Informing Latinas About Medications To Reduce Risk For Breast Cancer

描述（由申请人提供）：拉丁美洲和非拉丁美洲白色妇女之间存在显著的差异，预防和治疗乳腺癌。一个重要因素似乎是这些妇女群体之间在获得循证保健信息方面的差异。传播语言，识字和文化上适当的预防和治疗信息可以减少拉丁美洲人在获得循证健康信息和预防性护理方面的差距。兰德健康公司与Olive View-加州大学洛杉矶分校医学中心（OVMC）（一家洛杉矶县卫生服务部医院）合作，建议开发并实施三种替代策略的试点评估，以传达与CER“降低女性原发性乳腺癌风险的药物比较有效性”相关的患者目标信息。“总体目标是通过在有乳腺癌风险的西班牙语妇女中调整和测试创新的替代策略，增加本CER建议的使用、影响和实施。本CER目前没有面向消费者的材料。该提案有三个具体目标：1.进行形成性研究，为所选CER制定语言、识字、文化和内容适当的循证患者导向信息。2.开发和试点测试三种替代原型的功效（例如，印刷媒体、社区卫生工作者、计算机传递），以便向讲西班牙语的妇女传递信息。3.与AHRQ和其他利益攸关方合作，制定一项传播结果的计划，以促进CER建议在拉丁裔高危妇女中的有效性和影响。为了平衡消费者，临床和循证观点，该项目将采用利益相关者，关键知情人访谈和焦点小组的社区咨询委员会，以帮助确定和“翻译”的关键信息，确定最佳的传播场所，并招募高风险的妇女人口来测试车辆。我们将翻译定义为调整CER的循证建议的语言，识字水平和文化重点，以瞄准目标受众。本CER主题的可用传播材料技术性很强。因此，对于这个初始项目，我们集中精力使用多组随机对照试验评估翻译策略的相对疗效。我们的项目的一个重要部分将是制定一个传播计划，考虑扩大干预措施的替代方案，我们发现这些干预措施对未来评估其在真实的世界中的有效性是有效的。兰德健康公司组建了一个卓越的项目团队，该团队在证据审查过程、乳腺癌预防和治疗、健康传播、双语和双文化实施和评估方法方面拥有技能和经验，并具有与相关人群打交道的直接经验。 公共卫生相关性：缺乏语言，识字和文化上适当的循证信息有助于拉丁美洲和非拉丁美洲白色妇女之间的乳腺癌保健和健康的差距。拟议的项目将试点和比较三个以证据为基础的面向病人的教育原型，针对拉丁美洲人，为潜在的挽救生命的预防性治疗，并使用替代模式（印刷媒体，社区卫生工作者，计算机交付）。

DESCRIPTION (provided by applicant): Significant disparities exist between the prevention and treatment of breast cancer among Latinas and non-Latina white women. An important factor appears to be the difference in access to evidence-based health information between these groups of women. Dissemination of language-, literacy-, and culturally appropriate prevention and treatment messages could reduce disparities in access to evidenced-based health information and preventive care for Latinas at risk for breast cancer. RAND Health, in collaboration with Olive View-UCLA Medical Center (OVMC), a Los Angeles County Department of Health Services hospital, proposes to develop and conduct a pilot evaluation of three alternative strategies to communicate patient-targeted messages related to the CER, "Comparative Effectiveness of Medications to Reduce Risk for Primary Breast Cancer in Women." The overall aim is to increase the use, impact, and implementation of the recommendations of this CER by adapting and testing innovative alternative strategies among Spanish-speaking women at risk for breast cancer. No consumer-oriented materials currently exist for this CER. This proposal has three specific aims: 1. To conduct formative research to develop language-, literacy-, culturally-, and content-appropriate evidence-based patient-oriented messages for the chosen CER. 2. To develop and pilot test the efficacy of three alternative prototypes (e.g., print media, community health worker, computer delivery) for the delivery of the messages in Spanish-speaking women. 3. To develop, in collaboration with AHRQ and other stakeholders, a plan to disseminate the results to promote the effectiveness and impact of the CER recommendations among Latina women at risk. To balance consumer-, clinical, and evidence-based perspectives, the project will employ a community advisory board of stakeholders, key informant interviews, and focus groups to assist in identifying and "translating" the key messages, identifying the optimal dissemination venues, and recruiting a population of high-risk women to test the vehicles. We define translation as adapting the language, literacy level, and cultural focus of the CER's evidenced-based recommendations to target the intended audience. The available dissemination materials for this CER topic are highly technical. Thus, for this initial project, we concentrate on evaluating the relative efficacy of the translated strategies using a multi-arm randomized control trial. An important part of our project will be to develop a dissemination plan that considers alternatives for scaling up of the intervention(s) that we find to be efficacious for future evaluation of their effectiveness in the real world. RAND Health has assembled an exceptional project team with skills and experience in the evidence review process, breast cancer prevention and treatment, health communication, bilingual and bicultural implementation and evaluation methods, as well as direct experience with the population of interest. PUBLIC HEALTH RELEVANCE: Lack of language-, literacy-, and culturally-appropriate evidenced-based information contributes to disparities in breast cancer health care and health between Latinas and non-Latina white women. The proposed project will pilot and compare three evidence- based patient-oriented educational prototypes targeting Latinas, for a potentially life- saving preventive treatment, and using alternative modes of delivery (print media, community health worker, computer delivery).