Development and evaluation of a culturally-tailored clinic-based breast cancer risk reduction intervention for Latinas

This collaborative study sought to address Latina breast cancer (BC) screening disparities by increasing health literacy (HL) in a community health center setting in the U.S. - Mexico border region of San Diego County.  The San Diego State University (SDSU) and San Ysidro Health Center (SYHC) academic-community partnership conducted formative research to develop a culturally tailored promotora-based intervention. Salient themes from key informant interviews and focus groups with 109 individuals and BC information from evidence-based sources were used to develop the program. The Nuestra Cocina: Mesa Buena, Vida Sana (Our Kitchen: Good Table, Healthy Life) program includes 6 sessions targeting: health literacy, women’s health, breast cancer risk reduction, and patient-provider communication. Each session is coupled with cooking demonstrations that include cancer-risk reducing ingredients. A pilot study with 21 SYHC patients, recruited through clinic waiting rooms and outreach events, was conducted to examine the program’s acceptability, feasibility, and ability to impact knowledge and skills. Process evaluation measures included: fidelity, recruitment and retention issues, dosage, participant feedback, structured observations, and promotora feedback.  A brief survey was administered at baseline and program end. Results demonstrated that recruitment, intervention, and assessment methods were feasible and acceptable. Pre- post- analyses demonstrated that participants improved: their ability to correctly identify key cancer myths, their awareness of screening guidelines, their daily fruit and vegetable intake, and their ability to read a nutrition label (p < .05).  Process and impact evaluation data demonstrated that the newly developed Nuestra Cocina intervention can improve knowledge, HL skills, and patient empowerment.