Informing Latinas About Medications To Reduce Risk For Breast Cancer

描述（申请人提供）：拉丁裔和非拉丁裔白人女性乳腺癌的预防和治疗存在显著差异。一个重要因素似乎是这些妇女群体在获得循证保健信息方面存在差异。传播语言、识字和文化上适当的预防和治疗信息，可以缩小有患乳腺癌风险的拉丁裔在获得循证卫生信息和预防性护理方面的差距。兰德健康公司与洛杉矶县卫生服务医院Olive View-UCLA医学中心（OVMC）合作，提议开发并开展一项试点评估，评估三种替代策略，以传达与CER相关的以患者为目标的信息，“降低女性原发性乳腺癌风险的药物比较有效性”。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。目前还没有针对此CER的面向消费者的材料。这一建议有三个具体目标：1。开展形成性研究，为选定的CER开发适合语言、识字、文化和内容的循证患者导向信息。2. 开发和试点测试三种替代原型（例如，印刷媒体、社区卫生工作者、计算机传递）在讲西班牙语妇女中传递信息的效果。3. 与拉丁裔妇女咨询中心和其他利益攸关方合作，制定一项计划，传播研究结果，以促进风险中的拉丁裔妇女执行《性别风险评估》建议的有效性和影响。为了平衡消费者、临床和基于证据的观点，该项目将采用由利益相关者组成的社区咨询委员会、关键线人访谈和焦点小组，以协助确定和“翻译”关键信息，确定最佳传播场所，并招募高风险妇女群体来测试这些车辆。我们将翻译定义为适应CER基于证据的建议的语言，文化水平和文化重点，以针对目标受众。关于这个CER主题的现有传播材料是高度技术性的。因此，在这个初始项目中，我们主要通过多组随机对照试验来评估翻译策略的相对疗效。我们项目的一个重要部分将是制定一项传播计划，考虑扩大我们认为有效的干预措施的替代方案，以便将来评估其在现实世界中的有效性。兰德健康公司组建了一支杰出的项目团队，他们在证据审查过程、乳腺癌预防和治疗、健康沟通、双语和双文化实施和评估方法以及与相关人群的直接经验方面具有技能和经验。

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).