Developing Culturally-Tailored Interventions to Overcome Genomic Health Disparities in Communities of Color
FY22 SI-GECS Type 2
Abstract
The ‘Genomic Era’ holds great promise for improving health of individuals and families. Unfortunately advances in genomic healthcare have not benefited all populations equally. To realize the full potential of genomic advances, there is a need to understand human factors and culturally tailor interventions to increase genomic medicine uptake. Leveraging expertise across the disciplines of nursing, social work and sociology we will elucidate promoters/barriers to genomic medicine in communities of color (i.e., non-white). Project I includes a scoping review of Latinx genomic healthcare, an Amazon MTurk survey to examine Latinx genomic literacy/numeracy and community partnerships to conduct Latinx stakeholder interviews and uncover targets for interventions. Project II focuses on familial cancer caused by pathogenic variants in BRCA1/2. Partnering with cancer support groups, we will conduct mixed-methods studies in Black/African-American BRCA+ women and BRCA+ men – groups traditionally overlooked in BRCA research yet critical for cascade screening. Quantitative surveys and qualitative interviews will be employed to examine attitudes/beliefs, norms and perceived behavioral control relating to cascade screening. Mapping findings to the Theory of Planned Behavior, we will develop culturally adapted interventions to surmount genomic health disparities and enable more effective cascade screening to improve outcomes for at-risk blood relatives.
Presentations
- Patient centered care meets human centered design: Nursing interventions bridging genetic health disparities, International congress of Endocrinology, August 2022
- Impact of BRCA status on reproductive decision-making and self-concept: A mixed-methods study informing the development of precision health interventions, Massachusetts General Hospital Reproductive Medicine Symposium, April 2022
- The Male Breast Cancer Coalition, February 2022
- BC BRCA Study is currently organizing an advocacy panel at BC for Oct 2022
- Roundtable given based on grant topic by two BC undergraduate research assistants working on Racial and Ethnic Genomic Disparities (Day in Mixed Methods conference 2024)
Publications
- Grafft, N., Dwyer, A. A., & Piñeros-Leaño, M. (2022). Latinx individuals' knowledge of, preferences for, and experiences with prenatal genetic testing: A scoping review. Reproductive Health. 6;19(1):134.
- Mehmet, B., McDonald, I. R., Saldarriaga, S., Piñeros-Leano, M., & Dwyer, A. A. (2022). What’s missing in sex chromosome aneuploidies? Representation and inclusion. Journal of Pediatric Nursing. 62: 204-206.
- Hesse-Biber, S., Seven, M., Jiang, J., Van Schaik, S., & Dwyer, A. A. (2022). Impact of BRCA status on reproductive decision-making and self-concept: A mixed-methods study informing the development of tailored interventions. Cancers. 14: 1494.
- Dwyer, A. A., Hesse-Biber, S., Shea, H., Zeng, Z., & Yi, S. (2021). Coping response and family communication of cancer risk in men harboring a BRCA mutation: A Mixed methods study. Psycho-Oncology. 31(3): 486-495.
- Hesse-Biber, S.; Seven, M.; Shea, H.; Heaney, M.; Dwyer, A.A. Racial and Ethnic Disparities in Genomic Healthcare Utilization, Patient Activation, and Intrafamilial Communication of Risk among Females Tested for BRCA Variants: A Mixed Methods Study. Genes 2023, 14, 1450.
- Hesse-Biber, Sharlene, Memnun Seven, Hannah Shea, and Andrew A. Dwyer. 2024. "Intersectionality, BRCA Genetic Testing, and Intrafamilial Communication of Risk: A Qualitative Study" Cancers 16, no. 9: 1766.
- Adler JM, Hesse-Biber S, Seven M and Dwyer AA (2024) “Identity theft” in BRCA1/2: impact of positive genetic test results and risk-reducing interventions. Front. Genet. 15:1380637.
Additional Grants
- Dr. Dwyer was named a 2023 Macy Faculty Scholar by the Josiah Macy Jr. Foundation (Project: "Developing and evaluating genomic nursing competencies to bridge disparities in genomic healthcare"). Link.
Students Trained
- 2 Undergraduate Students
- Madeline Heaney
- Athala Salcedo
- 5 Graduate Students
- Hannah Shea
- Chinenye Ugochar
- N. Grafft
- I. McDonald
- S. Saldarriaga
Additional Accomplishments
- Co-sponsors events to bring awareness to disparities in cancer screening and genetic testing, e.g. Block Party: Mammos & Genetics Matter: Breast Cancer Awareness Block Party, October 2022. Harlem, NYC.
- List of partners: AfroPink, Facing our Risk of Cancer Empowered (FORCE), Male Breast Cancer Coalition, Black Breast Cancer Alliance (TOUCH), Chrysalis Initiative, SurviveHer. We are also in the process of forging links with new partners Potential Partners (My Faulty Gene, For the Breast of Us, La Vida Nueva)