Spanish-speaking Latinas Research Articles

Pasos Hacia La Salud II: A Superiority RCT Utilizing Technology to Promote Physical Activity in Latinas

IntroductionLatinas face increased risk for chronic diseases associated with insufficient physical activity (PA). The researchers previously showed that a website-based intervention could increase PA among insufficiently active Latinas, yet rates of meeting national PA guidelines were low. The original intervention was enhanced by adding additional features, content, and points of contact, including via text messaging. This study tests the efficacy of the enhanced intervention compared with the original, aimed at maximizing and sustaining PA gains across 24 months. It also examines if increases in PA differed by baseline PA. Study designThe researchers conducted a superiority randomized controlled trial (data collected 2018-2022, analyzed 2023). Setting/participantsParticipants were 195 Spanish-speaking Latinas ages 18-65 in the Providence, RI area. InterventionThe original intervention is an empirically supported Spanish-language, individually-tailored, website-delivered PA intervention. The enhanced intervention includes text messaging and additional data-driven content and interactive features. Main outcome measuresTotal weekly minutes of moderate to vigorous PA (MVPA) was measured via accelerometry and self-report at 6, 12, 18, and 24 months. ResultsParticipants in both groups increased their MVPA over 24 months. There were no significant between-group differences at 6 or 12 months; at 18 months the enhanced intervention group had higher levels of self-reported (mean (sd): 90.35 (43.55) vs. 70.18 (9.99)) and accelerometer-measured (66.21 (18.26) vs. 60.27 (16.00)) MVPA compared to the original intervention group. They also had higher levels of self-reported (111.17 (23.35) vs. 81.44 (1.82)) and accelerometer-measured (63.76 (15.12) vs. 54.86 (14.59)) MVPA at 24 months. Baseline PA moderated the intervention effect. ConclusionsThis study demonstrates the potential to enhance the efficacy of website-based PA interventions by utilizing text messaging, and adding more interactive features, content, and phone support. These enhancements may be particularly beneficial in supporting long-term PA maintenance. Trial registrationThis study is registered at www.clinicaltrial.gov (NCT03491592).

A Qualitative Exploration of Spanish-Speaking Latina Women’s Experiences Participating in WIC Before and During the COVID-19 Pandemic

BackgroundMore than one-third of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants identify as Latino, but participation has been declining and individuals who speak predominantly Spanish face additional barriers to participation. During the COVID-19 pandemic, there were changes in WIC eligibility and benefits that may have been differentially accessible to Spanish-speaking Latina participants due to factors such as language barriers and lack of awareness of changes. Understanding Spanish-speaking Latinas’ experiences with the WIC program generally and during the pandemic can inform efforts to equitably implement future emergency food response policies and improve the WIC program and Latina participant enrollment more broadly. ObjectiveThis study aimed to understand the perceptions and experiences of Spanish-speaking Latina WIC participants with the WIC program generally and with COVID-19 pandemic–related policy changes made to the WIC program. DesignQualitative in-depth interviews were conducted virtually in Spanish in August 2022 using a semi-structured guide. Participants/settingStudy participants were 18 Spanish-speaking Latina adult WIC participants living in North Carolina recruited using convenience sampling. AnalysisAll interviews were recorded, transcribed, and coded in Spanish. Thematic analysis with inductive coding was used to derive key themes. ResultsPerceptions about the WIC program in this sample were mixed. Participants felt positively about the healthfulness of foods included in the WIC food packages but expressed concern about the monthly benefit amounts being too low and the cultural appropriateness of food options. Pandemic policy changes, such as remote appointments and the Cash Value Benefit increase were perceived positively; however, barriers to using benefits during this time included limited communication from WIC agencies, food shortages, and concerns about not being granted US citizenship or permanent resident status due to use of WIC (ie, public charge rule). Social networks played an important role in learning about and enrolling in WIC and navigating food shortages during the pandemic. ConclusionsConcerns about the cultural appropriateness of foods provided, communication challenges, and the public charge rule emphasized the need for resources dedicated in the WIC program to improving Spanish-speaking Latina women’s experiences with WIC.

Infección de Amor (Infectious Love): Development and Acceptability of a Telenovela/Soap Opera Intervention for HIV Prevention For Latinas.

