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Meade CD, Stanley NB, Arevalo M, Tyson DM, Chavarria EA, Aguado Loi CX, Rivera M, Gutierrez L, Abdulla R, Christy SM, Gwede CK. Transcreation matters: A learner centric participatory approach for adapting cancer prevention messages for Latinos. Patient Educ Couns 2023; 115:107888. [PMID: 37463555 DOI: 10.1016/j.pec.2023.107888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Advancing health equity requires innovative patient education approaches for adapting English-language evidence-based interventions (EBIs) to resonate with multicultural, multilingual audiences. OBJECTIVE Examine the benefit, functionality, and practical considerations of transcreation (translation + cultural adaptation) as a critical and salient learner-centric process for developing a Spanish-language intervention (photonovella + video): Un examen sencillo para un colon saludable (A simple test for a healthy colon). PATIENT/COMMUNITY INVOLVEMENT We involved patients/community members in a participatory reflective process, from problem identification to intervention design, development, delivery, and impact measurement. METHODS A community-based participatory research (CBPR) approach involving formative research plus systematic iterative pretesting and learner verification checks augmented by a community advisory board guided the transcreation processes. RESULTS Data collected using a learner-centric approach effectively produced a new Spanish-language EBI and substantiated the value of co-learner/co-design methods. Learner-centric methods identified cultural nuances that were treated as knowledge and integrated into the intervention materials and study design. Pilot testing of the intervention among Latinos receiving care at community clinics demonstrated improved initial colorectal cancer screening uptake, awareness, and perceived susceptibility. DISCUSSION Inherent in the transcreation process was learner involvement that informed essential modification and adaptation of the materials. The transcreation methods led to the development of a culturally salient intervention that maintained theoretical integrity and message intent as well as behavioral activation. Findings have broad implications for the creation and transfer of EBIs to new audiences for greater adoption, engagement, and 'reach' of interventions. PRACTICAL VALUE Transcreation aligns with a growing paradigm shift in health communication science that brings to light the beneficial effect that construction and application of cultural knowledge has on patient education toward health equity.
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Affiliation(s)
- Cathy D Meade
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA.
| | - Nathanael B Stanley
- Office of Community Outreach, Engagement & Equity. Moffitt Cancer Center, Tampa, FL, USA
| | - Mariana Arevalo
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Office of Community Outreach, Engagement & Equity. Moffitt Cancer Center, Tampa, FL, USA
| | | | - Enmanuel A Chavarria
- Behavioral, Social, and Health Education Sciences Department, Emory University, Atlanta, GA, USA
| | - Claudia X Aguado Loi
- Department of Health Science and Human Performance, University of Tampa, Tampa, FL, USA
| | | | | | - Rania Abdulla
- NTRO Non-Therapeutic Research Office, Moffitt Cancer Center, Tampa, USA
| | - Shannon M Christy
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, USA
| | - Clement K Gwede
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA
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Thomas-Purcell KB, Patterson S, McIntosh AN, Richards C, Primus-Joseph M, Purcell DJ, Ashing K. Woman-to-woman: Feasibility of a lay health advisor program for cervical cancer education in Grenada, W.I. PEC Innov 2022; 1:100073. [PMID: 37213742 PMCID: PMC10194396 DOI: 10.1016/j.pecinn.2022.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 07/27/2022] [Accepted: 08/15/2022] [Indexed: 05/23/2023]
Abstract
Objective The aim of this study was to evaluate the impact of Woman- to-Woman, a lay health advisor (LHA)-led educational intervention on cervical cancer and human papillomavirus (HPV) knowledge in a cohort of at-risk Grenadian women. Methods LHAs from high-risk parishes were trained in the administration of the intervention and administered the program to 78 local women. Participants completed a pre- and post-knowledge test and a session evaluation. LHAs participated in a process evaluation focus group. Results Sixty-eight percent (68%) of participants obtained higher knowledge scores following the educational intervention. The difference between the pre- and post-test scores was statistically significant (p = 0.05). Almost 94% agreed that they were taught new and useful information by credible, community informed and responsive LHAs. Ninety percent (90%) indicated great satisfaction and high motivation to recommend to others. LHAs reported on the intervention and their community interactions. Conclusions Results demonstrate that a LHA-led educational intervention significantly improved participants' knowledge of cervical cancer, HPV, Papanicolaou test and vaccination against HPV. Innovations: Researchers trancreated an evidenced based intervention originally designed for Latina women for Grenadian women. There is no evidence in the literature of previous LHA- cervical cancer education studies conducted in Grenada nor the Caribbean.
