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Testing a culturally targeted narrative video to reduce disparities in the use of genetic counseling and testing in Latina women at-risk of HBOC

Award Number: R01CA248543
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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ABSTRACT National guidelines recommend that women at increased risk for Hereditary Breast and Ovarian Cancer (HBOC) due to BRCA1/2 mutations be referred for genetic counseling and consider genetic testing. Awareness of a positive result can inform treatment decisions for cancer patients and risk management plans in both cancer survivors and women unaffected with cancer. The slow translation of guidelines into practice particularly impacts minority populations who receive services in community health clinics. Latina women have lower awareness and use of genetic counseling and testing (GCT) than non-Latina Whites. Latinas face multiple health care, pragmatic, and psychosocial barriers to GCT uptake. Latinas prefer culturally targeted interventions in Spanish with plain language, visual aids, and a narrative format. We developed a culturally targeted narrative video in Spanish for at-risk Latinas. Piloted in a single-arm trial (N=40), Latinas reported high satisfaction and exhibited a significant increase in knowledge from pre- to post-test. Nearly all participants (95%) reported an interest in GCT, and 62% completed genetic counseling. We will use an innovative hybrid research design that combines elements of traditional efficacy studies as well as best practices from implementation research to enhance the quality and speed of the translational process. Guided by an expanded Integrated Behavioral Model, we will conduct a RCT to evaluate the efficacy of our video vs. the FORCE fact sheet on enhancing GCT uptake and psychosocial outcomes. To maximize the potential for implementation in community clinics, we will train clinic staff to administer the Referral Screening Tool (RST), a validated tool to identify women at-risk of HBOC. Guided by the Consolidated Framework for Implementation Research, we will conduct an Implementation Focused Process Evaluation to gather data on clinic implementation outcomes for use of the Referral Screening Tool and the video. We will refer participants to free Spanish telephone genetic counseling. We will randomize 300 at-risk Latinas at four sites with large Latinx populations. Our primary outcome is genetic counseling uptake. Aim 1. Evaluate the impact of our video vs. fact sheet on GCT uptake. Participants in the video arm will have higher genetic counseling uptake (H1.1.) and higher genetic testing uptake (H1.2.) at 4 months. Aim 2. Evaluate the impact of our video vs. fact sheet on psychosocial and process evaluation outcomes. H2.1: Video participants will have higher knowledge, positive attitudes, subjective norms, self-efficacy, and positive anticipatory emotions. H2.2. Video participants will have higher acceptability and feasibility ratings. Exploratory aim: Evaluate mechanisms of the video's impact on genetic counseling uptake (knowledge, attitudes, norms, self-efficacy, anticipatory emotions). If counseling uptake does not differ by arm, then we will evaluate predictors of uptake. Aim 3. Examine key implementation outcomes of feasibility, acceptability, adoption, fidelity, and future sustainability of using the Referral Screening Tool and the video at the community clinics.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $532,923 )
2024	2024	GEORGETOWN UNIVERSITY	MAIN CAMPUS	WASHINGTON	DC	20057	DISTRICT OF COLUMBIA	USA	Cancer Cause and Prevention Research	001	4	4/18/2024	NON-COMPETING CONTINUATION	$28,049
2024	2024	GEORGETOWN UNIVERSITY	MAIN CAMPUS	WASHINGTON	DC	20057	DISTRICT OF COLUMBIA	USA	Cancer Cause and Prevention Research	000	4	12/29/2023	NON-COMPETING CONTINUATION	$504,874
														Subtotal = $532,923

Issue Date FY: 2023 ( Subtotal = $548,766 )
2023	2023	GEORGETOWN UNIVERSITY	MAIN CAMPUS	WASHINGTON	DC	20057	DISTRICT OF COLUMBIA	USA	Cancer Cause and Prevention Research	000	3	12/20/2022	NON-COMPETING CONTINUATION	$503,970
2023	2023	GEORGETOWN UNIVERSITY	MAIN CAMPUS	WASHINGTON	DC	20057	DISTRICT OF COLUMBIA	USA	Cancer Cause and Prevention Research	001	3	3/16/2023	NON-COMPETING CONTINUATION	$44,796
														Subtotal = $548,766

Issue Date FY: 2022 ( Subtotal = $551,904 )
2022	2022	GEORGETOWN UNIVERSITY (THE)	37TH AND O ST NW	WASHINGTON	DC	20057	DISTRICT OF COLUMBIA	USA	Cancer Cause and Prevention Research	000	2	12/31/2021	NON-COMPETING CONTINUATION	$506,851
2022	2022	GEORGETOWN UNIVERSITY (THE)	37TH AND O ST NW	WASHINGTON	DC	20057	DISTRICT OF COLUMBIA	USA	Cancer Cause and Prevention Research	001	2	6/10/2022	NON-COMPETING CONTINUATION	$45,053
														Subtotal = $551,904

Issue Date FY: 2021 ( Subtotal = $596,045 )
2021	2021	GEORGETOWN UNIVERSITY (THE)	37TH AND O ST NW	WASHINGTON	DC	20057	DISTRICT OF COLUMBIA	USA	Cancer Cause and Prevention Research	000	1	12/28/2020	NEW	$596,045
														Subtotal = $596,045

Grand Total All Awards = $2,229,638

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Testing a culturally targeted narrative video to reduce disparities in the use of genetic counseling and testing in Latina women at-risk of HBOC

Award Number: R01CA248543

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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