Disparities in counseling and testing (genetic services) among Latinas and Hispanics at increased risk of hereditary breast and ovarian cancer (HBOC) result in less awareness of high lifetime cancer risks and thus increased risk of mortality due to a lack of appropriate risk management. Disparate uptake of genetic services in Latinas and Hispanics (hereafter ?Latinas?) includes limited awareness of referral to and access to services, as well as socioeconomic, language, and cultural barriers. Alternate models to facilitate risk appropriate referrals to and navigation through genetic services are urgently needed. In other cancer education contexts, community outreach and education professionals (hereafter, CORE-P), such as community health educators, promotoras, lay health advisors and patient navigators, have been effective in improving cancer screening behaviors in underserved populations. Increased screening and risk assessments can help reduce disparities in cancer incidence and mortality. Guided by core competencies from the Centers for Disease Control and Prevention and other national coalitions, we seek to educate bilingual Spanish-English speaking CORE-P to increase basic knowledge about: the role of genetics in disease, the limitations of their own genetic expertise, and how to make appropriate referrals for at-risk individuals to health care professionals with more genetic expertise, called ?referral-level competence.? Limited research has used CORE-P to increase Latinas? awareness and uptake of genetics services through education and support. Guided by principles of Adult Learning Theory and popular education techniques, we propose the Family Tree Program [Programa de ARBOLES Familiares: Assessing Risk of Breast Cancer through Outreach to Latinas with Education and Support] for bilingual CORE-P. The goal of the training program is to address the unmet referral-level competence needs by developing a trained network of CORE-P to ensure risk appropriate uptake of genetic services among Latinas at risk for HBOC. Specifically, we aim to: (1) refine and finalize an education curriculum for bilingual community outreach and education professionals (CORE-P), (2) implement the ARBOLES Familiares program among 250 bilingual CORE-P using an in-person workshop followed by online modules, and (3) identify the impact of the ARBOLES Familiares program on participants? knowledge, self-efficacy, skills, and the resulting community impact among high- risk Latinas.
The goal of the training program is to address unmet referral-level competence needs by developing a trained network of community outreach and education professionals (CORE-P) to ensure risk appropriate uptake of genetic services among Latinas at risk for hereditary breast and ovarian cancer (HBOC).