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Grant Details

Grant Number: 5R03CA191543-02 Interpret this number
Primary Investigator: Hurtado De Mendoza Casaus, Alejandra
Organization: Georgetown University
Project Title: Enhancing at-Risk Latina Women's Use of Genetic Counseling for Hereditary Breast and Ovarian Cancer
Fiscal Year: 2017


 DESCRIPTION (provided by applicant): Breast cancer is the leading cause of cancer death among Latinas. Latinas also have a high prevalence of BRCA1/2 gene mutations, which increases their risk of developing breast and ovarian cancer. Genetic cancer risk assessments (GCRA) for hereditary breast and ovarian cancer (HBOC) can inform prevention and treatment decisions resulting in breast cancer risk reduction. Despite guidelines to refer women at a high risk of carrying a mutation to GCRA services, Latinas underuse these services. Reasons for Latinas' low GCRA participation include environmental (e.g. access, limited Spanish resources) and psychosocial factors (e.g. knowledge, literacy, emotional concerns). Our preliminary data suggest that improving access may not necessarily translate into uptake and that providers face challenges communicating about genomics with Latina. To develop effective HBOC communication it is key to understand Latinas' intuitive beliefs about GCRA, which are informed by prior experience and culture (mental models), as they impact how risk information is processed. It is also necessary to understand emotional reactions and potential ambivalence about GCRA. There have been few interventions designed to increase GCRA use in Latinas. To move the field forward we will conduct a novel risk communication intervention designed to target mental models, emotions, and ambivalence. Guided by the Theory of Planned Behavior and Social Cognitive Theory, we will conduct a two-phased mixed methods study. In Phase I we will interview key informants (n=10) and at- risk Latinas (n=20) to describe their mental models and other psychosocial factors. These data will inform the risk-benefit messages that will be evaluated and refined in focus groups (n=20) and delivered via Latina actors and a trusted medical personality in a media intervention (i.e.YouTube video). In Phase II we will pilot the intervention on at-risk Latinas (n=40). After the baseline, women will watch the 15-minute video, complete a follow-up assessment, and will be referred to a patient navigator for resource linkages. GCRA uptake will be assessed at 3-months. Our primary outcome is intentions to use GCRA. Specific aims are: Aim 1. Describe and portray Latinas' GCRA mental models (risks and benefits perceptions, emotions, etc.) Aim 2. Using data from Aim 1, develop the content of the risk-benefit communication messages for at-risk Latinas and incorporate these into a Spanish-language YouTube video. Aim 3. Evaluate the acceptability and pre-post intervention differences on the primary outcome (intentions to use GCRA) and intermediate outcomes (e.g. attitudes). We will also explore post-intervention GCRA uptake as a secondary outcome. H.2.1. The intervention will result in a significant increase in intentions to use GCRA H.2.2. The intervention will result in improvements in intermediate outcomes: knowledge, attitudes, self- efficacy, and ambivalence. H.2.3. After the intervention, 30% of Latinas will participate in GCRA by 3 months post-intervention. H.2.4. The majority (≥75%) will be satisfied with the intervention


A culturally targeted video to promote genetic counseling in a community sample of at-risk US Latina women: The role of the concrete mindset.
Authors: Carrera P. , Sheppard V.B. , Caballero A. , Gómez-Trillos S. , Hurtado-de-Mendoza A. .
Source: Journal of community psychology, 2022 Apr; 50(3), p. 1331-1342.
EPub date: 2021-10-04.
PMID: 34606624
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Process evaluation of a culturally targeted video for Latinas at risk of hereditary breast and ovarian cancer.
Authors: Hurtado-de-Mendoza A. , Gómez-Trillos S. , Graves K.D. , Carrera P. , Campos C. , Anderson L. , Gronda A. , Orellana H. , Peshkin B.N. , Schwartz M.D. , et al. .
Source: Journal of genetic counseling, 2021 Jun; 30(3), p. 730-741.
EPub date: 2020-11-22.
PMID: 33222313
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Latinas' knowledge of and experiences with genetic cancer risk assessment: Barriers and facilitators.
Authors: Gómez-Trillos S. , Sheppard V.B. , Graves K.D. , Song M. , Anderson L. , Ostrove N. , Lopez K. , Campos C. , Gonzalez N. , Hurtado-de-Mendoza A. .
Source: Journal of genetic counseling, 2020 Aug; 29(4), p. 505-517.
EPub date: 2019-12-27.
PMID: 31883202
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Developing a culturally targeted video to enhance the use of genetic counseling in Latina women at increased risk for hereditary breast and ovarian cancer.
Authors: Hurtado-de-Mendoza A. , Graves K.D. , Gómez-Trillos S. , Song M. , Anderson L. , Campos C. , Carrera P. , Ostrove N. , Peshkin B.N. , Schwartz M.D. , et al. .
Source: Journal of community genetics, 2020 Jan; 11(1), p. 85-99.
EPub date: 2019-05-18.
PMID: 31104207
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Culturally Targeted Video Improves Psychosocial Outcomes in Latina Women at Risk of Hereditary Breast and Ovarian Cancer.
Authors: Hurtado-de-Mendoza A. , Graves K.D. , Gómez-Trillos S. , Carrera P. , Campos C. , Anderson L. , Luta G. , Peshkin B.N. , Schwartz M.D. , Cupertino A.P. , et al. .
Source: International journal of environmental research and public health, 2019-11-29; 16(23), .
EPub date: 2019-11-29.
PMID: 31795362
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Provider's Perceptions of Barriers and Facilitators for Latinas to Participate in Genetic Cancer Risk Assessment for Hereditary Breast and Ovarian Cancer.
Authors: Hurtado-de-Mendoza A. , Graves K. , Gómez-Trillos S. , Anderson L. , Campos C. , Evans C. , Stearns S. , Zhu Q. , Gonzalez N. , Sheppard V.B. .
Source: Healthcare (Basel, Switzerland), 2018-09-17; 6(3), .
EPub date: 2018-09-17.
PMID: 30227649
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Understanding Breast Cancer Survivors' Beliefs and Concerns About Adjuvant Hormonal Therapy: Promoting Adherence.
Authors: Hurtado-de-Mendoza A. , Jensen R.E. , Jennings Y. , Sheppard V.B. .
Source: Journal of cancer education : the official journal of the American Association for Cancer Education, 2018 Apr; 33(2), p. 436-439.
PMID: 28205022
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The Role of Knowledge on Genetic Counseling and Testing in Black Cancer Survivors at Increased Risk of Carrying a BRCA1/2 Mutation.
Authors: Hurtado-de-Mendoza A. , Jackson M.C. , Anderson L. , Sheppard V.B. .
Source: Journal of genetic counseling, 2017 Feb; 26(1), p. 113-121.
EPub date: 2016-07-12.
PMID: 27402168
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