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Development of a culturally sensitive narrative intervention to promote genetic counseling among African American women at risk for hereditary breast cancer
Author(s) -
Henderson Vida,
Chukwudozie Ifeanyi Beverly,
ComerHagans DeLawnia,
Coffey Vickii,
Grumbach Giesela,
Spencer Shirley,
Rodgers Carolyn,
Kaur Ravneet,
Newsome Jennifer,
Balay Lara,
Maga Tara,
Kendall Le’Chaun,
Balthazar Catherine,
Watson Karriem,
Winn Robert,
OdomsYoung Angela,
Hoskins Kent F.
Publication year - 2021
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.33525
Subject(s) - focus group , narrative , intervention (counseling) , medicine , qualitative research , grounded theory , breast cancer , genetic counseling , thematic analysis , narrative inquiry , genetic testing , health care , psychology , family medicine , nursing , cancer , sociology , social science , linguistics , philosophy , biology , anthropology , genetics , economics , economic growth
BACKGROUND African American women with hereditary breast cancer risk are less likely to undergo genetic counseling and testing compared with non‐Hispanic White women. Inequities in the use of precision cancer care are likely to exacerbate racial disparities in cancer outcomes. A culturally sensitive multimedia narrative intervention was developed to motivate African American women at risk for hereditary breast cancer to engage in genetic counseling. METHODS Development of the intervention was grounded in the Integrative Model of Behavioral Prediction using a phenomenological, deductive approach and employed multiple qualitative methods for data collection, including 1‐on‐1 interviews and story circles with members of the target audience to identify salient themes and lived experiences. Focus group testing was then conducted with members of the group of focus, primary care providers, and community stakeholders. RESULTS Six themes that mapped to the theoretical model were identified. Lived experiences were abstracted from story circle data to create a narrative storyline. Educational content and motivational messaging derived from the 6 themes were embedded into the script. Focus group testing with stakeholder groups was used to refine the intervention. Testing of the final multimedia narrative with focus groups indicated that the intervention was culturally sensitive and authentic, and the messaging was effective. CONCLUSIONS Multiple qualitative data collection methods and a robust theoretical framework of health behavior were key elements for this study to develop a culturally sensitive, narrative intervention that reflects lived experiences and motivates underserved African American women with hereditary breast cancer risk to engage in genetic counseling. This strategy can be applied to mitigate racial inequities in the use of other genomic approaches for personalizing cancer care.