 2017 by Wendy Clayton. Nursing Implications   CINAHL PsychINFO PubMed Number of studies found using keywords 52 18 99 Number of studies meeting inclusion criteria 25 11 37 Number of studies after removing duplicates 21 12 20 Number of studies after using exclusion criteria 5 2 7 There should be encouragement through nurses to participate in clinical trials, and reliable interventions should be available regardless of income, lifestyle, and demographics Nurses spend the most time with patients compared with other healthcare providers; hence, there is a responsibility and duty as a patient advocate to do everything within the scope of practice to combat the unnecessary morbidity and mortality associated with cancer screening disparities in African Americans References Tehranifar, P., Goyal, A., Phelan, J.C., Link, B.G., Liao, Y., Fan, X., …& Terry, M.B. (2016). Age at cancer diagnosis, amenability to medical interventions, and racial/ethnic disparities in cancer mortality. Cancer Cause & Issues, 27(4), 553-560. doi:10.1007/s10552-016-0729-2 Ryerson, A.B., Eheman, C.R., Altekruse, S.F., Ward, J.W., Jemal, A., Sherman, R.L., …& Kholer, B.A. (2016). Annual report to the nation on the status of cancer, 1975-2012, featuring the increasing incidence of liver cancer. Cancer, 112(9), 1312-1337. doi:10.1002/cncr.29936 Ackerson, K., & Gretebeck, K. (2007). Factors influencing cancer screening practices of underserved women. Journal of the American Academy of Nurse Practitioners, 19(11), 591-601. doi: 10.1111/j.1745-7599.2007.00268.x Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546-553. doi: 10.1111/j.1365-2648.2005.03621.x