Disseminating Breast Cancer Prevention to African American Women

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DESCRIPTION (provided by applicant): Dissemination is an important, but neglected component of the research process. Currently, efforts focus on disseminating interventions that have been developed and evaluated through randomized trials; however, mechanisms are also needed to disseminate the results from research to the lay public. The AHRQ uses a structured process to prepare comparative effective reviews (CER) of conditions. Although these reviews are developed for consumers, they are likely to have limited reach, especially among individuals from racial and ethnic minority groups, because the dissemination methods are not culturally sensitive and the content is not targeted to specific populations. Our group has considerable experience developing targeted information about breast cancer for African American women and using culturally sensitive dissemination strategies to reach this population. Therefore, in response to RFA-HS-10-004: Innovative Adaptation and Dissemination of AHRQ Comparative Effectiveness Reviews, we propose to apply this expertise to develop and evaluate a community-based approach for disseminating CERs about breast cancer prevention to African American women. The specific aims of the proposed research are: (1) to evaluate uptake of a community-based approach for disseminating CERs about breast cancer prevention to African American women based on sociodemographic characteristics, beliefs about medical research, and clinical variables and (2) to evaluate the impact of evidential (E) versus non-evidential (NE) content about breast cancer prevention on psychological and behavioral outcomes that include: knowledge about breast cancer and prevention options, communication with individuals in their social and medical network, and distrust of medical research. We will also determine the extent to which our dissemination efforts reach a sample that is demographically representative of African American women in the Philadelphia metropolitan area. This study will be implemented in two Phases and identify variables that mediate the relationship by E and NE content and changes in psychological and behavioral outcomes. In Phase I, we will use qualitative methods to adapt an existing CER on medications for breast cancer prevention to increase its relevancy for African American women. In Phase II, we will evaluate the uptake of a community-based dissemination forum and compare the effects of E and NE content on knowledge, communication about prevention, and distrust of medical research in a sample of 200 African American women. PUBLIC HEALTH RELEVANCE: Despite overall improvements, African American women continue to experience excess rates of morbidity and mortality from breast cancer compared to women from ethnic and racial groups. Lack of awareness about behavioral and medical strategies for breast cancer prevention contributes to poorer outcomes among African American women. Our research will develop and evaluate a novel, community-based strategy for disseminating information about breast cancer prevention options to women at risk for poorer outcomes.