{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:30:06Z","timestamp":1792791006185,"version":"4.5.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100004802","name":"California Breast Cancer Research Program","doi-asserted-by":"publisher","award":["24AB 1800"],"award-info":[{"award-number":["24AB 1800"]}],"id":[{"id":"10.13039\/100004802","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001006","name":"Breast Cancer Research Foundation","doi-asserted-by":"publisher","award":["BCRF-21-153"],"award-info":[{"award-number":["BCRF-21-153"]}],"id":[{"id":"10.13039\/100001006","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001006","name":"Breast Cancer Research Foundation","doi-asserted-by":"publisher","award":["BCRF-22-153"],"award-info":[{"award-number":["BCRF-22-153"]}],"id":[{"id":"10.13039\/100001006","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32MH15750"],"award-info":[{"award-number":["T32MH15750"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K99CA246058"],"award-info":[{"award-number":["K99CA246058"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Black women have the highest mortality from breast cancer compared with other racial\/ethnic groups. Black women with breast cancer also evidence compromised quality of life in some domains. Culturally relevant aspects of their experience are understudied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>The goal of this qualitative study was to examine the relevance of the Strong Black Woman schema in the cancer context.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Three Gatherings (i.e., culturally curated focus groups) were conducted with Black women who had been diagnosed with breast cancer and recruited from cancer-related listservs and events. A five-person team conducted reflexive thematic analysis of Gathering transcripts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The 37 participants ranged in age (30 to 94 years) and in diagnosis duration (2 months to 29 years). Reflexive thematic analysis yielded six themes that characterized the women\u2019s experience: historical legacy of the Strong Black Woman, navigating intersecting Strong Black Woman identities, everyday challenges encountered on the battlefield by Strong Black Women, Strong Black Woman in action during the breast cancer journey, the complexities of seeking and accepting support, and the liberated Strong Black Woman. The schema\u2019s negative consequences included the oncologic team and others expecting the participants to be strong and not to need support. Expectations to suppress emotions and continue caring for others to the neglect of the self also were evident. Positive consequences included engaging in self-advocacy in the oncologic context and redefining strength to include expressing emotions and accepting help.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The Strong Black Woman schema is highly relevant in the breast cancer context and could be addressed in culturally centered interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/abm\/kaad029","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T13:40:08Z","timestamp":1686836408000},"page":"733-742","source":"Crossref","is-referenced-by-count":8,"title":["\u201cNo Complaining, No Crying\u201d: A Qualitative Study of the Strong Black Woman Schema in the Breast Cancer Context"],"prefix":"10.1093","volume":"57","author":[{"given":"Tammie","family":"Denyse","sequence":"first","affiliation":[{"name":"Carrie\u2019s TOUCH , Sacramento, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8350-6407","authenticated-orcid":false,"given":"Kimberly J","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of California, Los Angeles , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4827-3927","authenticated-orcid":false,"given":"Jacqueline H J","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of California, Los Angeles , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8387-9556","authenticated-orcid":false,"given":"Yrvane K","family":"Pageot","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of California, Los Angeles , Los Angeles, CA , USA"},{"name":"Department of Medicine , University of California, Irvine, Irvine, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7803-5615","authenticated-orcid":false,"given":"Praise","family":"Owoyemi","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of California, Los Angeles , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamala Denise","family":"DeLuz","sequence":"additional","affiliation":[{"name":"Carrie\u2019s TOUCH , Sacramento, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9021-2549","authenticated-orcid":false,"given":"Annette L","family":"Stanton","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of California, Los Angeles , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,15]]},"reference":[{"key":"2023082117280906000_CIT0001","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J Clin."