Abstract A048: Creating a mobile device-based educational intervention for African American women with hereditary breast cancer risk
Authors: Comer-HaGans DeLawnia , Coffey Vickii , Grumbach Giesela , Spencer Shirley , Rodgers Carolyn , Kaur Ravneet , Aguirre Karen , Chukwudozie Ifeanyi Beverly , Henderson Vida , Watson Karriem S. , Balthazar Catherine , Odoms-Young Angela , Winn Robert A. , Hoskins Kent F. 
Published: August 2020

Abstract
Background: Our foundational work found very low rates of attendance at a genetic counseling (GC) consultation among AA women with hereditary breast cancer (BC) risk who were referred for GC, and a strong desire among women and their primary care physicians (PCPs) for culturally sensitive educational material to help women understand the purpose of GC. We are creating a story-based educational intervention delivered on a mobile device platform that is designed to motivate AA women with familial BC risk to attend GC. Content for the intervention is informed by constructs from the Integrative Model of Behavioral Prediction and by themes identified through qualitative research with high-risk AA women. Kreuter's model for culturally tailoring health interventions guided the creation of the intervention.
Methods: Using an iterative process encompassing semistructured, one-on-one interviews and group story circles with AA women referred for GC (primarily nonattenders), we identified themes that represent barriers and motivators to attendance for AA women. The storyline and educational content for the script were based on the themes identified. The script and artwork were tested with focus groups that included members of the target audience AA women with a family history of BC) and key community stakeholders. We are also conducting key informant interviews with PCPs providing care for AA women. The intervention, which will include live-action video sequences and segments of animation to illustrate key educational content, is based on the script that emerged through this iterative process.
Results: Findings from semistructured interviews (N=20) were augmented with data collected from group story circle sessions with a subgroup of women who participated in the one-on-one interviews (N=11). Nine thematic domains emerged from the combined data that are relevant to attendance at a GC appointment: (1) health education/health literacy, (2) trust, relationships, communication with providers, (3) empowerment, (4) health beliefs, (5) motivation/facilitators of breast care, (6) family support and secrecy, (7) religion/spirituality, (8) barriers, and (9) fear resulting from equating genetic counseling with receiving a cancer diagnosis. The findings were used to create a story-based script. Focus groups conducted with community stakeholders and the target audience led to revision in the overall design and style of the intervention (e.g., increased use of live actors and decreased animation) and additional content revisions (e.g., addressing familial secrecy and self-efficacy for women who do not have a referral for GC from a physician). Additional findings from focus groups will be presented and the completed educational video will be previewed.
Conclusion: A technology-enabled, culturally sensitive educational intervention that motivates AA women with increased BC risk to attend a GC consultation will facilitate implementation of a population health approach to eliminating BC disparities.
Citation Format: DeLawnia Comer-HaGans, Vickii Coffey, Giesela Grumbach, Shirley Spencer, Carolyn Rodgers, Ravneet Kaur, Karen Aguirre, Ifeanyi Beverly Chukwudozie, Vida Henderson, Karriem S. Watson, Catherine Balthazar, Angela Odoms-Young, Robert A. Winn, Kent F. Hoskins. Creating a mobile device-based educational intervention for African American women with hereditary breast cancer risk [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A048.