Table 3.
Association between Race/Ethnicity/Education, Medical Discrimination, Clinician Mistrust, Treatment Decision-Making and Receipt of Guideline-Concordant Breast Cancer Treatment
| Model 0: Unadjustedb |
Model 1c: Disparities |
Model 2ac: Discrimination |
Model 2bc: Clinician mistrust |
Model 2cc: Treatment Decision-Making |
Model 3d: Disparities and Interpersonal Factors |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
|
|
|
|
|
|
|
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| Combined race/ethnicity/educationa | 0.30 | 0.18 | 0.12 | |||||||||
| API <CD | 0.83 (0.43, 1.58) | 0.56 | 0.71 (0.35, 1.41) | 0.33 | 0.76 (0.37, 1.54) | 0.44 | ||||||
| API CD+ | 0.77 (0.43, 1.37) | 0.37 | 0.74 (0.39, 1.38) | 0.34 | 0.80 (0.42, 1.52) | 0.50 | ||||||
| Black <CD | 0.40 (0.18, 0.85) | 0.02 | 0.32 (0.14, 0.72) | 0.01 | 0.29 (0.12, 0.67) | <0.01 | ||||||
| Black CD+ | 1.43 (0.39, 5.27) | 0.59 | 1.34 (0.35, 5.14) | 0.67 | 1.43 (0.37, 5.54) | 0.60 | ||||||
| Hispanic <CD | 1.01 (0.37, 2.74) | 0.98 | 1.12 (0.40, 3.18) | 0.83 | 1.09 (0.38, 3.13) | 0.87 | ||||||
| Hispanic CD+ | 1.01 (0.20, 5.06) | 0.99 | 0.75 (0.14, 4.07) | 0.73 | 0.54 (0.09, 3.10) | 0.49 | ||||||
| White <CD | 1.15 (0.55, 2.41) | 0.72 | 1.03 (0.47, 2.26) | 0.94 | 1.10 (0.49, 2.44) | 0.82 | ||||||
| White CD+ | 1.00 | --- | 1.00 | --- | 1.00 | --- | ||||||
| Discrimination | 0.38 | 0.60 | 0.68 | |||||||||
| Never (0) | 1.00 | --- | 1.00 | --- | 1.00 | --- | ||||||
| Low (1–2) | 1.37 (0.78, 2.39) | 0.27 | 1.30 (0.73, 2.32) | 0.38 | 1.25 (0.69, 2.29) | 0.46 | ||||||
| Moderate (3–6) | 0.85 (0.50, 1.44) | 0.54 | 0.92 (0.52, 1.62) | 0.76 | 0.91 (0.50, 1.68) | 0.77 | ||||||
| Clinician Mistrust | 0.97 | 0.88 | 0.97 | |||||||||
| None (0) | 1.00 | --- | 1.00 | --- | 1.00 | --- | ||||||
| Any (1) | 1.01 (0.60 1.69) | 0.97 | 0.96 (0.55, 1.67) | 0.88 | 0.99 (0.55, 1.79) | 0.97 | ||||||
| Treatment | 0.45 | 0.31 | 0.25 | |||||||||
| Decision-Making | ||||||||||||
| Shared | 1.00 | --- | 1.00 | --- | 1.00 | --- | ||||||
| Physician-driven | 0.81 (0.45, 1.48) | 0.50 | 0.72 (0.38, 1.37) | 0.32 | 0.64 (0.32, 1.25) | 0.19 | ||||||
| Patient-driven | 0.76 (0.49, 1.17) | 0.21 | 0.71 (0.45, 1.13) | 0.15 | 0.70 (0.43, 1.15) | 0.16 | ||||||
a
CD=4-year college degree
b
Results are from four separate unadjusted models
c
Adjusted for age, AJCC stage, and tumor size
d
Adjusted for age, AJCC stage, tumor size, race/ethnicity/education and all three interpersonal factors