An Inter-Personal Framework for Lung Cancer Decision-Making in African Americans
We seek to administer a survey of validated items concerning social support and social influence to ALL African American lung cancer patients seeking treatment at Parkland (n= 100). From this cohort, we will sample 20 patients for joint, ethnographic interviews (open-ended questions) with their spouse/significant other or primary caregiver, for 3 sessions over time, to take place off-site in the community at a date and place convenient to the patient.
Aim 1: Survey all adult African American lung cancer patients, seen through Parkland Hospital (n=100). We will use select validated instruments (Aim 1) to assess dyadic coping, social support, social influence, and inter-personal communication. Surveys will be supplemented with EMR data on diagnostic and demographic characteristics (e.g. stage, histology, recommended treatment, age, marital and smoking status) that may be important in the decision-making process (Manfredi et al. 2010). Recruitment addressed in Human Subjects, Inclusion (attached). Prior experience indicates sample size is feasible; Parkland patients are receptive to surveys especially conducted during clinic wait time. A $10 gift card will be offered on completion of 30-40 minute survey.
Aim 2: We will use these survey data (Aim 1) to tailor a series of ethnographic, narrative joint interviews. We will identify a subsample of 20 married African American patients for joint interviews with each patient and their partner, to be conducted at three different time points; 60 interviews total. Interviews will be digitally recorded with participant consent.
Ethnographic interviews will be conducted off-site, at a time and place of the patient[Right Quote]s choosing (e.g. their home, local library, church or community center) where patient and significant other will feel comfortable.
Each joint interview will last between 90-120 minutes, subject to patient convenience and disease burden. A $30 gift card will be offered at the completion of each interview session.
Dr. Lee will oversee line-by-line coding of all interview transcripts using qualitative analysis software, NVivo9(TM), to insure a transparent and reproducible process where the team can track the evolution of their analyses. Transcripts will be analyzed for content using standard qualitative techniques for joint interviews (Eisikovits and Koren 2010) and methods of grounded theory (Glaser and Strauss 1967; Strauss and Corbin 1988). Participants[Right Quote] verbatim statements will be categorized according to their thematic content and arrayed against the preliminary framework (Aim 1). Interviews at three time points permit multiple rounds of coding to generate key themes iteratively. Dr. Lee will create a codebook for discussion with the study team. Coding decisions will be compared, new themes identified, and areas of disagreement resolved between Drs. Lee, Skinner, and Wiebe with physician consultation as needed.
- Adult, African American
- Lung cancer diagnosis
- Able to read, speak, and comprehend English
- Ability to communicate by voice (to participate in survey, interviews)