Abstract B015: Using co-design to develop culturally and linguistically appropriate breast cancer education materials
Authors: Serrano Mayra , Garcia Marisela , Nerio Katty , Brown Shirley , Lin Florence , Loh Alice , Lopez Ghecemt , Tucker Patricia D. , Ashing Kimlin T. , Bernstein Leslie , Chen Shiuan , Rakoff Michele , Neuhausen Susan 
Published: January 2023

Abstract
Background: Engaging diverse community members in research is vital to communicate and disseminate information to their communities. Co-design is a participatory approach to design solutions to problems and can be used to develop materials by bringing together individuals from diverse backgrounds. There is currently a gap in research of health education materials (i.e., Infographics) being created that employ a community co-design approach. We describe use of the co-design process to develop an infographic on breast cancer risk factors for broad community dissemination. Methods: The Community Leadership Committee (CLC) that represents the demographics of the Greater Los Angeles area was formed in 2015 and members were drawn from community and advocacy organizations, representing the four largest racial/ethnic groups (African American, Chinese, Latina, and Non-Hispanic White). The primary role of the CLC was to help create teachable, culturally-responsive materials on breast cancer and the environment. To address their communities’ informational needs about breast cancer and the environment, the CLC determined elected to develop infographics. Focus groups were held in summer of 2017 to evaluate the initial drafts of the infographics for clarity, utility, cultural and linguistic appropriateness and effectiveness. Focus group participants were recruited by the CLC members to and were conducted in English, Spanish, or Mandarin Chinese. Results: CLC members (N=18) informed the design and development of the infographic. Members of the CLC member ages ranged from 49 to 79. All members were female, 42%% were foreign-born, 34%% spoke Spanish, 20% spoke Chinese, and 75% were breast cancer survivors. A total of 6 focus groups were conducted with 53 women. The groups consisted of 4 groups in the English language [African American (N=12), non-Hispanic White (N=7), Chinese (N=9), and Hispanic/Latina (6)], one in Spanish (N=7), and Mandarin Chinese (N=12). The infographic went through 6 versions before being finalized, translated into Spanish and Chinese, and printed. Focus groups occurred between initial draft and draft #3. Some of the common themes included the importance of representation, readability, and visualization. CLC members preferred materials that included less text and more graphics to make it faster and easier to read. Collaboration with the CLC and findings from the focus groups led to the development and refinement of the final infographics Discussion: We have described the development of health education materials through a co-design process to increase the awareness of breast cancer risk. These findings emphasize the importance of involving people with lived experience and end users. Co-design is vital to ensuring the health education materials were appropriate, engaging, culturally and linguistically competent. Health education materials that resonate with their intended audience have the potential to influence health behaviors resulting in risk reduction.
Citation Format: Mayra Serrano, Marisela Garcia, Katty Nerio, Shirley Brown, Florence Lin, Alice Loh, Ghecemt Lopez, Patricia D. Tucker, Kimlin T. Ashing, Leslie Bernstein, Shiuan Chen, Michele Rakoff, Susan Neuhausen. Using co-design to develop culturally and linguistically appropriate breast cancer education materials [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B015.