Abstract B25: Empowering Latinas to obtain breast cancer screenings: Comparing intervention effects, part 1
Authors: Molina Yamile , Miguel Liliana G. San , Tamayo Lizeth , Gonzalez Sylvia , Torre Rosa de la , Peña Kryztal , Lucio Araceli , Hernandez Oliva , Arroyo Juanita , Medina Maria C. , Coronado Nora 
Published: February 2019

Purpose: Latinas suffer disproportionately from breast cancer relative to non-Latina Whites (NLWs), partially due to lower guideline-concordant screening. In response, a significant body of work first sought to characterize disparities and associated determinants. Second, multiple approaches were developed to address this disparity, including community health worker (CHW)-driven education to the target population and empowerment interventions, wherein CHWs train a subset of the population to disseminate education to other members of the target population and mobilize in the context of health. The next logical step is to compare the relative effectiveness of interventions for future large-scaled implementation.

Objective: We report emerging evidence from an ongoing, quasi-experimental trial that compares the effects of education and empowerment approaches on Latinas who are nonadherent to US Preventive Services Task Force breast cancer screening guidelines.

Methods: The setting for this trial is in two Latino, lower-income communities in Chicago (Pilsen/Little Village, East Side/Chicago). Women are recruited via two community-based organizations (The Resurrection Project, Centro Comunitario Juan Diego) and snowball sampling. Eligibility criteria include: 1) age of 50-74; 2) lack of screening within past 2 years; 3) no previous breast cancer diagnosis; and 4) no prior health volunteerism experience. After screening and providing informed consent, women are assigned to a cohort (6-10 sessions) and participate in a three-week intervention (three 2-hour sessions). The education intervention is administered in East Side/Chicago and the empowerment intervention is administered in Pilsen/South Chicago to avoid contamination effects. The education intervention consists of a session focused on breast cancer and methods of early detection, a session focused on diet as a method of prevention, and a session focused on physical activity as a method of prevention. The empowerment intervention consists of a session focused on breast cancer and methods of early detection, a session focused on one-on-one conversations with family and friends about breast cancer, and a session focused on health-related volunteerism. For women who wish to obtain mammography (from either arm), study team provides navigation to free/low-cost services and tracks participants throughout the continuum of care. Three questionnaires are given: baseline (before Session #1), postintervention (after Session #3), and a follow-up (6 months after Session #3). Receipt of screening is confirmed by study and medical records for women who have completed HIPAA forms. Participants are compensated $80 for their participation. As well, during and after the intervention, participants may refer other nonadherent Latinas to the study for a small incentive ($15).

Results: Our current sample is 37 women (20 education; 17 empowerment). The average age was 61.62 years old (SD = 6.02). Approximately 89% of participants were born in Mexico and approximately 81% had less than a high school education. The median annual household income was &lt;$15,000. A greater proportion of empowerment participants have scheduled a mammogram relative to education participants (20% vs. 76%; p=.001). Relative to education participants, a greater proportion of empowerment participants have discussed breast cancer with other nonadherent Latinas and referred them to the study (5% vs 33%; p = .05).

Discussion: Preliminary findings suggest the empowerment approach may be more effective in promoting breast cancer screening among nonadherent Latinas and disseminating information to their peers. Limitations concern generalizability due to a non-probability based sample and limited ability for causal inferences due to a lack of randomization. Next steps include comparing receipt of screening and characterizing diffusion of information throughout participants' social networks.

Citation Format: Yamile Molina, Liliana G. San Miguel, Lizeth Tamayo, Sylvia Gonzalez, Rosa de la Torre, Kryztal Peña, Araceli Lucio, Oliva Hernandez, Juanita Arroyo, Maria C. Medina, Nora Coronado. Empowering Latinas to obtain breast cancer screenings: Comparing intervention effects, part 1 [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 B25.