Abstract A025: Empowering Latinas to obtain genetic services: Comparing precision cancer prevention strategies
Authors: Torres Paola , Bujanda Carolina , Charchalac-Zapeta Celeste , Arroyo Juanita , Ganschow Pamela , Pan Vivian , Stackhouse Nathan , Kim Sage J. , Lucio Araceli , Molina Yamilé 
Published: December 2023

Abstract
Purpose: Precision cancer prevention strategies are critical for addressing the complex interplay of adverse social determinants of health (SDOH) and elevated biological risks for breast cancer (BC) among Latinas and other marginalized communities. FQHC-community-academic partnerships may have particularly high potential for operationalizing these strategies and reducing population-level disparities through enhancing genetic counseling and testing (GCT) and subsequent cascade testing/personalized care. Objective: To present emerging results from a RCT comparing the effectiveness of two precision cancer prevention strategies on increasing GCT among Latinas and networks with elevated biological and adverse SDOH risks. Methods: Latinas Lideres en Salud (LaLiSa) is an ongoing RCT is situated in a 14-site federally qualified health center (FQHC) in Chicago. This unique FQHC has a comprehensive GCT program, as part of its integration with an academic medical center. Eligibility criteria for patients include: 1) identification as Latina, Hispanic, Chicana, etc.; 2) age of 18+ years old; 3) personal or family history of BC or related cancers (e.g., ovarian); 4) no previous GCT uptake; and, 5) no prior volunteerism. Patients are randomly assigned to participate in one of two 3-week phone-based interventions from a community agency. Both interventions offer personalized BC education, SDOH screening and navigation, and free/low-cost GCT services. “Educate” offers education on risk reduction (diet, exercise). “Empower” offers skills training on sharing precision cancer prevention information with family and other network members, who can also be eligible for SDOH navigation and GCT services. Data collection includes two surveys (baseline, post-intervention) for relevant covariates and use of study/navigation records for GCT uptake. Results: Of 299 patients approached, 89 participants have enrolled in the RCT (42 educate, 45 empower), with 89% retention. Approximately 55% are 50+ years old, 85% prefer Spanish, 65% have less than a high school education, and 64% have Medicaid/Medicare. For BC and SDOH risks, 17% are cancer survivors, 81% have financial stress and 42% have other competing SDOH risks (intimate partner violence, housing instability, transit instability). No significant arm differences exist. About 76% have initiated GCT referrals and 43% of participants have received GCT services, including 70% who have been identified as having elevated hereditary risk. Empower participants have been more likely to obtain GCT services than Educate participants, (51% vs. 33%, aOR = 5.44, 95%CI[1.45, 20.40], p=.01) after adjusting for age and self-reported social desirability. Discussion: Emerging data suggest the feasibility of precision cancer prevention strategies through FQHC-community-academic partnerships. Empower approaches may be more effective for enhancing at-risk Latinas’ GCT uptake than Educate approaches, when combined with SDOH navigation and free/low-cost GCT services. Limitations concern generalizability due a small, non-probability based sample.
Citation Format: Paola Torres, Carolina Bujanda, Celeste Charchalac-Zapeta, Juanita Arroyo, Pamela Ganschow, Vivian Pan, Nathan Stackhouse, Sage J. Kim, Araceli Lucio, Yamilé Molina. Empowering Latinas to obtain genetic services: Comparing precision cancer prevention strategies [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A025.