BACKGROUND African American women with hereditary breast cancer risk are less likely to undergo genetic counseling and testing compared with non‐Hispanic White women. Inequities in the use of precision cancer care are likely to exacerbate racial disparities in cancer outcomes. A culturally sensitive multimedia narrative intervention was developed to motivate African American women at risk for hereditary breast cancer to engage in genetic counseling. METHODS Development of the intervention was grounded in the Integrative Model of Behavioral Prediction using a phenomenological, deductive approach and employed multiple qualitative methods for data collection, including 1‐on‐1 interviews and story circles with members of the target audience to identify salient themes and lived experiences. Focus group testing was then conducted with members of the group of focus, primary care providers, and community stakeholders. RESULTS Six themes that mapped to the theoretical model were identified. Lived experiences were abstracted from story circle data to create a narrative storyline. Educational content and motivational messaging derived from the 6 themes were embedded into the script. Focus group testing with stakeholder groups was used to refine the intervention. Testing of the final multimedia narrative with focus groups indicated that the intervention was culturally sensitive and authentic, and the messaging was effective. CONCLUSIONS Multiple qualitative data collection methods and a robust theoretical framework of health behavior were key elements for this study to develop a culturally sensitive, narrative intervention that reflects lived experiences and motivates underserved African American women with hereditary breast cancer risk to engage in genetic counseling. This strategy can be applied to mitigate racial inequities in the use of other genomic approaches for personalizing cancer care.
and Northeastern Illinois University collaborated to better understand biological differences in AA men that may impact PCa risks, by developing modeling systems to study PCa. The research projected aimed to develop a preclinical model to examine PCa in patient samples from Chicago. 2 The second project PB is collaborating through Chicago-CHEC is a project aimed at training and engaging a cohort of AA men as citizen scientists to ultimately assess a new biomarker called the Prostate Health Index for PCa screening in AA men. 3 The ability to engage the social networks of eight CHEC was established on community engaged principles supporting, fostering and, engaging community partners equitably in research. 1 PB, a communitybased organization founded on the south side of Chicago to address the multiple health and psychosocial needs of AA men, their families and, social networks. For more than 20 years, PB has been active in community-academic partnerships. As a key community partner for ChicagoCHEC, PB has been a community partner for two incubator pilot projects.One project was a one year pilot research project to examine the increased risk of AA men in developing PCa. Investigators Abstract Background: Community-academic partnerships play a vital role in ensuring the engagement of African American (AA) men in research. Project Brotherhood (PB) is a community organization that has played an integral role in advancing prostate cancer (PCa) research within two pilot projects supported by the Chicago Cancer Health Equity Collaborative (ChicagoCHEC).Community Perspective: It is rare to see community organizations led by AA men acknowledged for their role in advancing health equity research. We provide a community perspective of PB as a model in engaging AA men in research. PB has been recognized nationally by the Centers for Disease Control and Prevention (CDC) and others demonstrating their national footprint in advancing the inclusion of AA men in all aspects of research. We hope to demonstrate that engagement of AA men in research is important and feasible and to highlight PB as a national model in engaging AA men in research.
e13639 Background: Breast cancer (BC) mortality is substantially higher for African American (AA) women compared to their white counterparts. Genetic counseling (GC) is a key step in management of women with hereditary BC risk, but medically underserved women of color are less likely to receive these services. We report preliminary data from a pilot study examining the impact of a culturally sensitive, multimedia educational video created to motivate AA women with hereditary BC risk to attend GC. Development of the intervention was guided by the Integrative Model of Behavioral Prediction and qualitative research with the target audience. Methods: AA women eligible for GC for hereditary BC according to national criteria were identified through cancer genetic risk assessment (CGRA) performed at the time of a screening mammogram at the University of Illinois Health System in Chicago, IL, and were invited to participate in the study. Participants completed a baseline survey, viewed the educational intervention, and completed a post-intervention survey. The surveys included five-item Likert scales on intentions to act on the information presented, normative beliefs about GC, knowledge, and acceptability of the intervention. Responses were summarized as frequencies and proportions, and changes pre/post-intervention were evaluated using McNemar’s test. Results: The proportion of participants (n = 30) who rated they were “Extremely Likely” to make an appointment with a genetic counselor increased from 50% at baseline to 70% following the intervention (p = 0.04). After viewing the video, the proportion who rated they were “Extremely Likely” to speak with their doctor about genetic counseling increased from 60% to 77% (p = 0.10). There was a 16.6% increase (p = 0.05) in the proportion of women who indicated their family would be interested in learning more about GC, and 96.6% and 90% of participants agreed that the intervention video was enjoyable to watch and that they could relate to what the actors were saying, respectively. Changes in intentions to act on the information presented were not accompanied by changes in knowledge. Conclusions: A culturally sensitive multimedia intervention based on a theoretical model of health behavior increased intentions to attend GC among high risk AA women. The intervention was enjoyable for minority women to watch and increased intentions to discuss GC with family members. These findings indicate that culturally tailored motivational interventions have the potential to increase uptake of GC in underserved communities.
Background Despite the benefits of genetic counseling (GC) and testing, uptake of cancer genetic services is generally low and African American (AA) women are substantially less likely to receive genetic services than non-Hispanic White women. Our team developed a culturally sensitive, narrative decision aid video to promote uptake of GC among AA women at risk for a hereditary breast cancer syndrome. We report here a pilot study to demonstrate feasibility and acceptability of incorporating this intervention in conjunction with population-based cancer risk assessment in a clinical setting with medically underserved AA women. Methods AA women recommended for GC based on cancer genetic risk assessment performed in a mammography center were recruited at the time of the mammogram. A prospective, pre-post survey study design, guided by theoretical constructs, was used to evaluate baseline and immediate post-intervention psychosocial factors, including intention to participate in GC and intervention satisfaction. Results Pilot recruitment goals were met (n=30). Pre-intervention, 50% of participants indicated that they were extremely likely to make a GC appointment, compared with 70% post-intervention (p=0.0001). After watching the intervention, 50% of participants indicated that the video changed their mind regarding GC. Conclusions This study demonstrated cultural acceptability of a decision aid intervention designed to motivate AA women with hereditary breast cancer risk to attend a GC appointment. Our study showed that intention may be a specific and key construct to target in interventions designed to support decision-making about genetic services. Study results informed the design of a subsequent large scale, randomized implementation study.
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