Breast cancer survivors’ knowledge, attitudes, and information needs about fertility and pregnancy. Gwendolyn Quinn, PhD (MCC) and Eida M. Castro, PsyD, MSc(PHSU)
Breast cancer is the most common malignancy among women in developed countries. Improvements in screening programs and new treatment advances have contributed increased survival. Since breast cancer is also the most common cancer among reproductive aged women, an increasing number of survivors have not yet started or completed their families when diagnosed. Therefore, identifying concerns regarding future reproductive health, fertility and consequences of adjutant therapies are paramount to quality of life.
Understanding survivor’s knowledge, attitudes and informational needs towards this topic is essential to aid health care professionals in devising better educational tools, improving patient-provider communication and supplying needed information for improved decision making. Such tools will aid patients and survivors in making educated decisions about reproductive health issues such as fertility and childbirth which ultimately will improve quality of life. There is a need to overcome the methodological limitations of previous research on this topic. These include use of small sample sizes, reliance on qualitative interviews describing women’s attitudes about fertility-related issues, without determining the degree of endorsement of such attitudes. Finally, there is need to examine culturally and linguistically diverse samples.
The primary aim of this study is to examine young breast cancer survivors’ knowledge, attitudes, informational needs and decisions about fertility and pregnancy among breast cancer survivors using self-report questionnaires. In addition, we aim to identify if clinical, demographic factors, or quality of life ratings, influence the reproductive decisions and attitudes of survivors. This study has begun and is on-going under the direction of Dr. Vania Goncalves in Portugal (University of Coimbra). Dr. Gwendolyn Quinn and Dr. Eida Castro will replicate this study at Moffitt Cancer Center and Puerto Rico and compare results between these diverse populations.
Identifying Cancer Health Communication Channels for Hispanic Audiences. Gwendolyn Quinn, PhD (MCC) and Julio Jiménez, MD (PHSU)
Results from our previous U56 outreach projects and other public health research indicate that reaching Puerto Rican audiences requires more culturally appropriate, direct interpersonal communication methods than traditional US mainland-based cancer communication channels (e.g., distribution of educational materials). To this end, we will focus our examination on effective and efficient health communication methods.
Several professional organizations have established criteria to identify BC survivors at increased risk for hereditary breast and ovarian cancer (HBOC) due to germline mutations in known cancer susceptibility genes such as BRCA 1 and BRCA 2 (BRCA). Previous studies have documented the presence of BRCA mutations in U.S. Hispanic women and proven risk management strategies for BRCA carriers. However, high-risk BC survivors Hispanics participate in genetic counseling (GC) and testing (GT) at strikingly lower rates than non-Hispanic Whites. Our team has documented that lower uptake of GC and/or testing among Hispanic BC patients may be due to less patient and provider awareness/referral of and access to genetics services, insurance, language, and cultural barriers. In order to address this issue, alternatives to current models that fail to promote uptake and participation of Hispanic women in genetic counseling should be provided. Alternative approaches should include identification, referral, and delivery of GC for high–risk BC survivors that address geographical, linguistic (1% of U.S. genetic counselors are Hispanic/Latino), and logistic access barriers. A recent study demonstrated that telephone GC could provide an opportunity to remove geographical, linguistic (e.g., readily available bilingual professional), and logistic access barriers (e.g., appointment availability) aside from being a cost-effective strategy to increase access to GC. In addition, data from our pilot study (U54CA163068) highlights that brief mailed educational communications are an effective strategy to reaching Hispanics with health information. Our goal with this pilot project is to test an educational approach to increase uptake of telephone GC among high-risk Hispanic BC survivors in Tampa, FL and Ponce, Puerto Rico.
HPV vaccination rates offer a cost effective strategy for drastically reducing HPV disease burden; including the prevention of HPV-caused cervical, vulvar, vaginal, and anal cancers; precancerous cervical, vulvar, vaginal, and anal lesions; and genital warts. While rates of vaccine series initiation are higher in Hispanics both in the United States (U.S.) and Puerto Rico (PR), series completion remains an ongoing issue. Healthy People 2020 goals of 80% of 13-15 year old adolescents receiving all three doses of the HPV vaccine series are unlikely to be attained without additional intervention. A recent study conducted in safety- net clinics in Texas found that educational materials describing the HPV vaccine were effective for Hispanic populations in promoting HPV vaccine uptake. While this intervention holds promise for increasing HPV vaccine initiation rates in the Hispanic population, future refinement of the content (e.g., greater emphasis on series completion and male vaccination) and approach (i.e., a set of booklets/videos timed to coincide with series doses at 1 month and 6 months) may also facilitate series completion rates. In addition, our previous research demonstrates the importance of adapting Spanish educational materials within Hispanic sub-ethnic populations. Our goal with this pilot project is to adapt educational materials focusing on HPV- vaccine series completion and male vaccination tailored for the Hispanic population in Tampa, FL and Ponce, PR.