Breast cancer (BrCA) is the most common non-skin cancer among women in the United States (US) and the second leading cause of cancer death after lung cancer. In South Carolina (SC) BrCA incidence and mortality rates are higher for African-American (AA) women compared with European-American (EA) women. BrCA research often includes predominately EA women and there is limited evidence about the role of environmental exposures on BrCA risk among medically underserved groups, including AA communities. Understanding the complex factors contributing to BrCA risk is at the forefront of the US public health agenda and a national call to action recommends additional research to better understand how exposures to chemicals and physical agents individually or in mixtures contribute to increased BrCA risk. Using effective messaging and communication strategies in the dissemination of environmental health information with underserved groups is also a national priority. Communities care about their environments, and about whether environmental conditions will affect their heath and the health of their families. High-risk populations, including racial/ethnic minorities, are often dwelling in neighborhoods where they are disproportionately exposed to chemicals from the environment and, therefore, potentially more susceptible to poorer health outcomes. Having a clear understanding of their environmental risks is of critical importance to these medically underserved groups. The overall goal of Strategies for Communicating the Environmental Risks of Cancer (SCERC) is to contribute scientific evidence for the development of accurate, plain language, and culturally appropriate communication approaches focused on reducing BrCA risk from environmental factors for AA parents and/or caregivers of pre- pubescent AA girls. The body is particularly vulnerable to environmental exposures during specific lifespan periods including during puberty, thus we will focus the proposed prevention communications research prior to the pubescent stage in young girls.
Specific aims are to: (1) assess the readability, cultural sensitivity, and comprehensibility of existing BrCA and environmental risk messages; (2) design visual representations of BrCA environmental risks and evaluate AA parents? and caregivers? comprehension and receptiveness of visual formats as appropriate approaches for communicating about BrCA and environment risks; and (3) examine community-engaged strategies and criteria for the evaluation of risk messages about BrCA and the environment. The proposed R03 grant is critically needed to understand comprehensively the AA communities? understanding of existing BrCA environmental risk messages and their receptivity to innovative visual formats, and to engage and empower communities in initiatives that encourage critical evaluation of existing risk messages. Building community engagement into communications-oriented research will help communities gain a greater understanding of the current evidence and uncertainties regarding the environment and BrCA risk and a broader understanding of the scientific research method.
Engaging communities in dialogue and research about environmental issues has strong potential to improve the public?s knowledge about cancer risks and outcomes and about the scientific research process. The proposed interdisciplinary and community-engaged research will use innovative methods to study the most effective messages and communication approaches focused on reducing breast cancer risk from environmental factors for African-American parents and/or caregivers of pre-pubescent girls. Study findings will be critical for the development of future intervention programs assessing the behavioral uptake of risk messaging and behavioral change to reduce risk of an extremely burdensome disease among African American families in South Carolina.