Communicating Breast Cancer Risk in Ethnically Diverse Women
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: In the recently completed Breast Cancer Prevention Trial, tamoxifen has been reported to decrease the risk for developing breast cancer by 49%. Decisions about risk reduction must involve patients and health care providers in an informed-decision making process with careful consideration of individual risk factors and the potential risks and benefits of prescribed treatments. As a necessary first step in translating the recent breast cancer prevention results to clinical practice involving ethnic minority women, educational interventions which can effectively present quantitative information need to be developed. The purpose of the current proposal will be to develop and begin evaluation of a risk communication educational tool designed to facilitate accurate risk comprehension and subsequent transfer of the landmark tamoxifen breast cancer prevention results into a primary care setting of a public hospital based population of both English and Spanish speaking women. 
 
 
 
 
 
 
 
 A qualitative and quantitative approach will be used to inform the development of the format and language of the risk communication tool. All materials will be developed in English and Spanish using recognized techniques involving focus groups (2 African American, 2 Caucasian, 2 Hispanic English speaking, 2 Hispanic Spanish speaking, N=60-70), forward and backward translation, pre-testing (N=40, ten women from each ethnic/language preference group) to determine clarity, meaningfulness, and level of understanding, and test-retest reliability of the outcome measures. A pilot study involving a pre-test, post-test design will begin evaluation of the culturally sensitive risk communication tool on accuracy of risk perception compared to objective risk and accuracy of the perceived magnitude of breast cancer compared to other competing health risks, i.e., heart disease. Breast cancer risk will be determined using the Gail model and heart disease risk will be determined using criteria from the Framingham Study. Women will complete a pre-test questionnaire to identify demographic characteristics, individual risk factors for breast cancer and heart disease, perceived risk of breast cancer and heart disease, level of understanding of numeracy, and level of acculturation (Hispanic women only). To assess heart disease risk, women will have blood pressure, ECG and a fasting lipid determined. One to two weeks later they will return for a visit to receive results of their risk assessment using the newly developed risk communication educational tool and will complete a post-test questionnaire assessing perceived risk and level of numeracy. The impact of the risk communication tool on improvement of risk comprehension will be determined form pre-test to post-test. 
 
 
 
 
 
 
 
 Results from the successful completion of this project will support and inform the design of a full-scale randomized definitive trial of the effectiveness of the risk communication tool in public hospital and clinic settings.