Latinas continue to be disproportionately affected by HIV in the United States. Effective interventions to address HIV-related disparities among Latinas are available; however, they have not achieved widespread dissemination due to implementation challenges for real-world settings. A culturally tailored intervention that increases access to HIV prevention is urgently needed. The objective of this study was to develop a culturally tailored telenovela (i.e., a soap opera) to promote HIV prevention behaviors (condom use; HIV testing; and pre-exposure prophylaxis awareness, access, and use) among Latinas. The study was conducted in community organizations throughout South Florida. A total of 44 Spanish-speaking Latinas, 18-35 years old, and sexually active with a man in the past 6 months participated in the study. The final product was an HIV prevention telenovela that incorporated Latinas' ideas and feedback and was produced as four 10-minute filmed episodes. This study aimed to develop innovative approaches to reduce HIV-related disparities for Latinas.

Evaluating the implementation of Nuevo Amanecer-II in rural community settings using mixed methods and equity frameworks

BackgroundThe 10-week Nuevo Amanecer-II intervention, tested through a randomized controlled trial, reduced anxiety and improved stress management skills among Spanish-speaking Latina breast cancer survivors. This paper describes the implementation and equity evaluation outcomes of the Nuevo Amanecer-II intervention delivered in three California rural communities.MethodsUsing implementation and equity frameworks, concurrent convergent mixed methods were applied to evaluate implementation (feasibility, fidelity, acceptability, adoption, appropriateness, and sustainability) and equity (shared power and capacity building) outcomes. Quantitative data were collected using tracking forms, fidelity rating forms, and program evaluation surveys; qualitative data were collected using semi-structured in-depth interviews. Respondents included community-based organization (CBO) administrators, recruiters, compañeras (interventionists), and program participants.ResultsOf 76 women randomized to the intervention, 65 (86%) completed at least 7 of 10 sessions. Participants’ knowledge (85% correct of 7 questions) and skills mastery were high (85% able to correctly perform 14 skills). Mean fidelity ratings across compañeras ranged from 3.8 (modeled skills) to 5.0 (used supportive/caring communication); 1–5 scale. The program was rated as very good/excellent by 90% of participants. Participants and compañeras suggested including family members; compañeras suggested expanding content on managing thoughts and mood and healthy living and having access to participant’s survivorship care plan to tailor breast cancer information. CBOs adopted the program because it aligned with their priority populations and mission. Building on CBOs’ knowledge, resources, and infrastructure, implementation success was due to shared power, learning, responsibility, and co-ownership, resulting in a co-created tailored program for community and organizational contexts. Building intervention capacity prior to implementation, providing funding, and ongoing technical support to CBOs were vital for fidelity and enhancement of recruiter and compañera professional skills. Two of three CBOs created plans for program sustainability beyond the clinical trial; all administrators discussed the need for new funding sources to sustain the program as delivered.ConclusionsBuilding on community assets and using equitable participatory research processes were central to the successful implementation of a peer-delivered psychosocial intervention in three rural communities among Spanish-speaking Latinas with breast cancer.

Disparities in osteoarthritis diagnosis and symptoms between English- and Spanish-speaking Latinas over 40 years of age in the United States: a analysis of the Behavioral Risk Factor Surveillance System

ABSTRACT Objective Osteoarthritis (OA) is a prominent musculoskeletal disorder that affects approximately 303 million people worldwide. The challenges that language barriers present to the Latina population in regard to the diagnosis and treatment of OA remain largely unknown. The objective of this study was to examine disparities in the diagnosis and treatment of arthritic conditions in English- and Spanish-speaking Latinas over 40 years of age. Design We analyzed data from the CDC’s Behavioral Risk Screening and Surveillance System (BRFSS), combining the 2017–2020 cycles using sampling weights provided by BRFSS, adjusted for multiple cycles. Determination of English- or Spanish-speaking groups was based on the language of the survey submitted. We calculated population estimates for arthritis diagnosis, physical limitations, and mean joint pain among language groups and by age (40–64 and 65+) and determined associations via odds ratios. Results Rates of arthritis diagnosis between groups were similar; however we found that Spanish-speaking Latinas 65+ were statistically more likely to report being limited by pain (AOR: 1.55; 95% CI: 1.14–2.09), and among both age groups Spanish-speaking Latinas reported higher pain scores than the English-speaking group (40–64 age group: Coef: 0.74, SE = 0.14, P < .001; 65 + age group: Coef: 1.05, SE = 0.2, P < .001). Conclusion Results from this study show that while there were no significant differences in rates of diagnosis, Spanish-speaking Latinas were more likely to be limited by joint pain and report higher pain scores.

