E-messaging for Abnormal Mammogram Follow-up in Latinas
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: Latina women are more likely to be diagnosed with an advanced stage of breast cancer and are 20% more likely to die of breast cancer than non-Hispanic white women. Early diagnosis and treatment has been shown to improve survival, and following up on abnormal breast exams is critical to reduce death from breast cancer. Reminder systems can encourage women to have mammography exams. Fortunately, U.S. Census data show that 95% of families below the poverty level have telephones, and telephone reminders are more effective than mailed ones. 
 
 
 
 
 
 Question(s) or hypotheses: We believe that encouraging women to go to follow-up appointments soon after they have an abnormal breast exam will reduce the number of late stage breast cancers in Latina women, and improve overall survival from this disease. We propose an 18 month research pilot project to develop a culturally sensitive automated Breast follow-up Communication (ABC) message approach to improve attendance at follow-up appointments for abnormal mammogram results. We will talk to breast cancer survivors and health care professionals to find out what types of messages would be acceptable and culturally appropriate. We will also test the ABC messages with women from Tiburcio Vasquez Health Center (TVHC) who have received an abnormal mammogram. TVHC is a federally qualified health center that has four clinics in southern Alameda County, serving primarily Latinos
 
 
 
 
 
 General methodology: Aim I. We will hold 3 one hour focus groups with Latina breast cancer patients enrolled through groups connected to our community advisory board (CAB). Based on this information, the team will develop culturally acceptable patient ABC messages to motivate patients to complete follow-up care for their abnormal mammogram. Aim 2: We will interview 10 primary care providers at TVHC and referral health centers. Provider ABC messages will be developed from this input. Aim 3: Thirty women who have had an abnormal mammogram result will be assigned by chance to receive either current standard of care plus the messages right away (the intervention arm,15 women) or to get current standard of care but wait to get the messages (wait-list control arm, 15 women). Women in the intervention arm will receive four reminder ABC messages spaced over a two week period from the date of their abnormal mammogram receipt at TVHC. Women in the control arm will not receive these messages for four weeks but will then receive the same intervention. Data Analysis: Age and other characteristics will be collected to make sure they are no important differences in the two groups. We will compare how long it takes for women to come to their follow-up appointment. This will allow us to determine the impact of the ABC messages and whether specific characteristics are more likely to be present in women that quickly attend their follow-up visits. 
 
 
 
 
 
 Innovative elements: There are currently no other studies looking at electronic messaging reminder systems to ensure high-quality and timely follow-up of abnormal mammogram results. These systems must be built in conjunction with the needs of overburdened, understaffed and underfunded health clinics such as TVHC, and understanding the cultural requirements of the patient population. The long-term potential of this research is to increase breast cancer survival and reduce disparities. 
 
 
 
 
 
 Community involvement: TVHC has been instrumental in developing this proposal and initially discussed a collaboration with the Cancer Prevention Institute of California staff. Additionally, breast cancer advocates have been involved in developing this proposal, and will continue to be involved throughout the research project. Our CAB includes participation from major breast cancer advocacy organizations in the Bay area. Through our collaboration with TVHC and the CAB, we have integrated aspects into the project to ensure the sensitivity to the human issues and breast cancer advocacy concerns. 
 
 
 
 
 
 Future Plans: We anticipate that the results of this pilot project will be used as preliminary data for a larger application to evaluate the ABC message intervention in a large randomized trial. This application will be directed to CBCRP, Department of Defense or the National Institutes of Health.