Black Breasts Matter :: Black Country ICB

Research has shown women from Black African and Caribbean communities are known to develop breast cancer at a much younger age compared to white women. It also shows that seeking help and health advice at an earlier stage can contribute significantly to reducing inequalities in breast cancer outcomes. 

Using funds from West Midlands Cancer Alliance, the involvement team have worked with colleagues from across the system to design and commission a two-stage project. The project will help understand the barriers to attending screening appointments and co-design solution-focused initiatives. It consisted of a 4-week listening period and four co-design workshops.

Project objectives

1. To identify and evidence any barriers, blockages, and stigma to screening attendance/earlier presentation at General Practice.

2. To raise awareness of signs and symptoms of breast cancer in African and Caribbean women and the importance of early diagnosis.

3. To breakdown and address any barriers and blockages.

4. To deliver specific co-designed interventions or activities that can facilitate change.

Our ICS approach to working with people and communities champions the principles of starting with people, trusted voices are key, and investing in people and communities, and we kept this at the heart of the project throughout.

Eight local VCSE organisations that are trusted voices within our black African and Caribbean communities were commissioned to host conversations with local women to understand the barriers and stigmas in attendance at screening appointments or presenting at GPs with early symptoms. After an initial call, we gave the organisations a month to go away and host conversations in a way that worked for them. As an ICB, we didn’t attend the conversations, or ask for conversations to be set up for us – the VCSE organisations had complete autonomy over the conversation and listening period.

From the conversation period, we learned so much about myths around cancer, cultural beliefs, knowledge confidence and education, and the NHS. There was so much emotion and power in the stories we heard and really built a strong connection and ignited the passion in the room to develop solutions and interventions that really helped to breakdown and address any barriers and blockages.

“Her mum died from breast cancer and dad wouldn’t talk about it, refused to let the daughters speak about breast cancer, due to the fear of inviting it. She lost her 4 sisters all to breast cancer and was with us having treatment for breast cancer herself.”

The stories and insight we heard was used to co-design solutions and interventions over a course of three workshops which were led by Dr Martin Bollard from the University of Wolverhampton:

Workshop 1: Discovering a collective narrative
Workshop 2: Product solution formulation
Workshop 3: Product design workshop

The solutions that the group designed are three-fold; an infographic that tells their story, a talking head video of a mother and daughter myth busting through conversation, and a culturally competent cancer champion and train the trainer programme. We were also lucky enough to have interest and support from Denise Lewis and Beverley Knight as local black women to help promote and spread the messages across their channels.

The scripts for all of the videos, and the design for the infographic have been produced entirely by the organisations involved in the project and everyone involved feels really proud to own these assets and use them to help facilitate change.

One of the videos, can be viewed here:

“I feel the BBM project was short but effective in the approach allowing the team to engage with the women without restrictions and excessive paperwork” – THIA CIC

“The project has been beneficial because through the representatives, it has allowed black African & Caribbean women the opportunity to have a voice. For too long, I feel policy makers have just assumed that they know best and have designed services to, generally a one size fits all approach.” – Caroline Webb, Whitehouse Cancer Support

“Many of the women didn’t know what mammograms were and the women were learning from each other, which they found more believable and relatable” – Mamta Saini, Aspiring Futures

The biggest celebration belongs to the VCSE organisations involved in the project and the women that have told their stories to create such amazing, community-designed assets: