Abstract C77: Breast cancer interventions for Latinas: Incorporating feedback from target participants, interventionists, and stakeholders
Authors: Molina Yamile , Molina Yamile , Lucio Araceli , Aguirre Karen , Torres Jessica , Hernandez-Flores Mariana , Delgadillo Maria , Miguel Liliana San , Watson Karriem S. 
Published: March 2017

Purpose: Community-based breast cancer interventions have been developed to improve Latinas' stage at diagnosis. Variation in effectiveness and sustainability may exist because of differences in formative work. Projects have largely used either the perspectives of target participants or the perspectives of community partners. Little is known about the usefulness of multi-stakeholder engagement.

Objective: We describe themes that elucidate the different perspectives of target participants, interventionists and community leaders.

Methods: The larger study seeks to compare the relative effectiveness of two interventions to promote early breast cancer detection among Latinas in Chicago, IL. The current study includes:

1. 20 women who would be eligible for the larger study (e.g., identifies as Latina/Hispanic/Chicana; 52-74 years old; lack of mammogram in past 2 years);

2. 20 women who may be interventionists (e.g., identifies as Latina/Hispanic/Chicana; 52-74 years old; history of health promotion in the past 2 years); and

3. 8-10 individuals who may be part of the advisory board (e.g., membership within the CCTS community engagement advisory board in past 2 years).

The three sets of participants were given information about the study and responded to a qualitative, semi-structured guide pertaining to optimal intervention content and protocols to promote early breast cancer detection among Latinas in Chicago. Data were analyzed using content analysis with inductive and deductive approaches as well as the principles of constant comparison.

Results: Several salient themes concerning similarities and differences in perspectives among target participants, interventionists, and community leaders.

With regard to similarities, all participants emphasized that intervention content was needed that addressed solutions to systemic barriers to mammography uptake. For example, several mentioned the need to have information about how to access low-cost/free mammography services, especially those available within women's neighborhoods. Participants also noted intervention content should be framed to emphasize the benefits of early detection for family, especially women's children. In terms of processes, participants indicated interventions should include multiple sessions or at least one booster session. They further identified faith-based organizations (FBOs) and schools are helpful stakeholders to incorporate into recruitment and dissemination efforts.

Differences also existed. There was variation in the awareness about local breast health promotion for Latinas- whereas community leaders and interventionists named multiple existing programs, target participants were not aware of any existing programs nor had participated in any programs previously. In terms of content for specific early detection practices, target participants noted emphasizing self breast exams, whereas community leaders emphasized mammograms and clinical breast exams. In terms of processes, target participants highlighted the limited utility of flyers and emphasized the need for incorporating radio/media and primary care providers, whereas interventionists and community leaders emphasized community-based organizations and healthcare system community educators.

Discussion: Our findings suggest that intervention development may vary based on the type of stakeholder that is involved. Multi-stakeholder engagement may be helpful to identify: 1) salient issues and partners (e.g., systemic mammography barriers; FBOs and schools); and, 2) when innovative solutions are needed to address different perspectives of participants and partners. Thus, multi-stakeholder engagement may be useful for developing programs that are responsive to participants' needs and partners' existing capacity.

Citation Format: Yamile Molina, Yamile Molina, Araceli Lucio, Karen Aguirre, Jessica Torres, Mariana Hernandez-Flores, Maria Delgadillo, Liliana San Miguel, Karriem S. Watson. Breast cancer interventions for Latinas: Incorporating feedback from target participants, interventionists, and stakeholders. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C77.