Centering Identity and Connection: Exploring Motivations for Participation in a Psychosocial Intervention Among Black and African American Cancer Survivors

Background and Purpose: Black and African American women remain underrepresented in psychosocial cancer research and underserved by supportive care interventions. Despite experiencing elevated psychological distress, they are significantly less likely to be referred to or engage with psychosocial services due to structural inequities, medical mistrust, stigma, and practical barriers such as financial strain and lack of culturally appropriate services. The combination of under-referral, cultural disconnect, and invisibility within mainstream programming contributes to higher unmet needs and emotional burdens across the cancer continuum. This study explores the motivations that led Black and African American cancer survivors to participate in Mind Over Matter (MOM), a five-week group-based intervention designed to promote emotional resilience using cognitive behavioral therapy, acceptance and commitment therapy, and mind-body practices in a culturally responsive framework.

Methods: A qualitative descriptive design was employed. Fourteen Black women were purposively sampled from the MOM pilot study and participated in one of three virtual focus groups conducted after completing the intervention. Discussions focused on participant motivations, perceived relevance of the intervention, and overall satisfaction. Transcripts were analyzed using thematic analysis in Dedoose, with coding led by a multidisciplinary team of researchers, clinicians, and patient advocates.

Results: The participants were, on average, 55(+ 9.7) years old, African American (n=14), married (n=8), educated (n=13), had breast cancer (n=11), stage I and II (n = 9), were diagnosed 5 (+ 4.0) years ago, currently with no evidence of disease (n=8), and had private health insurance (n=8). Three primary themes emerged: (1) Desire for connection, highlighting participants’ yearning for a space where their experiences would be understood without explanation; (2) Representation in research, reflecting a deep appreciation for a study that intentionally centered Black voices in cancer care and addressed cultural invisibility; and (3) Desire to give back, with many participants expressing their hope that their involvement would support future Black survivors and drive system-level change.

Conclusions and Implications: Motivations for joining MOM extend beyond individual benefit and are grounded in a broader desire for culturally safe, relationally rich, and community-informed care. These findings underscore the importance of developing recruitment strategies that center cultural representation and belonging. Future psychosocial interventions should acknowledge the relational and justice-oriented motivations of Black participants and ensure co-design with communities to enhance relevance, equity, and impact.