Abstract C071: Cancer screening and breast cancer family history in Spanish-speaking Hispanic/Latina women in California

Abstract Background: Breast cancer is the most common cancer among women in the US and the leading cause of cancer death among women who self-identify as Hispanics/Latinas (H/L). Approximately 5-10% of breast cancer can be attributed to inherited genetic mutations in high penetrance genes such as BRCA1 and BRCA2. Studies have shown that genetic counseling can help women and their families make informed decisions about genetic testing, which in turn can lead to life-saving preventative strategies. H/L women are less likely to undergo genetic testing than Non-Hispanic White women. To address this disparity, we have developed a hereditary breast cancer outreach, education, and navigation program for Spanish-speaking Latinas in California. Materials and Methods: The “Tu Historia Cuenta” program is a promotores-based virtual outreach, education, and navigation program implemented in the cities of San Francisco, Sacramento, and Los Angeles. Participants responded to a demographic survey, a breast cancer family history survey, and a feedback survey. Survey responses were described for participants and compared by the area where the program took place using chi-square, Fisher exact tests, and t-tests. Multinomial logistic regression models were used for multivariate analyses. Results and Conclusion: We enrolled 1042 women, and 892 completed the family history survey. Among those who completed the survey, 62 (7%) were found to have a strong family history of breast cancer and qualified for referral to genetic counseling. We identified 272 women (42.8% of women aged 40 to 74 years) who were due for mammograms (64 of whom we have connected to a federally-funded screening program), 162 women (16% of women aged 25 to 65 years) due for Papanicolaou test, and 189 women (71.6% of women aged 50+) due for colonoscopy. Insurance rates differed across the three cities with San Francisco having the smallest proportion of uninsured individuals (9.3%) compared to Los Angeles and Sacramento (44.3% and 44%, respectively), which may be explained by differences in health care access. Through this study, we were able to connect with participants that are often excluded form research (35.8% of the study participants were uninsured and 48% were monolingual or had limited English proficiency). These results highlight the need for additional support for programs that spread awareness about cancer risk and facilitate access to resources, specifically within the H/L community. Citation Format: Lizeth I. Tamayo, Fabian Perez, Angelia Perez, Miriam Hernandez, Alejandra Martinez, Xiaosong Huang, Valentina Zavala, Elad Ziv, Susan L. Neuhausen, Luis Carvajal-Carmona, Ysabel Duron, Laura Fejerman. Cancer screening and breast cancer family history in Spanish-speaking Hispanic/Latina women in California [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C071.

Associations Between Acculturation and Weight, Diet Quality, and Physical Activity Among Latina Breast Cancer Survivors: The ¡Mi Vida Saludable! Study

BackgroundAmong Latinos, greater acculturation to the United States (US) is associated with risk of obesity and obesity-related comorbidities. Less is known about the associations between acculturation and obesity-related modifiable risk factors, such as diet quality and physical activity (PA) among Latina breast cancer survivors. ObjectiveThe aim of this study was to explore associations between acculturation and weight status, diet quality, and PA among Latina breast cancer survivors. DesignThis is a cross-sectional secondary analysis of baseline data on demographic and clinical characteristics, acculturation, anthropometric measures, diet quality, and PA collected from Latina breast cancer survivors enrolled in the ¡Mi Vida Saludable! (My Healthy Life) behavioral diet and PA intervention trial. Participants/settingParticipants were Latina women (n = 167) residing in New York City, with a medical history of stage 0 to III breast cancer, no evidence of recurrent or metastatic disease, and at least 90 days post cancer treatment who participated in the ¡Mi Vida Saludable! randomized controlled trial between July 2016 and October 2018. Main outcome measuresAcculturation status was measured by the Short Acculturation Scale for Hispanics score, language preference, place of birth, and duration of US residence. Weight, height, and waist and hip circumferences were measured at an in-person clinic visit. Diet information was collected via 3 telephone-based 24-hour dietary recalls and PA information was collected via staff administered 7-day recalls. Statistical analyses performedLinear regression models examined associations between acculturation and weight status, diet quality, and PA. ResultsBased on the Short Acculturation Scale for Hispanics acculturation score, more acculturated compared with less acculturated Latinas were younger in age, more educated, and had higher annual household incomes (all, P < .05). Compared with Spanish-speaking Latinas, English-speaking Latinas had larger waist circumference (103 vs 96.1 cm; P = .01) and poorer-quality diets (Healthy Eating Index 2015 scores, 57.3 vs 71.5; P < .001). Greater levels of acculturation were also associated with higher levels of leisure walking at a moderate-to-vigorous intensity (265.8 vs 179.0 min/wk; P =.04). ConclusionsGreater levels of acculturation were associated with higher central obesity and poorer-quality diets. Future lifestyle modification trials tailored to the unique role of acculturation on adopting behavior change recommendations is a promising next step in this line of research.

