Digital Storytelling Interventions to Promote Cancer Screening Among Hispanic/Latino Adults in Primary Care Settings
Cancer is the leading cause of death among Hispanic/Latino individuals, yet many do not complete cancer screenings due to systemic barriers. To address this issue, Rochester Healthy Community Partnership (RHCP) created “Stories for Change: La detección temprana puede salvar vidas” (S4C-cancer prevention). This digital storytelling intervention involved eight Hispanic/Latino cancer survivors or co-survivors who shared their experiences by creating 2-min videos. Their heartfelt stories aim to help patients make informed decisions about cancer screenings. RHCP piloted S4C-cancer prevention at three clinical sites to assess intervention acceptability and success (cancer screenings completed).
Abstract
Cancer is the leading cause of death among Hispanic/Latino individuals, yet many do not complete cancer screenings due to systemic barriers. To address this issue, Rochester Healthy Community Partnership (RHCP) created “Stories for Change: La detección temprana puede salvar vidas” (S4C-cancer prevention). This digital storytelling intervention involved eight Hispanic/Latino cancer survivors or co-survivors who shared their experiences by creating 2-min videos. Their heartfelt stories aim to help patients make informed decisions about cancer screenings. RHCP piloted S4C-cancer prevention at three clinical sites to assess intervention acceptability and success (cancer screenings completed). A total of 51 participants who were overdue for cancer screenings were recruited (breast=13; cervical=12; colorectal women=14; colorectal men=12). After viewing the intervention, 100% intended to be screened in the future. Within 7 months, 45% of participants completed their recommended cancer screenings. Among those who were screened, 89% stated that their decision was “very much” influenced by S4C-cancer prevention. Participants who did not complete screening cited barriers such as time, lack of access to health education, and fear. Those who had previously screened for the targeted cancer were more likely to complete screening after viewing S4C-cancer prevention. Additionally, participants suggested enhancing the videos by including more education on various cancer topics. We found high acceptability of S4C-cancer prevention. Despite all participants intending to get screened, half completed screening within 7 months of viewing the intervention.
Closing the Gap: Participatory Formative Evaluation to Reduce Cancer Screening Disparities among Patients with Limited English Proficiency
Nine percent of the US population has limited English proficiency (LEP), which is defined by the US Census Bureau as speaking English “less than very well.” LEP is an important mediator of health disparities and has been linked to overall poor health and low quality of healthcare delivery, decreased understanding of medical information, and dissatisfaction with care.
Journal of Cancer Education. 2020 Feb 12
Background: Nine percent of the US population has limited English proficiency (LEP), which is defined by the US Census Bureau as speaking English “less than very well.” LEP is an important mediator of health disparities and has been linked to overall poor health and low quality of healthcare delivery, decreased understanding of medical information, and dissatisfaction with care. Compared with patients who speak English well, LEP is associated with suboptimal disease-specific outcomes across multiple chronic conditions. These disparities are only partially mitigated by appropriate use of medical interpreters or provision of language-concordant providers.
Methods: This study employed a participatory formative evaluation approach, which included aspects of needs assessment, as well as engagement of potential users in intervention development in order to enhance usefulness and relevance. This study was approved by the (Mayo Clinic) Institutional Review Board (IRB #17–009432).
Results: Interviews were completed with 9 patients, 5 providers, 5 interpreters, and 3 (Cambodian, Hispanic, and Somali) community leaders. The median interview duration was 28 min (range 18–57). Patients and interpreters represented Cambodian, Somali, Spanish, and Vietnamese languages. Spanish (n = 2) and Somali (n = 6) patient interviews were conducted by bilingual study staff, while interviews in Cambodian (n = 1) and Vietnamese (n = 1) were conducted with the assistance of an interpreter. Themes from interviews were aligned with the constructs in the National Cancer Institute SEM.
Conclusion: These findings demonstrate that it is possible to engage a diverse group of stakeholders in strategies that are responsive to health care providers and patients, including LEP patients from heterogeneous backgrounds. Participatory methods of intervention planning furthered our understanding of study findings and engaged individuals to move projects from research to implementation. Next steps for this study team involve community-academic intervention implementation in the community and clinic settings.