Abstract D006: Community Research Collaboration to develop a promotor-based hereditary breast cancer education program for Spanish-speaking Latinos
Authors: Almeida Rebeca , Lopez-Macha Alejandra , Dugatkin Tania , Duron Ysabel , Fejerman Laura 
Published: September 2020

Abstract
Breast cancer is the most common cancer in Latinas and the leading cause of cancer death. Latinas tend to be diagnosed later, have poorer survival rates, and receive poorer quality care than white women. It has been well documented that women at high risk for hereditary breast cancer (women with strong family history, or BRCA1 or BRCA2 carriers) greatly benefit from genetic counseling, which enhances early cancer detection or risk-reduction strategies. Despite the growing availability of genetic counseling and testing for hereditary breast cancer, awareness and use of these services is low among Latinas. We developed a comprehensive, culturally-appropriate set of materials for a community health educator (promotor)-led hereditary breast cancer educational program for the Latino community. The conceptual framework used to design didactic curriculum and the program structure was based on the construct of “relational culture.” Materials were developed through an iterative process that involved exposure of the target populations to draft materials, discussion, and modification of materials. The focus groups took place in the cities of San Francisco, San Jose, Concord and Pittsburg between March 2018 and May 2019. We conducted 7 focus groups, including a total of 68 women (35 promotores, and 33 community members). On average, participants were 43 years old (SD= 11.62), and had been living in the U.S. for 16 years (SD= 7.55). Approximately eighty percent of the sample had limited English proficiency, fifty-one percent had public insurance, and forty-nine percent had a high school education. Sixty percent of them were unemployed, and seventy-two percent were born in Mexico. The conversation during the focus group sessions was directed towards hereditary breast cancer baseline knowledge, perceptions and learning preferences among Spanish-speaking Latino participants. A thematic analysis of the focus groups yielded five main themes: barriers, importance, dissemination, educational, and culture. 1) Barriers referred to the program’s ability to overcome traditional barriers to healthcare for Latinos; 2) Importance related to the significance of the program’s content; 3) Dissemination referred to the easiness and value of disseminating the information covered in the program; 4) Educational related to the program’s informational nature; and 5) culture referred to the program being perceived as culturally-appropriate. Results revealed that participants thought the materials were easy to understand, attractive, and engaging. They believed that the content would be easy to disseminate and important to the community. However, given that the materials encompassed genetics content, some promotores and community members expressed confusion, and feeling overwhelmed. To address this, materials were simplified, and additional didactic content was included. Future research is needed to determine the impact of the educational program on genetic counseling and screening behavior.
Citation Format: Rebeca Almeida, Alejandra Lopez-Macha, Tania Dugatkin, Ysabel Duron, Laura Fejerman. Community Research Collaboration to develop a promotor-based hereditary breast cancer education program for Spanish-speaking Latinos [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D006.