Abstract PO-061: 'Tu historia cuenta' online version: Promotores' experience and perspectives on the virtual adaption of a hereditary breast cancer education and risk identification program

Abstract Background: Breast cancer is the most common cancer in women in the U.S. and the leading cause of cancer related death among U.S. Latinas. Despite having lower breast cancer incidence, U.S. Latinas are more likely to be diagnosed with advanced stage disease compared to non-Hispanic White (NHW) women. This can be attributed to lower rates of screening and longer time to follow up after an abnormal mammogram in the former group. We developed a comprehensive promotores-led education and risk stratification program for Spanish-speaking Latinas to increase mammography screening, genetic testing, and the understanding of the impact of family history on cancer risk. Due to COVID-19 we adapted the program to a virtual platform. This study aimed to record and share the experience from the promotores' perspective as they educated the Latino(x) community through virtual sessions. Methods: We used a stakeholder continuous engagement approach and the construct of relational culture to build the program materials. The promotores were part of two organizations in California: Vision y Compromiso (Sacramento region, and San Francisco) and Promoters for Better Health (Los Angeles). Their experience was captured using semi-structured interviews guided by a set of questions and a request for additional thoughts. Demographic information was captured using a questionnaire. The promotores' voices were incorporated into this program through multiple interactions including the revision of the interviews. Results: All promotores (N=14) in the program were fluent in Spanish and self-identified as Hispanics/Latinos(x). Ages ranged between 34 and 62, most being first generation immigrants. Educational achievement varied from high school to college degree. Through the interviews and informal interaction, promotores shared that virtual platforms helped alleviate numerous obstacles for attendance like transportation, scheduling conflicts, and childcare costs. However, the online approach removed the personal connection that promotores usually have with participants. The most important challenge described was the lack of privacy and a safe space for participants to share, since many took the class in the middle of their homes near family members. The promotores agreed delivering the program gave them a greater sense of self-worth and confidence. They never thought that they could learn, and teach, community members about genetics and cancer risk. Conclusions: Despite the challenges brought about by COVID-19, the experience of transforming the ‘tu historia cuenta' program to a virtual platform provided unique opportunities for bi-directional collaboration between the academic and community partners and with the participants. Overall, we learned that the virtual program had both positive and negative aspects regarding community engagement. It also consistently empowered promotores as well as allowed them to continue their paid work during lock-down, which was equally appreciated during challenging economic times. Citation Format: Fabian Perez, Laura Fejerman, Eric Robles-Garibay, Angelica Perez, Elizabeth Quino, Maria Gonzalez, Miriam Hernandez, Alejandra Martinez, Patricia Castaneda, Raquel Ponce, Cindia Martinez, Ysabel Duron. 'Tu historia cuenta' online version: Promotores' experience and perspectives on the virtual adaption of a hereditary breast cancer education and risk identification program [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-061.

Community research collaboration to develop a promotores-based hereditary breast cancer education program for Spanish-speaking Latinas.

Breast cancer (BC) is the most common cancer in Latinas and the leading cause of cancer death. Latinas tend to be diagnosed at later stages, receive poorer quality care and have a higher risk of mortality than non-Latina White (NLW) women. Among women with a genetic predisposition to hereditary BC, genetic counseling can be beneficial. Latinas participate in genetic counseling at lower rates than NLW women. The goal of this study was to develop comprehensive, culturally appropriate materials for community health educators (promotores)-led hereditary BC education program for Spanish-speaking Latinas. We developed the curriculum through feedback from 7 focus groups, with a total of 68 participants (35 promotores and 33 community members). We used a mixed-methods approach that relied on quantitative analysis of survey questions and qualitative content analysis of the focus groups transcripts. Pre and post promotores' training survey responses suggested improvement in the promotores' cancer-related knowledge. Themes that emerged from the qualitative analyses were (i) barriers to health education and/or care; (ii) importance of educating the Latino community about BC and genetics and (iii) role of the promotores. Future research will further evaluate the impact of the program in promotores' knowledge and community members' screening behaviors.

