Phyliss Golden gets a lot of resistance from some of the women at Second Baptist Church when she reminds them its time for a mammogram.

G.J. McCarthy photo

Phyliss Golden, the health and wellness minister at Second Baptist Church and a registered nurse, tries to educate the women in her congregation about breast cancer. Research suggests that cancer awareness messages framed in a spiritual context might resonate more deeply than those given in a purely medical context.

"My approach is, God is in control of our future, but he expects you to take care of the temple he gave you," said Golden, the health and wellness minister at Second Baptist and a registered nurse at Boone Hospital Center.

It’s an approach University of Missouri-Columbia researchers say could work on a larger scale to help save some of the 5,830 black women who will die from breast cancer this year in the United States. The number is an estimate of the American Cancer Society.

Glenn Leshner and Cythnia Frisby, both associate professors in journalism at MU, and three doctoral students at MU examined the role that spirituality plays in the way black women process information about breast cancer.

Frisby	Leshner

The researchers surveyed 206 black women and 240 white women by phone in 11 U.S. cities, including Kansas City, between February and June 2004. The motivation for the study, Leshner said, was born from a desire to find ways to close the disparity in the mortality rate from breast cancer between black women and white women.

Black women are 18 percent more likely to die from cancer than white women according to Cancer Facts & Figures for African-Americans 2007-2008.

Research hasn’t made entirely clear the reason for this disparity. Research by The American Cancer Society, or ACS, indicates black women could lack access to quality health care or might not pursue treatment for breast cancer quickly enough. Research also shows aggressive tumors are more common in black women than in white women.

More scrutiny, the ACS said, indicates there are "differences in access to and use of early detection screening tests."

"For African-American women, an important dimension of health locus of control is spiritual - the belief that God has control over health," the researchers write in the abstract of their study, which was published in December in "Integrative Medicine Insights."

"Our results indicate that when a breast cancer prevention message is designed for African-American women, health communicators should consider how to positively utilize the role of spirituality in the women’s health message processing," Frisby said in the news release.

Entire advertising campaigns could be designed around the research, and Golden believes churches should play a role.

"For the African-American community, I think some information is better received from a well-known church," she said. "They’ll listen to that more than Boone Hospital Center."

Although the research showed black women are more likely to talk and listen to messages about breast cancer in a spiritual context, the study found it still did not motivate them to take action.

It also doesn’t seem to have an effect when Golden tries to use the argument with the women in her congregation who are not taking care of their health.

"Their response to the argument is usually agreeable, but then I’m persistently following up and they’re saying, ‘Oh, I haven’t done it yet,’ " she said.

There are many reasons why the women in her congregation don’t regularly get mammograms. There is a fear of the procedure itself, that it might hurt, she said. There is a fear of chemotherapy, which Golden said the older generation saw in its infancy when it was a horrible experience of relentless vomiting and constant nausea. It’s surprising but true that some women don’t want to know if they have breast cancer because they don’t want to lose their hair, she said.

"I have to keep referring to some of the older generation. We’re trying to rid the thought that’s been implanted in the mind of some of our seniors that African-Americans are guinea pigs. That’s a huge reason people don’t want to go to doctors," Golden said, referring to incidents such as the infamous U.S. Public Health Service’s Tuskegee Syphilis Study.

"It’s not that they experienced it, but they heard about it and believed it," Golden said. "So their response is, ‘If God wants me, he’ll take me.’ "

Golden said she tries to make sure women aren’t avoiding going to the doctor for reasons that could be overcome with her help: a need for a ride, wanting someone to explain the results or not having a doctor.

The biggest problem for her congregation members is the cost when they are uninsured, she said. The division in her congregation of those who take care of themselves and those who don’t closely follows the division between those who have health insurance and those who don’t. Golden said she plans to invite a mobile mammography unit to Second Baptist sometime this year, and she said she thinks people will be more willing to go to a screening at the church than the hospital because it’s less threatening financially and medically.

"In terms of making health care accessible to people that don’t have it, that’s a political issue that we certainly need to deal with," Leshner said.

Another communication angle Leshner is pursuing is the study of responses of black women to video recordings of stories told by black breast cancer survivors in their own words, he said. The study is half completed, but it needs additional funding to continue.

Mary Lou Kegler facilitates a statewide American Cancer Society support group for blacks with cancer. The Kansas City resident was diagnosed with breast cancer in 1998. Her doctor had alerted her that she needed to regularly get mammograms because something was going on and she listened, she said.

"I think God gives us the sense to put us in control of our health," she said.

Kegler said she viewed her cancer as just another thing God had put on her plate, and it was up to her and him working together to get through it. She thanks him daily, if not hourly, that’s she’s still here, she said.

She wants women to take care of themselves and be proactive about breast cancer prevention.

"I would say that we owe it to ourselves, to our children and to our children’s children to stay on top of health issues because God is still in the blessing business," Kegler said.

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