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BackgroundBreast cancer is the most common cancer diagnosed among Latinas in the United States and the leading cause of cancer-related death among this population. Latinas tend to be diagnosed at a later stage and have worse prognostic features than their non-Hispanic white counterparts. Genetic and genomic factors may contribute to observed breast cancer health disparities in Latinas.MethodsWe provide a landscape of our current understanding and the existing gaps that need to be filled across the cancer prevention and control continuum.ResultsWe summarize available data on mutations in high and moderate penetrance genes for inherited risk of breast cancer and the associated literature on disparities in awareness of and uptake of genetic counseling and testing in Latina populations. We also discuss common genetic polymorphisms and risk of breast cancer in Latinas. In the treatment setting, we examine tumor genomics and pharmacogenomics in Latina patients with breast cancer.ConclusionsAs the US population continues to diversify, extending genetic and genomic research into this underserved and understudied population is critical. By understanding the risk of breast cancer among ethnically diverse populations, we will be better positioned to make treatment advancements for earlier stages of cancer, identify more effective and ideally less toxic treatment regimens, and increase rates of survival.

The pilot study reported in this article culturally and linguistically adapted an educational intervention to promote cancer clinical trials (CCTs) participation among Latinas/os and African Americans. The single-session slide presentation with embedded videos, originally developed through a campus-community partnership in Southern California, was chosen for adaptation because it was perceived to fit the CORRECT model of innovation (credible, observable, relevant, relatively advantageous, easy to understand, compatible, and testable) and because of the potential to customize any components not identified as core, allowing them to be revised for cultural and linguistic alignment in New York City. Most of the 143 community participants (76.2%) were female; most (54.6%) were older than 59 years. More than half (78.3%) preferred to speak English or were bilingual in English and Spanish. A large proportion (41.3%) had not completed high school. Knowledge and perceived benefits and barriers regarding CCT showed small, though statistically significant, increases. There were no statistically significant group differences for changes in mean knowledge, perceived benefits, or perceived barriers when examined by ethnicity, education level, language, or other included sociodemographic variables. However, a small, but statistically significant difference in perceived barriers was observed when examined by country of origin, with the foreign born score worsening 0.08 points (SD = 0.47, p = .007) on the 5-point Likert-type scale administered posteducation compared to preeducation. Participants' open-ended comments demonstrated the acceptability of the topic and intervention. This adaptation resulted in an intervention with the potential to educate African American and Latina/o general community members in a new geographic region about the purpose, methods, and benefits of CCTs.

Perceived risk is a common component of health decision making theory. When affective components of risk are assessed as predictors of a behavior, they are usually examined separately from cognitive components. Less frequently examined are more complex interplays between affect and cognition. We hypothesized that cognitive and affective risk components would both have direct effects on colonoscopy behavior/intentions and that affective components would mediate the relationship of cognitively-based perceived risk to colonoscopy screening. In two secondary analyses, participants reported their cognitive and affective perceived risk for colorectal cancer, past colonoscopy behavior, and future screening intentions. In both studies, cognitive and affective risk components were associated with increased screening behavior/intentions and cognitive risk components were mediated through affective risk. Given the impact of early detection on colorectal cancer prevention, educational strategies highlighting both components of risk may be important to increase screening rates., Author(s): Lynne B. Klasko-Foster [sup.1] , Marc T. Kiviniemi [sup.2] , Lina H. Jandorf [sup.3] , Deborah O. Erwin [sup.4] Author Affiliations: (1) grid.273335.3, 0000 0004 1936 9887, Department of [...]