Self-Efficacy for Coping with Breast Cancer Treatment Among Spanish-Speaking Latinas.

Background: Cancer-related self-efficacy, a multidimensional construct, is the confidence that one can overcome challenges associated with cancer and its treatment; higher levels have been associated with better psychosocial outcomes of breast cancer survivors. Little is known about factors that influence it among Latina breast cancer survivors.Purpose: Assess associations of several aspects of health care processes and of spirituality with self-efficacy for coping with breast cancer treatment among primarily Spanish-speaking Latina breast cancer survivors.Methods: We analyzed baseline data from a randomized controlled trial of a cognitive–behavioral stress management intervention that enrolled 151 Spanish-speaking Latinas within 1 year of breast cancer diagnosis. Multivariate linear regression models examined associations of health care processes (quality of breast cancer care and information, participating in medical care, difficulty engaging with doctors) and spirituality (meaning/peace, faith, acceptance) with self-efficacy for coping with breast cancer treatment.Results: Mean age was 51 (standard deviation [SD]=11), 66% completed high school or less, and most reported financial hardship in the past year (78%). Average time since diagnosis was 3.8 months (SD=2.7). In bivariate analyses, all six determinants were significantly associated with self-efficacy for coping with breast cancer treatment; participating in medical care (B=0.56, p<0.001) and having a sense of meaning/peace (B=0.76; p<0.001) were independently associated, controlling for sociodemographic and treatment characteristics.Discussion: Interventions that promote participation in treatment decisions and sense of meaning and peace could improve confidence in coping with breast cancer treatment, and potentially quality of life, among Latinas living with breast cancer (Trial Registration Number: NCT01383174 [ClinicalTrials.gov]).

Feasibility of an online health intervention for Latinas with chronic pain.

Chronic pain is a common health problem in the United States, and it is associated with numerous physical and mental health issues. Disparities in pain treatment are high for particular populations, including Latinos, who comprise a significant percent of the U.S. The purpose of this study was to develop and evaluate an online health education intervention for Spanish-speaking Latinas with chronic pain. The intervention was developed based on a biopsychosocial approach to treatment and targeted multiple domains including exercise, psychological wellbeing, regaining function, emotional wellbeing, sleep hygiene, and stress management. Through a mixed-method, single-arm design, this pilot study examined patients' and providers' acceptability of and satisfaction with the intervention, as well as the impact of the intervention on patients' knowledge, chronic pain self-efficacy, pain severity, and pain interference (measured pre and post intervention). Both chronic pain patients (n = 40) and provider participants (n = 10) reported high rates of participation, and high ratings for website features and website content. Patient participants also experienced a significant increase in knowledge regarding pain management and treatment options, and in chronic pain self-efficacy, as well as a significant decrease in pain interference. Although means for pain severity were lower at the posttest session, this change was not significant. Overall, results indicate that an online educational intervention that targets Spanish-speaking Latinas with chronic pain is feasible, potentially impactful, and that there is a need for such interventions. Recommendations include additional content and interactive features that could improve satisfaction, engagement, and impact. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Abstract 15954: Arriba Por La Vida Estudio : A Randomized Trial Promoting Standing Behavior to Reduce Sitting Time Among Postmenopausal Latinas

Introduction: Increased sedentary behavior is independently associated with increased risk of cardiometabolic diseases. There are few community-based RCTs designed to address this behavior, and none among Latinas, who are particularly at risk for cardiometabolic diseases. This study presents the results of an intervention to reduce sitting time among postmenopausal overweight Latina women. Hypothesis: Participants randomized to the standing intervention arm will have a greater reduction in sitting time compared to those in the comparison arm. Methods: A total of 254 overweight, sedentary postmenopausal Latinas in San Diego were enrolled in a 12-week trial, and randomized to either an intervention to replace sitting time with standing bouts or a comparison group that received heart healthy information. The intervention, based on social-cognitive behavior change, included culturally-tailored coaching. Intervention participants received three in-person health-counseling sessions, one home visit, and five telephone calls using motivational interviewing; the comparison group received an equal number of contacts to discuss topics on healthy aging. The primary outcome was change in sitting time at 12 weeks measured via thigh-worn inclinometers (ActivPAL microTM). Group differences in outcomes were analyzed using linear mixed-effects models. Results: The trial arms were comparable at baseline with mean (SD) age 65 (6.5) years, education 10.7 (4.4) years, 32.4 (4.8) kg/m2 BMI, sitting time 540 (86) minutes/day. Significant differences between control and intervention groups were observed in change in sitting time (p&lt;0.001), standing time (p&lt;0.001), and stepping time (p=0.016). For control and intervention groups, mean (SE) in minutes/day of sitting time change was -7.5 (9.1) and -71.0 (9.8); standing time change was 2.5 (6.5) and 49.6 (7.0); stepping time change was 4.7 (2.4) and 13.2 (2.6), respectively. Conclusions: The findings demonstrate that our intervention was successful at reducing sitting time and increasing standing time and step counts. Results demonstrate that it is feasible and effective to implement sitting time reduction interventions among older, predominately Spanish-speaking postmenopausal Latinas.

