Abstract A22: Developing an intervention to promote breast cancer control among minorities
Authors: Hinton Lisa , Lam Helen , Kim Karen 
Published: May 2015

Background: Many studies suggested that culturally specific interventions were needed to improve cancer screening among minorities. However, the development process of such interventions and how they work are rarely mentioned. Theory-driven interventions are highly recommended. Using theories to guide the development of interventions for minority groups may not be adequate, since most theories were developed and tested in Euro-Americans and may not reflect the minority groups' life experience. In this study, we described how an intervention to promote breast cancer control among minorities was developed based on a well-studied theory and life experience from one of the minority populations - African American (AA).

Intervention Development: The development of this innovative intervention, “A Walk Through The Cure”, involved three phases. During the first phase, focus groups were conducted in the targeted AA community. Focus groups are useful to exploring people's knowledge, beliefs, perceptions and experiences. They allow us to examine not only what participants think, but how they think and why they think that way. Focus groups are particularly sensitive to cultural variables. In phase 2, the focus group findings were organized using the Theory of Planned Behavior (TPB). The TPB was designed to address behaviors over which individuals have some choices and control. The TPB is based on the assumption that individuals are rational and that they make systematic use of information available to them, and that they consider the implication of their actions before they behave. Phase 3 was to design an intervention based on the information from phase 2. The goal of the new intervention was to create an interactive environment to provide a mechanism for participants to understand the process of breast cancer care. The new intervention allows participants to gain knowledge through direct experience and provides an opportunity to communicate and discusses myths and perceptions with health providers in a less threatened real-life setting.

Pilot Study: Twenty-five community health workers and community members from a local African American community were invited to participate in the “A Walk Through The Cure” program. Participants were led on a walking tour of breast cancer care related centers, including Breast Health Center, Oncology clinic and Infusion Center, Oncology Radiation Center and Cancer Resource Center at the medical center. Each stop of the tour was staffed by a faculty member. A mini lecture was given by the faculty at each stop and participants were encouraged to ask questions. The tour lasted about two hours, and ended with an interactive discussion led by breast cancer survivors who shared their story of survival. Qualitative data were collected through a survey with open-ended questions. The overall feedback was positive and encouraging, and all participants reported an increase in breast cancer control related knowledge by comparing a pre and post self-assessment.

Conclusion: Most of the intervention studies focused on evaluating the overall relationship between an intervention and outcomes without concerning the transformation process or underlying mechanism. Without knowing what made the intervention work or not working, it would be difficult to pinpoint what needed to be done for future improvement or development. This study laid out the underlying mechanisms of an innovative intervention. Although strategies to replicate interventions from one minority group to another have yet to be identified, successful replications depend upon many factors, such as the degree of overlap in cultural beliefs, health beliefs, health practices, and the focus of the intervention. We plan to test the intervention in other minority groups.

Citation Format: Lisa Hinton, Helen Lam, Karen Kim. Developing an intervention to promote breast cancer control among minorities. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A22. doi:10.1158/1538-7755.DISP13-A22