Building Mixtec Community Capacity to Address Breast Health
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. An estimated 20,000 Mixtecs live in Ventura County. Many are unable to read and write even at a basic level in any language and speak neither Spanish nor English, but only their native non-written Mixteco language. They face exploitation and discrimination in labor, housing and everyday life and most live in extreme poverty. 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 to about 5,000 individuals annually. The UCLA Center for Cancer Prevention and Control Research has assisted MICOP with training Mixtec-Spanish bilingual promotoras and during that training, MICOP staff and promotores identified breast health as a community priority. 
 
 
 
 
 
 Question(s) or hypotheses: The pilot CRC represents one of the first research projects in the Mixtec community with a focus on breast health. We will need information on community demographics and breast cancer screening utilization and a method for recruiting Mixtec women before we can launch a trial in this population. Research questions center around how to best reach out to Mixtec farmworkers, what types of programs can be successfully implemented, and what are scientifically rigorous study methodologies that are acceptable to this community. 
 
 
 
 
 
 General methodology: MICOP promotores will conduct a door-to-door needs assessment with at least 1,000 households to obtain information on household composition, needs, and service utilization, including breast cancer screening among age-eligible women, as well as eliciting community concerns and current access to service agencies. This directory will be a tool for recruiting community members for breast cancer research and other studies and will assist MICOP in planning and delivering community services. We will conduct focus groups and one-on-one interviews with women and men, as well as one-on-one interviews with staff from 3 community clinics to learn about barriers and facilitators of breast cancer screening and to explore how we can adapt evidence-based strategies to promote breast health for the Mixtec population. By working together, we hope to strengthen our partnership, and we will conduct a partnership evaluation to determine strengths of our partnerships and aspects that need to be improved. 
 
 
 
 
 
 Innovative elements: Innovative aspects of this proposal are (1) the focus on an overlooked population that does not have a written language, (2) the inclusion of men in an attempt to modify strong community norms against breast cancer screening, (3) the involvement of promotoras in assessing the needs of the population and in developing intervention strategies to promote breast health, and (4) a strong focus on Mixtec community capacity building . 
 
 
 
 
 
 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 and UCLA. The Mixtec Advisory Committee (13 women and 8 men) as well as a group of 12 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 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. While we will conduct focus groups with a small number of women and men to gain a better understanding of the community norms regarding breast cancer screening and what it will take to modify these norms, the community needs assessment (AIM 1) will involve 1,000 households and therefore allow for broader community involvement. In addition, MICOP is planning to use the needs assessment form developed in the proposed study in other ongoing projects and outreach efforts to build a large data base for service planning and delivery. 
 
 
 
 
 
 Future Plans: At the end of the 18 months pilot study, we expect to have the tools, strategies and products developed to promote breast health in this population. We plan to apply for a Full CRC award to test these strategies. However, this effort can only be successful if community norms regarding breast cancer screening can be modified. Long-term goals are to build the Mixtec community capacity to address breast cancer disparities and to promote breast health.