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    Research Grants Awarded

    Partners in Living: The Theory of Planned Behavior as a Family Intervention Strategy to Influence Breast Cancer Screening Behavior of Latina Immigrants

    Study Section:
    Population Specific

    Scientific Abstract:
    Background: Breast cancer is the leading cause of cancer death among Latinas; yet screening rates for Latinas continue to be among the lowest reported for ethnic groups. Studies reveal that Latinas hold strong cultural beliefs that predispose them to avoid breast screening. Social support is reported in the literature as a positive influence on cancer screening behavior. However, because the Latina immigrant relies on family above friends and often is isolated from extended family members, support for cancer screening from her partner may be a critical factor in compliance. Research suggests that improved education of, and communication between partners may enhance the Latino’s cultural inclination to protect his partner’s health. The project is based on the Theory of Planned Behavior (TPB), a robust model that has been successfully applied with a wide range of health behaviors and cultural groups. Objectives: This project will examine the research questions: 1) What are the attitudes, subjective norms, behavioral and normative beliefs, and behavioral intentions of Latinas regarding breast screening prior to participation in a family intervention? 2) What are the effects of the intervention on these variables? 3) Is there a difference in compliance with breast screening by Latinas after the intervention? Specific Aim: To determine the effects of a family intervention on the motivation and subsequent behavior of Latinas in relation to breast cancer screening. Study Design: The tools to measure the TPB variables will be developed using focus groups derived from the population under study. The sample will include 100 Latinas and their partners. HACER, a local leadership organization for Latino immigrants, will collaborate with the university on the project. The culturally and linguistically oriented intervention will take place during sessions following weekly English classes offered at an outreach ministry called HOPE. Data on demographics, acculturation, and compliance with breast cancer screening guidelines will be collected. The sample will be tested using the TPB tools before and after the intervention. Visits made to local hospitals for clinical breast examination and mammography will be tracked. Outcomes: Information from this study will inform community outreach programs designed to improve compliance of Latinas with a breast cancer screening protocol. It will serve as a model for partnership programs designed to serve immigrant groups in rural areas.

    Lay Abstract:
    Background: Breast cancer is the leading cause of cancer death among Latinas, yet reports of recent practices show that they are not following current recommendations for breast cancer screening. Cultural beliefs and attitudes have been shown to contribute to the low level of breast cancer screening reported for Latinas. Research shows that the support of others has a positive influence on the practice of cancer screening. However, the Latina immigrant, who tends to rely more on family than friends for support and who may be isolated from her extended family, may rely on her partner’s support for the motivation she needs to seek out breast cancer screening examinations. Without the support of her partner, the Latina immigrant may find breast cancer screening an overwhelming task. Research suggests that Latinos may encourage their partners to seek breast cancer screening if they know more about it, and can communicate about it. Objective: The main objective of this study is to determine how a family intervention will affect the attitudes, beliefs, expectations, and subsequent behavior of Latinas toward breast cancer screening. Study Design: Prior to the study, a group of Latinas and Latinos will try out the intervention to provide the researcher with feedback about whether it is culturally appropriate, and adjustments will be made as needed. The study sample will include 100 Latinas and their partners who agree to participate in the interventions. The interventions will take place after evening English language classes offered by an outreach ministry called HOPE. The interventions will be provided in Spanish and will include education about breast cancer and screening, and will allow partners to discuss these topics with each other through a structured exercise. HACER, a local leadership organization for Latino immigrants, will collaborate with the university to carry out the interventions. Each Latina will complete a survey just before and just after the intervention. Information such as history of previous breast screening, age, length of time living in the United States , and country of birth will be obtained. Visits Latinas may make to local clinics and hospitals for clinical breast examinations and mammography will be tracked. Outcomes: The findings of this study will increase our knowledge about how to design rural outreach programs that are intended to increase the number of Latinas who follow breast cancer screening recommendations.