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

George Luta,Vanessa B. Sheppard,Beth N. Peshkin,Lyndsay Anderson,Pilar Carrera,Claudia Campos,Alejandra Hurtado-de-Mendoza,Marc D. Schwartz,Kristi D. Graves,Sara Gómez-Trillos,Nathaly Gonzalez,Ana-Paula Cupertino

doi:10.3390/ijerph16234793

Abstract

Latina women at risk of hereditary breast and ovarian cancer (HBOC) have lower awareness, knowledge, and use of genetic counseling and testing services (GCT) than non-Latina Whites. Few interventions have been developed to reduce these disparities among at-risk Latinas. This pilot study assessed the impact of a culturally targeted narrative video developed by our team. The study included 40 Latina immigrants living in the United States who were at risk of HBOC, including affected and unaffected women. We assessed pre-post differences in psychosocial outcomes. Participants were 47.35 years old on average (SD = 9.48). Most (70%) were unaffected with cancer, had an annual income of $40,000 or less (65%), an education of High School or less (62.5%), and were uninsured (77.5%). The video significantly enhanced knowledge (p < 0.001), positive attitudes (p < 0.05), anticipatory positive emotions (p < 0.05), and intentions to participate in counseling (p < 0.001). Importantly, the video also significantly reduced negative attitudes (p < 0.05), and attitudinal ambivalence (p < 0.001). The culturally targeted video shows preliminary evidence in improving psychosocial outcomes related to GCT uptake in Latinas at risk for HBOC. This intervention is a promising easily-disseminable strategy to address disparities in GCT utilization.

Highlights

BRCA1/2 gene mutations are the most commonly identified mutations that increase the risk of hereditary breast and ovarian cancer (HBOC) [1]
Our primary recruitment method was through partnerships with two community-based organizations (CBOs) that provide patient navigation services to Latinas in the mid-Atlantic area of the U.S we conducted community outreach via flyers and radio, and contacted women from a research registry who had agreed to be contacted for future studies [48]
We developed a 20-item scale that tapped into the main informational messages about HBOC delivered in the video (e.g., HBOC risk factors, purpose of genetic counseling and testing services (GCT)) (α = 0.49 pre; α = 0.61 post)

Summary

Introduction

BRCA1/2 gene mutations are the most commonly identified mutations that increase the risk of hereditary breast and ovarian cancer (HBOC) [1]. Breast cancer survivors with BRCA1/2 mutations are three times more likely to develop contralateral breast cancer than non-carriers [5]. National guidelines recommend referral to genetic cancer risk assessment for all women at high risk of HBOC based on personal and family history [6,7]. Genetic cancer risk assessment typically includes meeting with a genetic counselor and considering the option of genetic testing if recommended. A positive BRCA1/2 gene test result impacts treatment choices in women diagnosed with cancer and risk management in women with and without a cancer diagnosis [8], including an uptake of risk-reducing surgeries [9]. Risk-reducing surgeries can reduce breast cancer risk by over

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