4.1 Article

Process evaluation of a culturally targeted video for Latinas at risk of hereditary breast and ovarian cancer

Journal

JOURNAL OF GENETIC COUNSELING
Volume 30, Issue 3, Pages 730-741

Publisher

WILEY
DOI: 10.1002/jgc4.1361

Keywords

breast cancer; education; genetic counseling; hereditary breast and ovarian cancer; latinx; underrepresented populations

Funding

  1. National Cancer Institute [R03CA191543]
  2. Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) by Federal Funds
  3. National Center for Advancing Translational Sciences (NCATS)
  4. National Institutes of Health (NIH), through the Clinical and Translational Science Awards Program (CTSA) [KL2TR001432]
  5. Ministry of Science, Innovation, and Universities in Spain [PGC2018-093821-B-I00]

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The culturally targeted narrative video about HBOC for Latina women was well-received, with high engagement and identification among participants. Participants reported mostly positive emotions and those with low health literacy and affected by HBOC showed higher identification with the main character. Qualitative data supported these findings.
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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