Culturally Relevant Cancer Risk Counseling for Underserved Latinas

Pilot Abstract

The primary purpose of this project is to evaluate the effects of a culturally relevant genetic cancer risk assessment (GCRA) intervention on a population of underserved women of Hispanic descent, and examine a social-cognitive-cultural model of post-GCRA cancer screening and prevention behaviors that can guide future GCRA and psychosocial interventions for this population. The following aims will be addressed: 1) Assess cognitive, social and cultural factors influencing cancer screening and prevention behaviors following culturally relevant GCRA 2) Conduct a focus group with Latina women who recently underwent GCRA to identify important cultural components in order to individualize GCRA to this population and 3) Evaluate changes in breast and ovarian cancer screening and prevention behaviors after culturally relevant GCRA. Two focus groups will be conducted in separate single sessions consisting of Latina women that have recently undergone GCRA. The focus group will entail completion of researcher-developed instruments and participation in facilitated discussions of the instruments, key study variables, and other culturally relevant issues. Based on focus group qualitative data specific modifications will be made to assure that the GCRA protocol is culturally relevant. All participants will undergo culturally relevant GCRA following referral by their primary physicians. Genetic testing for a BRCA mutation will be offered when there is medical necessity and a reasonable calculated probability of a detectable mutation. Cancer screening and prevention recommendations will be given based on genetic test results or empiric risk estimates. Participants will complete a baseline medical history questionnaire and survey instruments measuring acculturation, fatalism, self-efficacy, expected outcomes, and social support pre-GCRA and 3-months post GCRA. A hereditary cancer knowledge survey will be completed by participants pre GCRA, immediately post GCRA and 6-months post GCRA. A follow-up questionnaire will be administered to participants 6-months post GCRA to assess adherence to risk management r recommendations. The proposed pilot study is designed to develop and implement culturally relevant GCRA services for low income Latinas and to place the intervention within a theoretical context. The long-term objectives of this study are to utilize these pilot data to develop future interventional and longitudinal studies with experimental designs which can help reduce the disparity in the prevalence, recurrence, and mortality of cancer between the majority and minority population.