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Affiliation(s)
- Kamilah B. Thomas-Purcell
- Department of Health Science, College of Health Care Sciences, Nova Southeastern University, Ft. Lauderdale, FL, USA
- Corresponding author at: 3200 South University Drive, Terry Bldg. 1232, Ft. Lauderdale, FL 33328, USA.
| | - Samantha Patterson
- Canton Medical Education Foundation Aultman /Cleveland Clinic Mercy Hospitals, Canton, OH, USA
| | - Andrew N. McIntosh
- Women's and Children's Health Services Unit, Dr. D. Orlando Smith Hospital, Tortola, British Virgin Islands
| | - Christine Richards
- Department of Public Health and Preventive Medicine, St. George's, Grenada, West Indies
| | | | - Donrie J. Purcell
- Satcher Health Leadership Institute, Morehouse School of Medicine, Atlanta, GA, USA
| | - Kimlin Ashing
- Division of Health Equity, City of Hope Medical Center, Duarte, CA, USA
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Rivera YM, Vélez H, Canales J, Jiménez JC, Moreno L, Torres J, Vadaparampil ST, Muñoz-Antonia T, Quinn GP. When a Common Language Is Not Enough: Transcreating Cancer 101 for Communities in Puerto Rico. J Cancer Educ 2016; 31:776-783. [PMID: 26365291 PMCID: PMC4791206 DOI: 10.1007/s13187-015-0912-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In Puerto Rico (PR), cancer is the leading cause of death. Previous research has identified the need for cancer education in PR. Using culturally adapted cancer curricula to train local health educators may effectively increase cancer education and reduce health disparities. This article describes the three-phase process used to transcreate the Cancer 101 curriculum to train Master of Public Health (MPH) students to educate PR communities. First, an expert panel collaboratively reviewed the curriculum for content, legibility, utility, and colloquialisms. Recommendations included incorporating local references and resources, replacing words and examples with culturally relevant topics, and updating objectives and evaluation items. Subsequent focus groups with 10 MPH students assessed the adaptation's strengths, weaknesses, and utility for future trainees. Participants were satisfied with the curriculum's overall adaptation, ease of use, and listed resources; further improvements were suggested for all modules. Final expert panel revisions highlighted minor feedback, with the final curriculum containing nine transcreated modules. The transcreation process identified the need for changes to content and cultural translation. Changes were culturally and literacy-level appropriate, represented PR's social context, and were tailored for future trainees to successfully deliver cancer education. Findings highlight the importance of adapting Spanish educational materials across Hispanic sub-groups.
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Affiliation(s)
- Y M Rivera
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA
| | - H Vélez
- Public Health Program, Ponce Health Sciences University, Ponce, PR, 00732, USA
| | - J Canales
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA
| | - J C Jiménez
- Clinical Psychology Program, Ponce Health Sciences University, Ponce, PR, 00732, USA
| | - L Moreno
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA
| | - J Torres
- Biochemistry Department, Ponce Health Sciences University, Ponce, PR, 00732, USA
| | - S T Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA
- Department of Oncologic Science, University of South Florida, Tampa, FL, 33612, USA
| | - T Muñoz-Antonia
- Department of Oncologic Science, University of South Florida, Tampa, FL, 33612, USA
- Department of Tumor Biology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA
| | - G P Quinn
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612, USA.
- Department of Oncologic Science, University of South Florida, Tampa, FL, 33612, USA.
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