Use of a culturally-competent strategy to investigate breast and colorectal cancer screening knowledge and decision making among Hispanic women

Background: Breast and colorectal cancer (CRC) together account for nearly 22% of the cancer mortality burden in South Texas (CDC, 2009). The favorable trends noted in breast and CRC mortality for white women during the 2000s were not evident for Hispanic women, many of whom have poor access to healthcare and early detection services. Little is known about Hispanic women's cancer screening knowledge and decision making in this setting. Methods: Traditional cafecitos were combined with audio-taped focus group methodology and conducted to explore Hispanic women's opinions of the content and structure of informative and effective decision aids for breast and CRC that would optimize decision making of preventive measures and screening procedures. Cafecitos are small, traditional, informal discussions among similar people with coffee and pan dulce (sugar-free sweet breads) in an urban South Texas setting, aged 50 years of age and older. Recordings were transcribed by two different assistants and data were coded and analyzed for frequencies of relevant content themes using NUD*IST 5 software for code-based qualitative analyses. Results indicated that participants (n = 21) not only lacked education about breast and CRC screenings, but also had misinformation about risk and early stage diagnoses for both cancers. These findings indicated strong participant interest in communication strategies necessary to understand and reduce the risk of developing breast and CRC. Conclusions: Faith/religiosity, fatalism, external locus of control, and familialism play a large role in screening decision aid tools. Future public health nursing interventions should focus their efforts on one or all four components. According to women's suggestions, several decision aid tools should be incorporated and presented together as one large and more comprehensive decision aid tool to help individuals make informed decisions. Women need information about the personal risk of developing targeted cancers and ways to reduce their risk in formats that are meaningful to this population. Social networks of family and friends can be effective dissemination tools to advocate breast and CRC screening.