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.
J Genet Couns. 2021 Jun;30(3):730-741. doi: 10.1002/jgc4.1361. Epub 2020 Nov 22.
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.
这篇论文介绍了一项针对遗传性乳腺癌和卵巢癌（HBOC）高危拉丁裔女性的文化定向叙事视频的过程评估。有 HBOC 患病风险的讲西班牙语的拉丁裔女性参与了一项单臂研究（n=40）。参与者观看了作者制作的视频，并回答了调查问题。我们使用混合方法评估了假设的叙事干预中介理论构念（即，交通或参与、与角色的认同、情绪）和实施结果（例如，可接受性）。描述性统计总结了理论构念和实施结果。我们进行了曼-惠特尼 U 检验，以评估受影响与未受影响参与者以及不同教育和健康素养水平参与者之间在理论和实施结果方面的差异。我们使用共识定性研究框架分析定性数据。参与者的平均年龄为 47.1 岁（SD=9.48）。大多数参与者是高中毕业生或以下学历（62.5%）。视频的可接受性极高（Md=10.0，IQR=0.2，范围 1-10）。大多数人（82.5%）建议通过社交媒体传播视频。参与者参与度很高（Md=5.7，IQR=1.5，范围 1-7），与主要角色强烈认同（Md=8.7，IQR=2.6，范围 1-10），并报告经历了大多数积极的情绪（Md=9.5，IQR=2.8，范围 1-10）。低健康素养和受影响的参与者报告与主要角色的认同显著更高（p<.05）。定性数据强化了定量发现。女性报告获得了知识、纠正了误解并感到有力量。我们的文化定向视频非常受欢迎，针对叙事干预的行为改变机制。该视频易于传播，可作为包括受影响和未受影响的女性以及不同教育和健康素养水平的患者在内的教育工具使用。未来的研究应测试该视频在增强遗传咨询和检测接受度方面的影响。
