Abstract 10: The Evolution of Parents' Beliefs about Childhood Cancer: A Qualitative Study in Guatemala

Purpose: Ninety percent of children with cancer live in low- and middle-income countries, and fewer than 40% survive. In these countries, rates of treatment abandonment can be up to 50-60%, contributing to the mortality gap. Fatalistic cancer beliefs may lead to delayed diagnosis and poor outcomes, including treatment abandonment. This study explored the evolution of Guatemalan parents9 cancer beliefs during initial pediatric cancer communication, and the sociocultural and contextual factors that influence these beliefs. Methods: Twenty families of children with cancer were included in this study. We audio-recorded initial psychosocial and diagnostic conversations between parents, psychologists, and oncologists, then conducted semi-structured interviews with parents. Audio-recordings were transcribed and translated from Spanish into English and thematically analyzed. Results: Guatemalan parents9 beliefs evolve as they learn about cancer through various sources. Sources of information external to the cancer center, including prior experiences with cancer, media exposure, community discussion, and clinical encounters, contribute to pre-existing beliefs, many of which are fatalistic and influenced by Mayan spirituality. Sources internal to the cancer center include psychologists and oncologists, other providers, other patients and families. Psychologists acknowledge pre-existing beliefs and deliver cancer education using verbal explanations and hand-drawings. Oncologists provide diagnostic information and outline treatment plans. Both support hope by providing a path toward cure. Parents9 lived experience is a culmination of sources and simultaneously independent. Ultimately most parents arrive at an understanding of cancer that is consistent with an allopathic medical model and offers optimism about outcomes. Conclusion: An interdisciplinary communication process that includes multimedia education, is attentive to pre-existing beliefs, and supports hope may encourage acceptance of the allopathic model and need for treatment. Providers in settings of all resource levels may be able to use these techniques to support cross-cultural cancer communication, reduce treatment abandonment, and improve therapy adherence. Citation Format: Dylan Graetz, Silvia Rivas, Lucia Fuentes, Annie Caceres-Serrano, Gia Ferrara, Antillon-Klussmann, Monika Metzger, Carlos Rodriguez-Galindo, Jennifer Mack. The Evolution of Parents9 Beliefs about Childhood Cancer: A Qualitative Study in Guatemala [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 10.