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OBJECTIVE: To understand patients’ perspectives on responding to a question about their race and ethnicity in a primary care setting. DESIGN: Qualitative study using semistructured individual interviews conducted between May and July 2016. SETTING: An academic family health team in Toronto, Ont, where collection of sociodemographic data has been routine since 2013. PARTICIPANTS: Twenty-seven patients from 5 of the 6 clinic sites of the family health team, ranging in age, sex, educational background, and immigration status. METHODS: Semistructured interviews were conducted with patients who completed a sociodemographic questionnaire after registration for their medical appointment. Patients were asked whether responding to the question was difficult or uncomfortable, how they interpreted the term race and ethnicity, and what response options they considered. Interviews were audiorecorded, transcribed, and coded iteratively. MAIN FINDINGS: Patients did not report discomfort with responding to a question about race and ethnicity in their family doctor’s office. Although many patients considered the question straightforward, some patients reported different interpretations of the question. For example, some thought the question about race and ethnicity related to parental origin or ancestry, whereas others considered the question to be about personal place of birth or upbringing. Many patients appreciated being able to select from a variety of specific response options, but this also posed a difficulty for patients who could not easily find an option that reflected their identity. Patients with mixed heritage experienced the most challenges selecting a response. CONCLUSION: Patients attending a primary care clinic were not uncomfortable responding to a question about race and ethnicity. However, patients had different interpretations of what was being asked. Future research should explore perspectives of patients in other primary care settings and test different methods for collecting data about their race and ethnicity.

Ontario’s Regional Cancer Programs provide an organized system of adjuvant treatment and follow-up care in its 13 Regional Cancer Centres. For breast cancer patients in particular, these centres become a part of daily activities, as appointments over five years of cancer care result in patients repeatedly accessing these centres at varying frequencies over their treatment periods. The experience of seeking out and receiving care has grown to incorporate cancer care services that exist on a variety of spatial scales, in both formal and informal environments (e.g. support groups, workshops). This study focuses on the role of geography in health behaviors and care experiences of breast cancer patients. Individual interviews were conducted with patients (n=23) attending the Juravinski Cancer Centre in Hamilton, Ontario about their care experiences in their community, and the location and organization of the centre. Rosenstock’s (1966) health belief model and Bandura’s (1986) social cognitive theory informed the analysis of patient satisfaction and produced attitudes that impact the likelihood of health action. Results demonstrated that patients were generally satisfied with their interactions with health care providers and the design and location of the centre. Parking and perceived disconnect between the centre and community health care providers (e.g. family doctors) were identified as being sources of patient dissatisfaction. Patients made sense of their care experience through ‘routinization’ – fixed times and predictable intervals – of travel and appointment schedules. Satisfaction with accessibility to health care providers when at home (e.g. call-in services) appeared to impact at-home adherence to medication and suggested lifestyle changes. Uptake of community support services depended on patient perceptions of need, suitability and proximity, but went largely unused. Patients’ understanding of their care experiences highlight the need to give greater consideration to geography and the physical care environment in the future planning of breast cancer care services. Master of Arts (MA)