},{"issue":"1","key":"2023082117280906000_CIT0002","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1177\/0891243206294108","article-title":"You have to show strength: An exploration of gender, race, and depression","volume":"21","author":"Beauboeuf-Lafontant","year":"2007","journal-title":"Gend Soc."},{"issue":"8","key":"2023082117280906000_CIT0003","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1037\/amp0000081","article-title":"Reducing disparities and achieving equity in African American women\u2019s health","volume":"71","author":"Belgrave","year":"2016","journal-title":"Am Psychol."},{"key":"2023082117280906000_CIT0004","volume-title":"Too Heavy a Yoke: Black Women and the Burden of Strength","author":"Walker-Barnes","year":"2014"},{"key":"2023082117280906000_CIT0005","volume-title":"Black Macho and the Myth of the Superwoman","author":"Wallace","year":"1999"},{"issue":"5","key":"2023082117280906000_CIT0006","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1177\/1049732310361892","article-title":"Superwoman schema: African American women\u2019s views on stress, strength, and health","volume":"20","author":"Woods-Giscomb\u00e9","year":"2010","journal-title":"Qual Health Res."},{"issue":"3","key":"2023082117280906000_CIT0007","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1177\/1533210110386776","article-title":"Mind-body interventions to reduce risk for health disparities related to stress and strength among African American women: The potential of mindfulness-based stress reduction, loving-kindness, and the NTU therapeutic framework","volume":"15","author":"Woods-Giscomb\u00e9","year":"2010","journal-title":"Complement Health Pract Rev."},{"key":"2023082117280906000_CIT0008","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1002\/cncr.22358","article-title":"Quality of life of African American cancer survivors: A review of the literature","volume":"109","author":"Powe","year":"2007","journal-title":"Cancer."},{"issue":"1","key":"2023082117280906000_CIT0009","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10549-016-3963-0","article-title":"To be young, Black, and living with breast cancer: A systematic review of health-related quality of life in young Black breast cancer survivors","volume":"160","author":"Samuel","year":"2016","journal-title":"Breast Cancer Res Treat."},{"issue":"2","key":"2023082117280906000_CIT0010","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1002\/(SICI)1097-0142(19990115)85:2<418::AID-CNCR20>3.0.CO;2-9","article-title":"Quality of life of African-American and white long term breast carcinoma survivors","volume":"85","author":"Ashing-Giwa","year":"1999","journal-title":"Cancer."},{"issue":"4","key":"2023082117280906000_CIT0011","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1007\/s11764-009-0097-y","article-title":"Racial\/ethnic differences in quality of life after diagnosis of breast cancer","volume":"3","author":"Janz","year":"2009","journal-title":"J Cancer Surviv."},{"issue":"3","key":"2023082117280906000_CIT0012","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1007\/s10549-016-3965-y","article-title":"Understanding racial differences in health-related quality of life in a population-based cohort of breast cancer survivors","volume":"159","author":"Pinheiro","year":"2016","journal-title":"Breast Cancer Res Treat."},{"issue":"3","key":"2023082117280906000_CIT0013","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1007\/s00520-018-4545-y","article-title":"An overview of the unique challenges facing African-American breast cancer survivors","volume":"27","author":"Husain","year":"2019","journal-title":"Support Care Cancer."},{"issue":"5","key":"2023082117280906000_CIT0014","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1093\/jnci\/djr541","article-title":"Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: A systematic review","volume":"104","author":"Howard-Anderson","year":"2012","journal-title":"J Natl Cancer Inst."},{"issue":"1, Article 8","key":"2023082117280906000_CIT0015","first-page":"139","article-title":"Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory, and antiracist politics","volume":"1989","author":"Crenshaw","year":"1989","journal-title":"Univ Chic Leg Forum."},{"issue":"5","key":"2023082117280906000_CIT0016","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1037\/cou0000231","article-title":"Applying intersectionality to explore the relations between gendered racism and health among Black women","volume":"64","author":"Lewis","year":"2017","journal-title":"J Couns Psychol."},{"issue":"8","key":"2023082117280906000_CIT0017","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1080\/01612840.2019.1584654","article-title":"The Giscomb\u00e9 Superwoman Schema Questionnaire: Psychometric properties and associations with mental health and health behaviors in African American women","volume":"40","author":"Woods-Giscomb\u00e9","year":"2019","journal-title":"Issues Ment Health Nurs."},{"issue":"5","key":"2023082117280906000_CIT0018","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1002\/smi.2464","article-title":"Applying the stress and \u2018strength\u2019 hypothesis to Black women\u2019s breast cancer screening delays","volume":"28","author":"Black","year":"2012","journal-title":"Stress Health."