Building Mixtec Community Capacity for Breast Health,Phase 2
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: Introduction: Mixtec have immigrated from one of the poorest areas of Mexico and have become one of the largest indigenous groups of farm workers in California, estimated at 82,000 to 125,000. Mixteco/Indigena Community Organizing Project (MICOP), a 501(c)(3) nonprofit corporation, was founded in 2001 and provides referrals to health and social services, case management, trainings and educational workshops, language interpretation services, along with cultural pride and awareness events for the indigenous community in Oxnard, Ventura County. UCLA and MICOP have completed a CRC pilot study (focus groups and almost 1,000 household surveys) which showed extremely low breast cancer screening rates (11% of women 50 years and older had a mammogram within the past 24 months) and provided suggestions from the community on how to promote breast health. We also introduced many community members to research and developed acceptable research methods. 
 
 
 
 
 
 Question(s) or hypotheses: This application for a second Pilot CRC Award proposes to conduct qualitative research on key issues that will shape future interventions to promote breast health in the indigenous community. We will seek to understand community norms regarding what constitutes good health, how to maintain health and how to prevent disease. We will learn about community experiences with the health care system, specifically when community members seek health care, how they communicate with health care providers and to what extent do they understand what providers tell them, and what financial implications of utilizing the health care system are. We will also explore factors that positively and negatively affect breast cancer risk, such as lifestyle and environmental factors. We will debrief promotoras and interpreters who are employed by health care providers in Oxnard to learn from their experiences of how they assist community members to navigate the health care system, what strategies they use successfully and what obstacles they encounter in their daily work with this population. 
 
 
 
 
 
 General methodology: We will train indigenous promotoras to conduct one-on-one in-depth interviews in indigenous languages or Spanish and to prepare a detailed written or oral report of what was discussed and what opinions were expressed by respondents. Trained promotoras will conduct one-on-one interviews with indigenous women. They will debrief indigenous women after a health care encounter to learn details of a specific health care experience; and they will pose a series of questions to promotoras and interpreters and ask them to recount recent experiences with patients (without revealing their names). While some of these queries will be structured by an outline of questions and topics, others will be relatively open and unstructured following the tradition of story-telling, Promotoras will audio-record the interviews and work in a team to transcribe the discussions into Spanish or English. Data will be analyzed using techniques based on grounded theory methodology. 
 
 
 
 
 
 Innovative elements: Innovative aspects of this proposal are the focus on an indigenous community, focus on community norms and behaviors regarding health and disease prevention that will guide us in framing future programs on breast health, drawing on the experiences of indigenous navigators and interpreters who assist this community in a number of health care settings, and exploring a new methodology of having trained promotoras transcribe key informant interviews in a team approach.
 
 
 
 
 
 Community involvement: Breast health was identified as a health priority in focus groups with both Mixtec promotores and women in the Mixtec community. The proposal was jointly developed by MICOP, Every Woman Counts and UCLA. The Mixtec Advisory Committee as well as a group of 10 promotores voted to support the proposed study and provided letters of support. The community will stay involved and informed about the project through updates at the monthly community meetings that are often attended by several hundred members of the Mixtec and Zapotec community. The Mixtec Advisory Committee has agreed to review all study protocols and assessment forms, advise on all activities throughout the study, and assist in interpretation and dissemination of the findings. 
 
 
 
 
 
 Future Plans: Our research partnership is committed to continue research in the indigenous community relevant to breast health, such as nutrition and safety around pesticides, as well as other health issues. An in-depth understanding of the issues that will be explored in this qualitative study will provide a strong foundation for a future intervention to address breast health in this community. Long-term goals are to continue to build the Mixtec community capacity to engage in research, to address breast cancer disparities and to promote breast health.