Developing a culturally targeted video to enhance the use of genetic counseling in Latina women at increased risk for hereditary breast and ovarian cancer

Abstract

Disparities for genetic cancer risk assessment (GCRA) for hereditary breast and ovarian cancer (HBOC) persist between Latina and non-Hispanic Whites. There are few tested culturally targeted interventions. We developed a culturally targeted video to enhance GCRA uptake in at-risk Latinas. Interviews with healthcare providers (n = 20) and at-risk Latinas (n = 20) were conducted as formative research to inform the development of the video. Findings from the formative research, health behavior conceptual models, and evidence-based risk communication strategies informed the messages for the script. Then, we conducted a focus group with at-risk Latinas (n = 7) to obtain feedback for final refinement of the script. The final video was piloted for acceptability and potential dissemination in a sample of Latino community health workers (CHWs) (n = 31). Providers and at-risk Latinas suggested using simple language and visual aids to facilitate comprehension. Participants in the focus group identified areas for further clarification (e.g., cost). The result was an 18-min video that illustrates BRosa's^story. Rosa learns about HBOC risk factors and overcomes barriers to attend genetic counseling. CHWs reported high overall satisfaction with the video (M = 9.61, SD = .88, range 1-10). A culturally targeted video has the potential to reach underserved populations with low literacy and English proficiency.

Development of a culturally sensitive narrative intervention to promote genetic counseling among African American women at risk for hereditary breast cancer

“…In contrast, our aim was not primarily educational, but rather to create a culturally sensitive and authentic narrative intervention that would promote attendance at a GC consultation among AA women at risk for hereditary breast cancer. Hurtado‐de‐Mendoza and colleagues recently reported their work creating a similar intervention for Latinas 43 . Although some common themes were identified, the experiences of AA women in this country are substantially different (eg, medical mistrust caused by historic abuse), leading to sociocultural barriers that are unique to the AA experience that need to be addressed.…”

Scaling Genetic Counseling in the Genomics Era

“…Genetic counseling-related initiatives to reduce access disparities include some of the service delivery approaches discussed above (79,88) that reduce the need for patients to travel and attend in-person counseling visits. For example, a study investigating the efficacy of video counseling specifically targeted toward Latinx patients at risk for hereditary cancer identified overall patient satisfaction (42). Genetic counselors are also involved in studies in the National Institutes of Health-funded CSER consortium (11), which enrolls primarily patients from medically underserved and diverse racial/ethnic populations with a goal of reducing barriers (logistical, geographical, language, etc.)…”

Culturally Targeted Video Improves Psychosocial Outcomes in Latina Women at Risk of Hereditary Breast and Ovarian Cancer

“…We developed a culturally targeted Spanish-language narrative video for at-risk Latinas. The development process is reported elsewhere [35]. Briefly, our multidisciplinary team collaborated with filmmakers from an actor training studio program to develop the script and video.…”

“…The 18 min video illustrates the GCT process with the story of Rosa, a Latina breast cancer survivor who learns about her risk for HBOC, overcomes barriers to attend genetic counseling, and attends a genetic counseling appointment. The script was informed by extensive formative research, evidence-based risk communication strategies, and health behavior models [35]. For instance, the video sought to elicit emotions, to convey information to address knowledge gaps (e.g., age at breast cancer diagnosis as a risk factor), and to clarify misconceptions identified in our formative research (e.g., the misconception that Pap smear is a screening test for ovarian cancer) [35,36].…”

“…The script was informed by extensive formative research, evidence-based risk communication strategies, and health behavior models [35]. For instance, the video sought to elicit emotions, to convey information to address knowledge gaps (e.g., age at breast cancer diagnosis as a risk factor), and to clarify misconceptions identified in our formative research (e.g., the misconception that Pap smear is a screening test for ovarian cancer) [35,36]. The video also targeted psychosocial outcomes from the Theory of Planned Behavior (TPB) [37], including attitudes, subjective norms, perceived control, and behavioral intentions.…”