Abstract A073: Cultural adaptation of an evidence-based intervention: The Conexiones program for Latina mothers with cancer

Abstract

Abstract BACKGROUND. Nationwide Hispanic women <50 years show rising cancer incidence rates for all sites.  Disparities in incidence for certain cancers among Hispanic women <50 worsen as the focus changes from a national level to the U.S.-Mexico border region. The medically underserved border region lacks psychosocial resources to improve cancer survivorship among Latinas and their families. Culturally relevant interventions are essential to addressing cancer disparities in young Latinas. PURPOSE. To describe the conceptual framework and steps used to culturally adapt the Enhancing Connections  program, an evidence-based cancer-parenting intervention (EBI) designed to support mothers and their children in coping with maternal cancer. METHODS. Validated with predominately White, middle-class mothers diagnosed with breast cancer, Enhancing Connections was culturally adapted to create the Conexiones program for Latina mothers living with any cancer type on the border. This process expanded on cultural adaptation frameworks for Hispanics. RESULTS. The EBI developers and cultural adaptation team (i.e., Latina researchers) cultivated a trusting collaboration to safeguard fidelity to the EBI during the multi-phase adaptation process. Given limited research on young parenting Latina cancer survivors, the researchers conducted an in-depth assessment of the new consumer group, relevant stakeholders, and the border environment. The assessment informed a rigorous preliminary adaptation of the EBI which included surface and deep structure modifications to make the program culturally relevant and engaging for the new consumer group. Program materials were then translated to Spanish and shared with the Latina border community to identify and correct remaining areas of cultural mismatch between the new consumer group and the EBI’s validation group (i.e., NHW women). This community evaluation of the program also helped uncover and correct cultural mismatches between the new consumer group and the adaptation team (i.e., Latina academic researchers). The cultural adaptation also included modifying research methods to fit the new consumer group (e.g.,  study eligibility, recruitment efforts, and study measures). A pilot study confirmed feasibility, fidelity, and acceptability of Conexiones and informed further program refinement. The pilot study also provided preliminary evidence of Conexiones’ efficacy establishing the pathway for a randomized control trial with young, diagnosed Latina mothers in the border region. CONCLUSION. Adapting an EBI to new consumers is a complex process that involves much more than simply translating the program materials into a new language. Rather, Enhancing Connections was systematically adapted using a multi-component framework and significant community engagement to create Conexiones. As few EBIs are tested with high risk, vulnerable populations and virtually none with Hispanic mothers living with cancer in the border community, this adaptation can serve to inform other researchers working with underserved populations. Citation Format: Rebecca Palacios, Clara Reyes, Isela Garcia, Frances Lewis. Cultural adaptation of an evidence-based intervention: The Conexiones program for Latina mothers with cancer [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A073.