},{"issue":"4","key":"2023082117280906000_CIT0019","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1177\/0095798414543014","article-title":"Stress and mental health: moderating role of the strong Black woman stereotype","volume":"41","author":"Donovan","year":"2015","journal-title":"J Black Psychol."},{"issue":"4","key":"2023082117280906000_CIT0020","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1037\/cdp0000015","article-title":"Anxiety and depression among African American women: The costs of strength and negative attitudes toward psychological help-seeking","volume":"21","author":"Watson","year":"2015","journal-title":"Cult Divers Ethn Min Psychol."},{"key":"2023082117280906000_CIT0021","doi-asserted-by":"crossref","first-page":"115452","DOI":"10.1016\/j.socscimed.2022.115452","article-title":"The Ubuntu Approach in Project SOAR (Speaking Our African American Realities): Building a robust community-academic partnership and culturally curated focus groups","volume":"314","author":"Denyse","year":"2022","journal-title":"Soc Sci Med."},{"key":"2023082117280906000_CIT0022","author":"APA Style","year":"2023"},{"key":"2023082117280906000_CIT0023","volume-title":"Focus Groups: A Practical Guide for Applied Research","author":"Krueger","year":"2014"},{"key":"2023082117280906000_CIT0024","volume-title":"Basic and Advanced Focus Groups","author":"Morgan","year":"2018"},{"issue":"1","key":"2023082117280906000_CIT0025","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1525822X16639015","article-title":"How many focus groups are enough? Building an evidence base for nonprobability sample sizes","volume":"29","author":"Guest","year":"2017","journal-title":"Field Methods."},{"key":"2023082117280906000_CIT0026","article-title":"\u201cI\u2019m fighting for my life\u201d: Exploring interactions between Black women with breast cancer and healthcare providers","author":"Martin","journal-title":"Qual Health Res."},{"key":"2023082117280906000_CIT0027","author":"QSR International Pty Limited","year":"2018"},{"issue":"2","key":"2023082117280906000_CIT0028","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol."},{"issue":"1","key":"2023082117280906000_CIT0029","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1002\/capr.12360","article-title":"Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches","volume":"21","author":"Braun","year":"2021","journal-title":"Couns Psychother Res."},{"key":"2023082117280906000_CIT0030","volume-title":"Transforming Qualitative Information: Thematic Analysis and Code Development","author":"Boyatzis","year":"1998"},{"key":"2023082117280906000_CIT0031","doi-asserted-by":"crossref","DOI":"10.4135\/9781526430236.n14","article-title":"Thematic analysis in organizational research","volume-title":"The SAGE Handbook of Qualitative Business and Management Research Methods: Volume 2: Methods and Challenges","author":"King","year":"2018"},{"issue":"4","key":"2023082117280906000_CIT0032","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","article-title":"Reflecting on reflexive thematic analysis","volume":"11","author":"Braun","year":"2019","journal-title":"Qual Res Sport Exerc Health."},{"key":"2023082117280906000_CIT0033","volume-title":"Successful Qualitative Research: A Practical Guide for Beginners.","author":"Clarke","year":"2013"},{"issue":"10","key":"2023082117280906000_CIT0034","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1177\/1049732304270394","article-title":"Bracketing in research: A typology","volume":"14","author":"Gearing","year":"2004","journal-title":"Qual Health Res."},{"key":"2023082117280906000_CIT0035","volume-title":"Researching Lived Experience: Human Science for an Action Sensitive Pedagogy","author":"Van Manen","year":"2016"},{"issue":"6","key":"2023082117280906000_CIT0036","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1037\/a0040323","article-title":"Incorporating intersectionality into psychology: An opportunity to promote social justice and equity","volume":"71","author":"Rosenthal","year":"2016","journal-title":"Am Psychol."},{"issue":"1","key":"2023082117280906000_CIT0037","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s40615-021-01198-y","article-title":"Contextualizing Black women\u2019s mental health in the twenty-first century: Gendered racism and suicide-related behavior","volume":"10","author":"Vance","year":"2022","journal-title":"J Racial Ethn Health Disparities."},{"issue":"9\u201310","key":"2023082117280906000_CIT0038","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s11199-018-0956-y","article-title":"Underneath the mask of the strong Black woman schema: Disentangling influences of strength and self-silencing on depressive symptoms among US Black women","volume":"80","author":"Abrams","year":"2019","journal-title":"Sex Roles."