Social Marketing and Cancer Genetics among Hispanics

To realize the benefits of recent advances in cancer genetics, it is critical to identify and refer families in greatest need of genetic counseling and testing services. BRCA1/2 mutations that place an individual at higher risk for Hereditary Breast Ovarian Cancer (HBOC) Syndrome have been extensively screened for and documented within Hispanic populations. While professional and scientific organizations have set forth clinical criteria to identify individuals at high risk for HBOC there is a disparity in access to and use of cancer genetics services in Hispanic communities. The disparity has been clearly identified as a priority by the National Human Genome Research Institute and the National Cancer Institute. There are a lack of studies regarding knowledge, attitudes, and behaviors related to cancer genetics among Hispanic women at increased risk for HBOC among various Hispanic ethnic groups. The goal of the proposed study is to better understand cultural differences that may impact utilization of BRCA1/2 testing for HBOC among three major U.S. Hispanic ethnic groups (Mexicans, Puerto Ricans, Cubans). The state of Florida has the fourth largest and most ethnically diverse Hispanic population in the U.S. and the Florida Department of Health is presently working to integrate genetics services into public health and primary care practice. Given the large percentage of uninsured or underinsured Hispanic women who receive the majority of their medical care from the health department, the Hillsborough County Health Department (HCHD) is an ideal location to study factors that may affect uptake and utilization of cancer genetics services among low-income Hispanic women who may be at increased risk for a HBOC. The present study will apply key principles of Social Marketing (SM) to achieve two specific aims: (1) To examine knowledge, attitudes, and behaviors related to cancer genetics among Mexican, Puerto Rican, and Cuban women at increased risk for HBOC and (2) To develop a series of culturally relevant messages related to HBOC and genetic counseling and testing specific to Mexican, Puerto Rican, and Cuban American women at increased risk for HBOC and identify appropriate dissemination channels for these messages. Study findings will serve as the basis for a larger intervention trial based in a public health department setting to educate Hispanic women at increased risk for HBOC about genetic counseling and testing for HBOC and possibly other hereditary cancers that will apply the final three phases of social marketing including: pretesting the messages, implementation and evaluation of the messages.