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Hurtado-de-Mendoza A, Gómez-Trillos S, Graves KD, Carrera P, Campos C, Anderson L, Gronda A, Orellana H, Peshkin BN, Schwartz MD, Cupertino P, Ostrove N, Luta G, Gonzalez N, Sheppard VB. Process evaluation of a culturally targeted video for Latinas at risk of hereditary breast and ovarian cancer. J Genet Couns 2020; 30:730-741. [PMID: 33222313 DOI: 10.1002/jgc4.1361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/26/2022]
Abstract
This paper presents a process evaluation of a culturally targeted narrative video about hereditary breast and ovarian cancer (HBOC) for Latina women at risk for HBOC. Spanish-speaking Latina women at risk for HBOC participated in a single arm study (n = 40). Participants watched the video developed by the authors and responded to surveys. We used mixed methods to assess theoretical constructs that are hypothesized mediators of narrative interventions (i.e., transportation or engagement, identification with characters, emotions) and implementation outcomes (e.g., acceptability). Descriptive statistics summarized theoretical constructs and implementation outcomes. We conducted Mann-Whitney U tests to assess the differences in theoretical and implementation outcomes between participants who were affected versus. unaffected and participants with different levels of education and health literacy. We used the consensual qualitative research framework to analyze qualitative data. Participants' mean age was 47.1 years (SD = 9.48). Most participants were high school graduates or less (62.5%). Acceptability of the video was extremely high (Md = 10.0, IQR = 0.2, scale 1-10). Most (82.5%) suggested video dissemination be through social media. Participants were highly engaged (Md = 5.7, IQR = 1.5, scale 1-7), strongly identified with the main character (Md = 8.7, IQR = 2.6, scale 1-10), and reported experiencing mostly positive emotions (Md = 9.5, IQR = 2.8, scale 1-10). Participants with low health literacy and affected participants reported a significantly higher identification with the main character (p<.05). Qualitative data reinforced the quantitative findings. Women reported gaining knowledge, correcting misconceptions, and feeling empowered. Our culturally targeted video is highly acceptable and targets mechanisms of behavior change for narrative interventions. The video is easily disseminable and can be used as an education tool for patients including affected and unaffected women and patients with different education and health literacy levels. Future studies should test the impact of the video in enhancing genetic counseling and testing uptake.
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Affiliation(s)
- Alejandra Hurtado-de-Mendoza
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Sara Gómez-Trillos
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Kristi D Graves
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Pilar Carrera
- Department of Social Psychology and Methodology, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Lyndsay Anderson
- School of Nursing, College of Health and Human Services, California State University, Sacramento, CA, USA
| | - Andrés Gronda
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Halyn Orellana
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Beth N Peshkin
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Marc D Schwartz
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Paula Cupertino
- Cancer Prevention and Control Program, John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | | | - George Luta
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA.,Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center, Washington, DC, USA
| | | | - Vanessa B Sheppard
- Department of Health Behavior Policy, Virginia Commonwealth University, Richmond, VA, USA
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Gómez‐Trillos S, Sheppard VB, Graves KD, Song M, Anderson L, Ostrove N, Lopez K, Campos C, Gonzalez N, Hurtado‐de‐Mendoza A. Latinas’ knowledge of and experiences with genetic cancer risk assessment: Barriers and facilitators. J Genet Couns 2019; 29:505-517. [DOI: 10.1002/jgc4.1201] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 11/21/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Sara Gómez‐Trillos
- Lombardi Comprehensive Cancer Center Georgetown University Medical Center Washington District of Columbia
- The Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research Washington District of Columbia
| | - Vanessa B. Sheppard
- Department of Health Behavior and Policy Virginia Commonwealth University School of Medicine Richmond Virginia
| | - Kristi D. Graves
- Lombardi Comprehensive Cancer Center Georgetown University Medical Center Washington District of Columbia
- The Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research Washington District of Columbia
| | - Minna Song
- Lombardi Comprehensive Cancer Center Georgetown University Medical Center Washington District of Columbia
| | - Lyndsay Anderson
- Department of Nursing California State University Sacramento California
| | | | - Katherine Lopez
- Lombardi Comprehensive Cancer Center Georgetown University Medical Center Washington District of Columbia
| | | | | | - Alejandra Hurtado‐de‐Mendoza
- Lombardi Comprehensive Cancer Center Georgetown University Medical Center Washington District of Columbia
- The Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research Washington District of Columbia
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Hurtado-de-Mendoza A, Graves KD, Gómez-Trillos S, Song M, Anderson L, Campos C, Carrera P, Ostrove N, Peshkin BN, Schwartz MD, Ficca N, Cupertino AP, Gonzalez N, Otero A, Huerta E, Sheppard VB. Developing a culturally targeted video to enhance the use of genetic counseling in Latina women at increased risk for hereditary breast and ovarian cancer. J Community Genet 2019; 11:85-99. [PMID: 31104207 DOI: 10.1007/s12687-019-00423-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 04/25/2019] [Indexed: 01/28/2023] Open
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 "Rosa'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.
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Affiliation(s)
- Alejandra Hurtado-de-Mendoza
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA. .,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA.
| | - Kristi D Graves
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Sara Gómez-Trillos
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Minna Song
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA
| | - Lyndsay Anderson
- Department of Nursing, California State University, Sacramento, USA
| | - Claudia Campos
- Nueva Vida, DC Office-Alexandria, 206 N. Washington St. Suite 300, Alexandria, VA, 22314, USA
| | - Pilar Carrera
- Department of Psychology, Universidad Autonoma de Madrid, Madrid, Spain
| | | | - Beth N Peshkin
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Marc D Schwartz
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Nan Ficca
- National Conservatory of Dramatic Arts, Washington, DC, USA
| | - Ana-Paula Cupertino
- Cancer Prevention and Control Program, John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Nathaly Gonzalez
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Capital Breast Cancer Center, 1000 New Jersey Ave, SE, Washington, DC, USA
| | - Andrea Otero
- Instituto de Medicina Oncológica y Molecular de Asturias (IMOMA), Av. Richard Grandío, 33193, Oviedo (Asturias), Spain
| | - Elmer Huerta
- Cancer Preventorium, Washington Cancer Institute, MedStar Washington Hospital Center, 110 Irving St, NW, Washington, DC, USA
| | - Vanessa B Sheppard
- Department of Health Behavior Policy, Virginia Commonwealth University, Richmond, VA, USA
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