Abstract PO-028: Successful implementation of Latina breast health programs: A multi-stakeholder analysis to answer a multilevel question
Authors: Molina Yamilé , Chebli Perla , Torres Stephanie A. , Olazar Joanna , Olazar Jeanette , Reyes Katherine , Arroyo Juanita , Medina Maria , Coronado Nora , Lucio Araceli , Rauscher Garth H. , Green Lauren , Ganschow Pamela , Kroenke Candyce H. , Atkins Marc 
Published: January 2022

Abstract
Background: Multiple interventions have been developed to address Latina-White breast cancer (BC) disparities. Yet, little is known about what drives successful implementation, resulting in limited and less successful translation to practice. Engaging participants, community staff, and academicians in program evaluation may enhance identification of factors driving implementation, given differences in lived experience and intervention roles. Objective: We engaged 20 Latina participants, 3 community health workers (CHWs), and 3 research staff to identify determinants of: (1) intervention appropriateness (extent to which interventions addressed BC disparities), (2) feasibility (extent to which intervention delivery/participation was possible), and (3) acceptability (extent to which interventions were satisfactory). Method: The “Empowering Latinas to Obtain Breast Cancer Screenings” trial compared the efficacy of two interventions on BC screening uptake among 142 Latinas who were non-adherent to US Preventive Services Task Force (USPSTF) BC screening guidelines. Both interventions employed CHWs with personal/family history of BC to deliver 3 group sessions and refer patients to navigation services. The current study focuses on a qualitative program evaluation of the trial. All participants completed audio-recorded semi-structured interviews. A sample question was “What helped make it possible to participate in/lead the intervention?.” We conducted deductive content analysis, guided by the Consolidated Framework for Implementation Science, on verbatim transcripts. Results: Emergent themes suggest distinct multilevel determinants of different implementation outcomes. Intervention acceptability and appropriateness were driven by (1) characteristics at intervention (e.g., adaptability to personal needs – e.g., personalized literacy assistance; addressing diverse barriers to BC screening); (2) characteristics of the CHW interventionists (e.g., information delivered via BC survivors' personal experiences); and, (3) characteristics of organizations (e.g., trusted service providers). Intervention feasibility was driven by (1) organizational (e.g., intervention compatibility with mission; clear delineated a priori tasks for intervention delivery) and (2) partnership characteristics (e.g., strength of relationships between academics, community leaders, and clinical navigation BC services). Differences in stakeholder perspectives aligned with their lived experiences. For example, participants' personal challenges with BC screening, CHWs' past experiences leading BC programs, and researchers' awareness of past research on BC disparities affected perceptions about intervention appropriateness. Conclusions: Our findings highlight the value of multi-stakeholder analysis and specify the types of intervention and study team characteristics that are needed to make interventions appropriate, acceptable, and feasible for Latina-White BC equity.
Citation Format: Yamilé Molina, Perla Chebli, Stephanie A. Torres, Joanna Olazar, Jeanette Olazar, Katherine Reyes, Juanita Arroyo, Maria Medina, Nora Coronado, Araceli Lucio, Garth H. Rauscher, Lauren Green, Pamela Ganschow, Candyce H. Kroenke, Marc Atkins. Successful implementation of Latina breast health programs: A multi-stakeholder analysis to answer a multilevel question [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-028.