Abstract B38: The ties that bind: Associations of communication, cancer history, and screening intention among diverse Kin KeeperSM families
Authors: Nolan Timiya S. , Tan Alai , Williams Karen Patricia 
Published: February 2019

Background: Breast cancer incidence rates are increasing among women of color as compared to non-Latina white women as mortality rates are decreasing at slower rates. Latina women have the highest incidence of cervical cancer, followed by African American (AA) women. AA, Latina, and Arab women are more frequently diagnosed with advanced stage cancers than non-Latina Whites, which increases the risk of cancer-related death. Though breast and cervical cancer are screen detectable, most Americans are unaware of mammography and/or Pap smear screening guidelines. Understanding health disparity and deficient health literacy among women of color, the Kin KeeperSM Cancer Prevention Intervention was developed and culturally targeted to improve breast and cervical cancer literacy as well as increase health-related behaviors among AA, Latina, and Arab women living in Michigan. The purpose of this abstract is to describe a secondary analysis of associations between family communication, family cancer history, and screening intention among the nonadherent study participants (those who had never been screened or who were nonadherent to published guidelines as of 2010).

Methods: Delivered by community health workers, the Kin KeeperSM intervention educated female family members in at-home group settings. Data collected were sociodemographics, family communication (Family Adaptability and Cohesion Scale IV), family history of any cancer, and mammography or Pap smear screening intention within 12 months (Kin KeeperSM Personal Action Plan). We conducted descriptive statistics, chi-square, and multiple logistic regression analyses.

Results: Of the 516 Kin KeeperSM participants, 123 (AA-39.0%; Latina-15.4%; Arab-45.5%) and 98 (AA- 26.5%; Latina- 16.3%; Arab- 57.1%) women reported that they were not adhering to the published guideline for mammography (yearly after age 40) or Pap smear (every three years) exams, respectively. After adjusting for women's sociodemographics (age, ethnicity, marital status, education, employment, and insurance), receiving the Kin KeeperSM intervention (OR = 1.95 for mammography; OR = 1.62 for Pap smear) and higher family communication (OR = 2.57 for mammography; OR = 3.68 for Pap smear) increased the likelihood of having intent to screen within 12 months. Family history of cancer increased the likelihood of planning for mammography (OR = 2.25); however, family history did not affect Pap smear screening intention (OR = 0.92).

Discussion/Conclusion: Kin KeeperSM with its family-centered approach improved mammography and Pap smear screening intention among a group of nonadherent, diverse women. Given that planning for a Pap smear exam was not likely to be affected by family history of cancer or ever having screening, women may not associate the Pap smear exam with cancer screening. Further study is warranted to identify factors associated with improving Pap smear adherence.

Citation Format: Timiya S. Nolan, Alai Tan, Karen Patricia Williams. The ties that bind: Associations of communication, cancer history, and screening intention among diverse Kin KeeperSM families [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B38.