Abstract B059: Every day counts to cada dia cuenta: Adapting a behavioral intervention trial to accommodate Spanish language participants in a multisite study
Authors: Navarro Suarez Diana L. , Sheean Patricia , Alonso Estefania , Contreras Sandra , O’Connell Kathleen , Tovar Margaret , Stolley Melinda 
Published: September 2024

Abstract
Introduction. The number of women living with metastatic breast cancer (MBC) has doubled in the last decade. Hispanic women have lower incidence of breast cancer than non-Hispanic White women but are more likely to be diagnosed at an advanced stage. Targeted therapies can impose prolonged symptom burden resulting in significant distress and physical limitations for women with MBC. Minimizing symptom burden, while maximizing treatment response and quality of life (QoL) are the primary goals in the metastatic setting. Thus, the demand for evidence-based interventions to help improve QoL, prognosis and survivorship is critical. Every Day Counts (EDC) examines the impact of a diet and exercise intervention on QoL and explores potential mechanistic pathways (e.g., body composition, inflammation) linking lifestyle to QoL. Initially, study eligibility excluded non-English speakers. Given the burden of MBC among Latinas, including Spanish language participants was a priority; the process of achieving this goal is described herein. Methods: Participants complete surveys and physical assessments at baseline and are then randomized to the 16-week lifestyle intervention OR the attention control organizational program. Both are led by a trained coach and include a program binder and weekly text messages whereas only the intervention receives a Fitbit and cooking classes. After the16-week program, participants complete surveys and physical assessments, and the control group participants crossover to the lifestyle program. Surveys include QoL, diet, physical activity, pain, cognitive function, sleep, outcome expectancy, social support, mood, and self- efficacy. Physical assessments include a 24-hour diet recall, DEXA, 6-minute walk, sit-to-stand, handgrip, arm curl, single leg balance, and blood draw. Adapting the trial for Spanish language participants required multiple steps and was led and implemented by bilingual, bicultural staff that went beyond translation and back-translation. Material Inventory. Review participant- facing materials to inform plan for adaptation and translation. Survey Review (N=17). Identify which measures are available and validated in Spanish using Pubmed and other search engines and/or contacting instrument author(s). Intervention Review. Staff review for content relevance for Latinas, include images and recipes illustrative of Latina culture. Translation. The study used a translation/back-translation process for recruitment scripts and materials, consent form, all surveys not available in Spanish, physical assessment protocols, intervention and control materials and text messages. Translation Review. To ensure the context of translation across dialects common to the Midwest, materials were reviewed by community members (Mexico, Puerto Rico, Dominican Republic), with discrepancies resolved by staff. Discussion:: Transitioning studies to be more inclusive will increase critical access to much-needed trials that will impact disparities evident among minoritized communities.
Citation Format: Diana L. Navarro Suarez, Patricia Sheean, Estefania Alonso, Sandra Contreras, Kathleen O’Connell, Margaret Tovar, Melinda Stolley. Every day counts to cada dia cuenta: Adapting a behavioral intervention trial to accommodate Spanish language participants in a multisite study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B059.