Longitudinal Correlates of Maternal Involvement and Spanking in Spanish-speaking Latinas Who Have Experienced Intimate Partner Violence.

Mothers experiencing intimate partner violence (IPV) have been found to have negative long-term parenting outcomes, such as reduced maternal involvement and greater use of physical punishment, which represent potential pathways by which IPV negatively affects children. Factors influencing these parenting practices have not been examined in IPV-exposed Latinas. The aim of this study is to understand the factors that affect maternal involvement and spanking by Latinas to contribute to culturally-informed intervention development and refinement. A total of 93 Spanish-speaking Latinas who had experienced IPV completed standardized measures of maternal involvement, spanking, IPV, depression, and posttraumatic stress (PTS) and provided demographic information. Slightly over half of the women participated in an intervention program. Longitudinal multilevel modeling (MLM) demonstrated that higher levels of maternal depression predicted lower levels of involvement over time. PTS reexperiencing symptoms were positively related to involvement, such that mothers with higher levels of reexperiencing reported higher levels of involvement. An independent longitudinal MLM revealed that higher amounts of IPV exposure and higher levels of PTS arousal symptoms were associated with higher levels of spanking, while maternal employment was associated with lower levels of this same parenting behavior. Maternal involvement increased over time, where there was no significant change in spanking over time, and no effect of the intervention program on either parenting practice. Results suggest clinical interventions should target reductions in depression and specific PTS symptom subdomains as pathways to improving parenting in IPV-exposed Latinas. Continued study is needed to understand the relationship between reexperiencing and maternal involvement.

Abstract A22: Challenges using mobile technology for research participation in preventive health research: A preliminary investigation with Spanish-speaking Latinas

Abstract Technology offers significant contributions to improve health care. However, less than half of foreign-born Latinos utilize data applications. The acceptability and application of these new communication and data harnessing tools can present both opportunities and challenges for some. We report our observations of the challenges Latinas face using mobile technology. Latina mothers were recruited from a pilot diabetes risk reduction program. A total of 32 mothers participated in the program; 63% were Spanish speakers, 59% were foreign-born, 66% had ≤high school education, and 91% reported income &amp;lt;$40,000. Participants used a mobile device to perform two tasks: 1) complete an online survey on a tablet and 2) download and install a fitness tracker mobile application. Mothers rated their confidence in their ability to use mobile technology using a 4-point Likert scale. Participants with little/no confidence requested paper versions of the survey. Most mothers required staff assistance to complete the survey and set up their fitness tracker. Spanish-speaking mothers were more likely to report little/no confidence connecting to Wi-Fi (χ2=13.175, p&amp;lt;0.01), downloading an app (χ2=11.277, p=0.01), and creating an electronic account (χ2=7.882, p&amp;lt;0.05). Although participants were smartphone users, the majority needed dedicated, individual assistance to complete the tasks (e.g., survey and app). Growing evidence suggests that Latinos have the capacity to use mobile technology to increase healthy behaviors. Our findings suggest that lower-income Spanish speakers require more assistance with technology for research data collection. Studies and programs using mobile technology should account for the added staffing and resources required to conduct studies with this population. Citation Format: Alejandro Fernandez, Mayra Serrano, Marisela Garcia, Katty Nerio, Kimlin Ashing. Challenges using mobile technology for research participation in preventive health research: A preliminary investigation with Spanish-speaking Latinas [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr A22.