},{"issue":"7","key":"2023082117280906000_CIT0039","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1177\/00957984211021229","article-title":"The role of coping in the relationship between endorsement of the strong Black woman schema and depressive symptoms among Black women","volume":"47","author":"Jones","year":"2021","journal-title":"J Black Psychol."},{"issue":"4","key":"2023082117280906000_CIT0040","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1080\/13557858.2020.1818695","article-title":"Superwoman Schema: A context for understanding psychological distress among middle-class African American women who perceive racial microaggressions","volume":"27","author":"Knighton","year":"2022","journal-title":"Ethn Health."},{"issue":"1","key":"2023082117280906000_CIT0041","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1177\/0361684319883198","article-title":"The misunderstood schema of the strong Black woman: Exploring its mental health consequences and coping responses among African American women","volume":"44","author":"Liao","year":"2020","journal-title":"Psychol Women Q."},{"key":"2023082117280906000_CIT0042","doi-asserted-by":"crossref","DOI":"10.1037\/cdp0000533","article-title":"Association between superwoman schema, depression, and resilience: The mediating role of social isolation and gendered racial centrality","author":"Nelson","year":"2022","journal-title":"Cult Divers Ethn Min Psychol."},{"issue":"8","key":"2023082117280906000_CIT0043","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1177\/0095798417732414","article-title":"Strong Black woman schema and psychological distress: The mediating role of perceived emotional support","volume":"43","author":"Watson-Singleton","year":"2017","journal-title":"J Black Psychol."},{"key":"2023082117280906000_CIT0044","doi-asserted-by":"crossref","first-page":"115070","DOI":"10.1016\/j.socscimed.2022.115070","article-title":"Superwoman schema and John Henryism among African American women: An intersectional perspective on coping with racism","volume":"316","author":"Perez","year":"2022","journal-title":"Soc Sci Med."},{"issue":"1","key":"2023082117280906000_CIT0045","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/nyas.14188","article-title":"Racial discrimination, the superwoman schema, and allostatic load: Exploring an integrative stress-coping model among African American women","volume":"1457","author":"Allen","year":"2019","journal-title":"Ann N Y Acad Sci."},{"issue":"5","key":"2023082117280906000_CIT0046","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/geront\/gnac005","article-title":"Superwoman schema, racial identity, and cellular aging among African American women","volume":"62","author":"Thomas","year":"2022","journal-title":"Gerontologist."},{"issue":"4","key":"2023082117280906000_CIT0047","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1007\/s10943-010-9395-y","article-title":"I\u2019m a Jesus girl: Coping stories of Black American women diagnosed with breast cancer","volume":"50","author":"Gregg","year":"2011","journal-title":"J Relig Health."},{"issue":"7","key":"2023082117280906000_CIT0048","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1177\/0193945907302968","article-title":"\u201cI\u2019ve been through something\u201d: Poetic explorations of African American women\u2019s cancer survivorship","volume":"29","author":"Kooken","year":"2007","journal-title":"West J Nurs Res."},{"key":"2023082117280906000_CIT0049","author":"Anthony","year":"2021"},{"key":"2023082117280906000_CIT0050","author":"American Cancer Society"},{"issue":"5","key":"2023082117280906000_CIT0051","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1002\/pon.3620","article-title":"Psychosocial interventions addressing the needs of Black women diagnosed with breast cancer: A review of the current landscape","volume":"24","author":"Whitehead","year":"2015","journal-title":"Psycho-Oncology."},{"issue":"50","key":"2023082117280906000_CIT0052","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1093\/jncimonographs\/lgu032","article-title":"Does a community-based stress management intervention affect psychological adaptation among underserved black breast cancer survivors","volume":"2014","author":"Lechner","year":"2014","journal-title":"J Natl Cancer Inst Monogr."}],"container-title":["Annals of Behavioral Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/abm\/article-pdf\/57\/9\/733\/51201845\/kaad029.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/abm\/article-pdf\/57\/9\/733\/51201845\/kaad029.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T17:28:45Z","timestamp":1692638925000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/abm\/article\/57\/9\/733\/7198506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,15]]},"references-count":52,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,6,15]]},"published-print":{"date-parts":[[2023,8,21]]}},"URL":"https:\/\/doi.org\/10.1093\/abm\/kaad029","relation":{},"ISSN":["0883-6612","1532-4796"],"issn-type":[{"value":"0883-6612","type":"print"},{"value":"1532-4796","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9,1]]},"published":{"date-parts":[[2023,6,15]]}}}