Identity Safety in Cancer Screening: Building a Basic Research-to-Clinic Translation of Social Identity Theory

Abstract

Environmental cues can signal identity threat (e.g., potential discrimination) or identity safety (e.g., belonging) to socially marginalized people. However, scant research has examined safety and threat cues in healthcare. In our T1-T2 concurrent triangulation mixed-methods study, participants (age 35–60; ∼25% each cisgender Black women, Black men, Latina, Latino) completed quantitative (n = 288) and qualitative (n = 80) surveys. Participants rated their past healthcare experiences and future cancer screening intentions, analyzed via multiple regression. Participants responded to short-answer questions about their healthcare experiences to identify cues to identity threat and/or identity safety, analyzed via grounded theory. Identity safety related to prostate, breast, and colorectal cancer screening intentions, controlling for mistrust and past discrimination. Qualitative results concurred, indicating that interpersonal cues and environmental features cue safety or threat. Our findings support that Black and Latine people value identity safety in cancer screening, and future interventions could test promoting safety cues to promote cancer screening.