Abstract A043: Baseline characteristics of rural Spanish-speaking Latina breast cancer survivors enrolled in a community-based RCT of a peer-delivered cognitive-behavioral stress management intervention: The Nuevo Amanecer rural trial

Abstract Introduction: Effective interventions tailored for rural Spanish-speaking Latina breast cancer survivors are needed to address their psychosocial health disparities. Purpose: Describe development of a rural community-based cognitive-behavioral stress management program, Nuevo Amanecer-R (NA-R) (New Dawn-R) and baseline characteristics of rural Latina breast cancer survivors enrolled in the RCT testing the program. Methods: Using community-based participatory research (CBPR) strategies, we applied a translational model appropriate for underserved populations that integrated an evidence-based intervention, a community best-practices program, and formative research to develop a program that could be delivered by trained breast cancer survivors (peers) in rural settings. We trained community recruiters to enroll, and collect hair and saliva biospecimens from, Spanish-speaking Latinas with nonmetastatic breast cancer in 3 rural California communities. Women were randomized to receive the program immediately or in 6 months. Primary outcomes include the Functional Assessment of Cancer Therapy-Breast Quality of Life (FACT-B) Total Score and its Physical, Social, Emotional, Functional Well-being, and Additional Concerns about Breast Cancer subscale scores (higher scores=better quality of life), with assessments at baseline, 3 months, and 6 months. Results: Based on input from survivors, advocates, and clinicians, modifications to the initial program for rural Latina survivors included further simplification of language, more visuals, developing stress management videos in Spanish and English, and expansion from 8 to 10 sessions to increase skills practice and healthy lifestyles information. Trained peers are delivering the 10-week NA-R program through weekly in-person 90-minute sessions in participants' homes. Components include managing the initial impact of cancer, finding cancer information and support, thoughts and mood management skills, behavioral stress management skills, and goal-setting. Of 231 women approached, 54 (24%) refused, 24 (10%) were ineligible, and 153 (66%) were randomized (76 to intervention, 77 to control group). To date, all baseline, 90% of 3-month, and 92% of 6-month assessments are completed. Participant characteristics are: mean age of 54.8 years (range, 28 to 88); 69% have &amp;lt; high school education; 66% are married; 80% have public/no health insurance; and 48% experienced financial hardship in the past year. Baseline FACT-B mean scores are: Total Score, 96.7 (possible range 0-144); Emotional Well-being, 17.3 (possible range 0-24); Functional Well-being, 18.2 (possible range 0-28); Social/Family Well-being, 18.2 (possible range 0-28); Physical Well-being, 20.4 (possible range 0-28); and Breast Cancer Concerns, 22.7 (possible range 0-36). Conclusions: Using CBPR principles in the design and implementation of community-based RCTs enhances cultural appropriateness, congruence with community contexts, and recruitment and retention. Citation Format: Jasmine Santoyo-Olsson, Anita L. Stewart, Carmen Ortiz, Steven Gregorich, Anna Maria Napoles. Baseline characteristics of rural Spanish-speaking Latina breast cancer survivors enrolled in a community-based RCT of a peer-delivered cognitive-behavioral stress management intervention: The Nuevo Amanecer rural trial [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A043.

Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): A Randomized Controlled Trial of a Health Communication Intervention for Latinas

Latinas in the United States are more likely to be diagnosed with late-stage breast cancer (BC) compared to non-Latinas. Literacy-appropriate and culturally sensitive cancer communication interventions can help address existing racial/ethnic BC disparities. We formatively developed a new BC prevention brochure for Spanish-speaking Latinas (≥35 years). Eligible women (n = 240) from a large public hospital in California were randomly assigned to one of three study arms: Group 1 received the new brochure, Group 2 included a community health worker (CHW) who delivered the new brochure's content, and a control group received a standard educational brochure. Participants completed three surveys (baseline, postintervention, 3-month follow-up) with a 100% completion rate for the first two surveys and 80.4% completion after 3 months. We assessed the difference in outcomes for BC risk knowledge, perceived BC susceptibility, and BC information self-efficacy between groups. Participant mean age was 52.3 years, and 82.1% reported low English proficiency. Mean knowledge scores increased and perceived BC susceptibility improved for all groups (p ≤ .05), yet treatment effects were not significant between groups for these outcomes. BC information self-efficacy also increased from baseline to postintervention for all groups to >80%. After 3 months, only Group 2 and the control group retained their increases and treatment effects were significant only for Group 2 compared to other groups in unadjusted and adjusted models. A CHW-delivered intervention may be more effective in improving BC information self-efficacy among Latinas compared to print material alone. More research is needed to examine the efficacy of CHW-delivered interventions.

