Sociocultural Factors and BRCA Genetic Counseling for Diverse Latinas

鉴于越来越多的证据表明遗传性乳腺癌和/或卵巢癌（HBOC）大大增加了一些家庭的癌症风险（1;2），这些高风险妇女接受遗传咨询以使她们能够获得挽救生命的信息至关重要。不幸的是，研究表明，拉丁裔，美国人口中增长最快的部分，是所有种族中最不可能寻求遗传咨询和随后的HBOC检测的（3-5）。提出的探索性定性R03旨在确定解释拉丁裔女性在未接受过咨询的高危女性中寻求BRCA遗传咨询的代表性不足的因素。在我们的行为预测适应综合模型的指导下（图1），具体目的是探索和记录：1)纽约市（NYC）具有提示HBOC家族史的不同高危拉丁裔人对BRCA遗传咨询的信念和态度；2)社会文化因素及其对不同高危拉美裔人群BRCA遗传咨询信念和态度的影响，包括：a)文化信仰和价值观；B)文化适应和异文化压力；C)社会支持；D)乳腺癌和/或卵巢癌的个人和家族病史；e)组织因素，包括社会经济地位和获得医疗保健的机会。这些信息将有助于指导未来文化上适当的干预计划的发展，以增加拉丁裔参与乳腺癌和/或卵巢癌易感性的遗传咨询。

DESCRIPTION (provided by applicant): Project Summary Given the mounting evidence that hereditary breast and/or ovarian cancer (HBOC) substantially increases cancer risk in some families (1;2), it is critical that such high-risk women receive genetic counseling to empower them with life-saving information. Unfortunately, research suggests that Latinas, the fastest growing segment of the U.S. population, are the least likely of all ethnic groups to seek genetic counseling and subsequent testing for HBOC (3-5). The proposed exploratory qualitative R03 seeks to determine factors that explain the under-representation of Latinas in seeking BRCA genetic counseling for HBOC among high-risk women who have not previously undergone counseling. Guided by our Adapted Integrative Model of Behavioral Prediction (Figure 1), the specific aims are to explore and document: 1) Beliefs and attitudes about BRCA genetic counseling among diverse, high-risk Latinas with family histories suggestive of HBOC in New York City (NYC); 2) Sociocultural factors and their influence on beliefs and attitudes about BRCA genetic counseling among diverse, high-risk Latinas including: a) cultural beliefs and values; b) acculturation and acculturative stress; c) social support; d) personal and family history of breast and/or ovarian cancer; and e) organizational factors, including socioeconomic status and access to medical care. This information will help guide the future development of culturally-appropriate intervention programs to increase Latinas' participation in genetic counseling for breast and/or ovarian cancer susceptibility. PUBLIC HEALTH RELEVANCE: Project Narrative The proposed exploratory research will determine factors that explain the under-representation of Latinas in genetic counseling for hereditary breast and/or ovarian cancer (HBOC). This qualitative information will help guide the future development of culturally-appropriate intervention programs to increase Latinas' participation in BRCA genetic counseling for breast and/or ovarian cancer susceptibility and therefore seek to reduce the health disparity witnessed in this population group.