Barajas Rolando, Barajas Clara B, Ramos Yaideliz M Romero, Trillos Sara Gómez, Sawhney Sabrina, Campos Claudia, Hurtado-de-Mendoza Alejandra, Rotunno Melissa, Gillanders Elizabeth
Georgetown University School of Medicine, Washington, DC, USA.
Division of Cancer Control and Population Sciences, Genomic Epidemiology Branch, National Health Institutes/National Cancer Institute, Bethesda, MD, USA.
J Community Genet. 2024 Oct;15(5):475-488. doi: 10.1007/s12687-024-00728-5. Epub 2024 Sep 6.
Latinas are less likely to receive genetic counseling and genetic testing (GCT) compared to non-Latina Whites because of systemic and patient-level barriers. We developed and tested fotonovelas to increase awareness of GCT among Latinas at-risk of hereditary breast and ovarian cancer (HBOC). Content for the fotonovelas was drawn from an existing culturally targeted narrative video focused on improving GCT use among Latinas at-risk of HBOC. Using mixed methods, we interviewed cancer patients (n = 10) and their relatives (n = 10) to assess the preliminary efficacy of the fotonovelas through pre-and post-fotonovela items assessing self-rated knowledge of GCT and willingness to discuss cancer with family. Health workers (n = 10) provided feedback on the fotonovela content. McNemar's test was used to examine differences in the proportions of the outcomes pre- and post-fotonovelas. Interviews were transcribed and coded in Dedoose using a consensual qualitative research approach. Reading the fotonovelas increased self-rated knowledge of GCT by 22% (p = 0.16), from 50 to 60% in patients and from 63 to 100% among relatives. Analogously, reading the fotonovela increased willingness to talk about cancer with family by 33% (p = 0.02), from 70 to 100% in patients and from 38 to 75% in relatives. We identified six themes, some centered around the fotonovela's message, feedback, and perceived barriers to GCT. Overall, participants liked the use of fotonovelas to increase GCT awareness and cancer conversations with family. Fotonovelas could potentially be used as educational tools to increase GCT awareness and cancer conversations among Latino families at-risk of HBOC.
由于系统性和患者层面的障碍,与非拉丁裔白人相比,拉丁裔女性接受遗传咨询和基因检测(GCT)的可能性较小。我们开发并测试了图文小说,以提高有遗传性乳腺癌和卵巢癌(HBOC)风险的拉丁裔女性对GCT的认识。图文小说的内容取材于一个现有的针对特定文化群体的叙事视频,该视频专注于提高有HBOC风险的拉丁裔女性对GCT的使用。我们采用混合方法,采访了癌症患者(n = 10)及其亲属(n = 10),通过图文小说前后的项目来评估图文小说的初步效果,这些项目评估了对GCT的自我评估知识以及与家人讨论癌症的意愿。卫生工作者(n = 10)对图文小说的内容提供了反馈。使用McNemar检验来检查图文小说前后结果比例的差异。访谈内容在Dedoose中进行转录和编码,采用共识定性研究方法。阅读图文小说后,患者对GCT的自我评估知识提高了22%(p = 0.16),从50%提高到60%,亲属从63%提高到100%。类似地,阅读图文小说后,与家人谈论癌症的意愿提高了33%(p = 0.02),患者从70%提高到100%,亲属从38%提高到75%。我们确定了六个主题,有些围绕图文小说的信息、反馈以及对GCT的感知障碍。总体而言,参与者喜欢使用图文小说来提高对GCT的认识以及与家人进行癌症相关的对话。图文小说有可能被用作教育工具,以提高有HBOC风险的拉丁裔家庭对GCT的认识以及进行癌症相关的对话。