Physical Activity Intervention Effects on Sedentary Time in Spanish-Speaking Latinas

Latinas have high rates of sedentary behavior and related health disparities, but it is unknown if interventions to increase physical activity will also reduce sedentary time. The current study examined changes in objectively measured sedentary time among Latinas in a randomized controlled trial of a physical activity intervention. Spanish-speaking Latinas (N = 202) were randomized to an exercise or wellness group and wore an accelerometer at baseline, 6 months, and 12 months. Participants were sedentary on an average of 8.86hours per day (SD = 2.60) at baseline. The intervention group had significantly greater increases in sedentary time compared with the control group, with the intervention group engaging in 146 more minutes per week of sedentary time at 6 months and 254 minutes per week of sedentary time at 12 months than the control group (P = .02). The intervention effect on sedentary behavior remained after controlling for moderate to vigorous physical activity. Additionally, time spent in moderate to vigorous physical activity was positively associated with more sedentary time (P = .04). An intervention to increase moderate to vigorous physical activity resulted in greater sedentary time, raising concerns regarding compensation and highlighting the need for interventions to address both physical activity and sedentary behavior to improve public health.

24: Validation of the body image in pelvic organ prolapse questionnaire in Spanish-speaking Latinas

24: Validation of the body image in pelvic organ prolapse questionnaire in Spanish-speaking Latinas

Translating a stress management intervention for rural Latina breast cancer survivors: The Nuevo Amanecer-II

ObjectivesAdapt a cognitive-behavioral stress management program (Nuevo Amanecer or NA) to be generalizable to rural, low literacy Spanish-speaking Latinas with breast cancer survivors at all phases of survivorship.MethodsApply the Transcreation Framework, a community-engaged translational model, to develop the adapted program (Nuevo Amanecer or NA-II), design a randomized controlled trial for community settings, identify recruiters and interventionists, and recruit participants into the trial.ResultsAdaptations included expanding the program from eight to ten weeks, simplifying materials, and increasing skills practice. We added stress management videos, healthy lifestyles information, and survivorship information. Interventionists were trained Latina breast cancer survivors. All core components of NA were retained in NA-II including managing the impact of cancer, information on breast cancer and its treatment, finding cancer information, getting support, managing thoughts, stress management techniques, and setting goals. Participants receive a program manual. Each session includes a review of that week’s content using the manual, practicing a stress-management skill, setting a specific goal, and reviewing videos. Spanish-speaking Latinas with non-metastatic breast cancer were recruited by community recruiters. Of 231 women approached, 24% refused, 10% were ineligible, and 153 (66%) were randomized to the intervention or a wait-list control group. The sample was vulnerable: 69% had < high school education, more than half had only Medicaid or no insurance, 91% was foreign born, and 48% reported financial hardship in the past year.ConclusionsApplying the Transcreation Framework to engage stakeholders in designing community-based RCTs enhanced congruence with community contexts and recruitment of this vulnerable population.

Maternal Acceptance of Children’s Negative Emotions Among Spanish-Speaking Latinas Who Have Experienced Intimate Partner Violence

Intimate partner violence (IPV) is a significant social concern, with high prevalence rates among Latinas and resulting serious negative outcomes, including parenting difficulties. Parenting following exposure to IPV is paramount as IPV can be frightening to children as well as disruptive to their development of emotional and self-regulation abilities. In fact, prior research has found that parents who are accepting of the expression of negative emotion in children may be able to protect them against some of the harmful effects of IPV. However, little is known about the way in which IPV-exposed Latina mothers approach their children’s negative emotions. The aim of this study was to examine factors associated with maternal acceptance of children’s negative emotions in IPV-exposed Spanish-speaking Latinas. This study examined predictors of Latinas’ acceptance of their children’s negative emotion, including the amount of IPV experienced, depressive and posttraumatic stress symptoms, and demographic factors. Results revealed that depressive symptoms were associated with lower levels of maternal emotion acceptance while maternal employment and domestic violence shelter use were associated with greater maternal acceptance of children’s negative emotions. Finding suggest that there are potentially modifiable factors that may be associated with levels of acceptance of child negative emotions among Spanish-speaking Latinas who have experienced IPV. The limitations and implications of the findings are discussed.