Abstract The purpose of this study was to educate Latino and African American urban populations about cancer clinical trials. Compared to whites, both African Americans and Latinos tend to have lower access to cancer treatment and to be diagnosed at advanced stages, trends associated with increased mortality and more difficult treatments. Clinical trials offer the possibility of developing improved treatments and participants may access treatments before they are widely available. Yet, while overall 3-5% of cancer patients participate in clinical trials, a lower proportion of ethnic minorities participate, resulting in limited generalizability of outcome data on the effectiveness of interventions to prevent and control cancer among underrepresented groups, and less access to newer treatments. Previous research has identified barriers to minority participation in clinical research related to scientific literacy (including fear of mistreatment), language, and civic literacy (lack of trust in biomedical systems). This paper describes the adaptation of a community-based cancer clinical trials educational program from the West Coast of the United States to the East Coast. Researchers and program staff from the two sites worked closely together to share materials, including the pre- and post-program questionnaires and the curriculum formatted in PowerPoint. The program curriculum was revised to be consistent with contextual factors, in order to be culturally competent in the adapting region, as follows. Minority cancer clinical trial participants who were representative of local populations were invited to participate in videotaped interviews about their research experiences. Taped segments of local interview subjects were integrated into the presentation, and segments featuring West Coast research participants were removed. The Spanish language in the curriculum was revised to match regional usage of Latino groups dominant in the East Coast region, while attempting to maintain fidelity with the original meaning. Community outreach, program delivery, and data collection methods were revised to be compatible with the capacity of the adapting site, including revising the measures to match Spanish-language changes made in the curriculum and shifting from written questionnaires to Audience Response electronic technology. Every possible effort was made to otherwise maintain fidelity during implementation and measurement. In the data analysis phase, the research staff is sharing syntax for variable recoding and creation, and will discuss and compare findings across both sites. To test the feasibility of the adaptation, a recruitment goal of 120 participants (40 African Americans, 40 English-speaking Latinos, and 40 Spanish speaking Latinos) was planned. To meet our recruitment goals, over all, 143 people attended our replication programs. To measure participant responsiveness, participants were asked to provide open-ended written comments. The vast majority expressed satisfaction with the presentation. The main themes identified from their comments were that the program was interesting, important, and useful, and that they learned something new. Negative feedback regarding the presentation was minor and related to technical difficulties which prolonged the meetings. We discuss the procedures and lessons learned during the adaptation and feasibility testing of this intervention. This study demonstrates that adaptation of a cancer clinical trials education program from one geographic region to another is feasible, and that the process and the initiative benefit from the sharing of materials between multiple sites. These data contribute to the growing literature on dissemination and implementation research in cancer control and prevention. Citation Format: Debra J. Pelto, Georgia Robins Sadler, Ogo Njoku, Maria Carina Rodriguez, Alma Behar, Vanessa L. Malcarne, Lina Jandorf. Adaptation of a cancer clinical trials educational program for African Americans and Latinos. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A56. doi:10.1158/1538-7755.DISP13-A56

African American women have the highest colorectal cancer incidence and mortality rates among women of any race/ethnicity in the United States. Colonoscopy screening is an efficacious procedure for the prevention and early detection of colorectal cancer, making it a promising tool in the effort to eliminate colorectal cancer disparities. Toward that end, the present qualitative study sought to assess acceptability of and preferences for a beauty salon--based intervention to promote colonoscopy screening among African American women. A total of 11 focus groups were conducted: 6 with staff from African American-serving salons (n = 3 with salon owners, n = 3 with salon stylists) and 5 with African American salon clients. Theory-guided focus group questions were used to explore participants' beliefs, interests, and preferences associated with the proposed intervention. Results indicated that, across all subgroups, participants were highly supportive of the idea of a salon-based intervention to promote colonoscopy screening among African American women, citing reasons such as the commonplace nature of health discussions in salons and the belief that, with proper training, stylists could effectively deliver colorectal cancer-related health information to their clients. The greatest differences between salon staff and clients were found with respect to the specifics of the intervention. Staff focused more heavily on content-related issues, such as the specific information that should be stressed in the intervention, whereas clients focused largely on process-related issues, such as the preferred intervention formats and how stylists should present themselves to clients. The findings from this study offer both encouragement and important groundwork for the development of a salon-based, stylist-delivered intervention to promote colonoscopy screening among African American women.

Lay Health Advisor (LHA) programs hold tremendous promise for reducing health disparities and addressing social determinants of health in medically underserved communities, including African American populations. Very little is understood about the capacity of LHAs in these roles and the broader contributions they make to their communities. This article seeks to address this gap by describing the characteristics and capacity of a sample of 76 female African American LHAs from a nationally disseminated evidence-based LHA program for breast and cervical cancer screening (The National Witness Project), as well as potential differences between cancer survivors and nonsurvivors who serve as LHAs. A conceptual model for understanding LHA capacity and contributions in underserved communities at the individual, social, and organizational levels is presented. We describe LHA experiences and characteristics (e.g., experiences of mistrust and discrimination, racial pride, sociodemographics), capacity at the individual level (e.g., psychological and physical health, health behaviors), capacity at the social level (e.g., social networks, social support), and capacity at the organizational level (e.g., role-related competencies, self-efficacy, leadership, role benefits/challenges). Data were obtained through interview-administered telephone surveys between 2010 and 2011. Findings highlight the critical capacity that LHAs bring to their communities and the importance of supporting LHAs to sustain these programs and to address racial/ethnic health disparities.