Raising Awareness and Education of Genetic Testing and Counseling through Fotonovelas among Latina Women At Risk for Hereditary Breast or Ovarian Cancer

Abstract

Background Latinas are less likely to receive genetic counseling and genetic testing (GCT) compared to non-Latina Whites because of systemic and patient-level barriers. We developed and tested fotonovelas to increase awareness of GCT among Latinas at-risk of hereditary breast and ovarian cancer (HBOC). Methods Content for the fotonovelas was drawn from an existing culturally-targeted narrative video focused on improving GCT use among Latinas at-risk of HBOC. Using mixed-methods, we interviewed cancer patients (n = 10) and their relatives (n = 10) to assess the preliminary efficacy of the fotonovelas through pre-and post-fotonovela items assessing self-rated knowledge of GCT and willingness to discuss cancer with family. Health workers (n = 10) provided feedback on the fotonovela content. McNemar's test was used to examine differences in the proportions of the outcomes pre- and post-fotonovelas. Interviews were transcribed and coded in Dedoose using a consensual qualitative research approach. Results Reading the fotonovelas increased self-rated knowledge of GCT by 22% (p = 0.16), from 50–60% in patients and from 63–100% among relatives. Analogously, reading the fotonovela increased willingness to talk about cancer with family by 33% (p = 0.02), from 70–100% in patients and from 38–75% in relatives. We identified six themes, some centered around the fotonovela’s message, feedback, and perceived barriers to GCT. Overall, participants liked the use of fotonovelas to increase GCT awareness and cancer conversations with family. Conclusions Fotonovelas could potentially be used as educational tools to increase GCT awareness and cancer conversations among Latino families at-risk of HBOC.