Designing Audience-Centered Interactive Voice Response Messages to Promote Cancer Screenings Among Low-Income Latinas

Abstract

IntroductionCancer screening rates among Latinas are suboptimal. The objective of this study was to explore how Latinas perceive cancer screening and the use and design of interactive voice response (IVR) messages to prompt scheduling of 1 or more needed screenings.MethodsSeven focus groups were conducted with Latina community health center patients (n = 40) in need of 1 or more cancer screenings: 5 groups were of women in need of 1 cancer screening (breast, cervical, or colorectal), and 2 groups were of women in need of multiple screenings. A bilingual researcher conducted all focus groups in Spanish using a semistructured guide. Focus groups were recorded, transcribed, and translated into English for analysis. Emergent themes were identified by using thematic content analysis.ResultsParticipants were familiar with cancer screening and viewed it positively, although barriers to screening were identified (unaware overdue for screening, lack of physician referral, lack of insurance or insufficient insurance coverage, embarrassment or fear of screening procedures, fear of screening outcomes). Women needing multiple screenings voiced more concern about screening procedures, whereas women in need of a single screening expressed greater worry about the screening outcome. Participants were receptive to receiving IVR messages and believed that culturally appropriate messages that specified needed screenings while emphasizing the benefit of preventive screening would motivate them to schedule needed screenings.ConclusionParticipants’ receptiveness to IVR messages suggests that these messages may be an acceptable strategy to promote cancer screening among underserved Latina patients. Additional research is needed to determine the effectiveness of IVR messages in promoting completion of cancer screening.

What do people fear about cancer? A systematic review and meta‐synthesis of cancer fears in the general population

“…People distinguished causes and risks that were perceived to be under individual control (discussed as part of theme 3) from those that were not. Participants mentioned a number of uncontrollable cancer risks, such as age and pollution, but only familial or genetic factors strongly influenced people's cancer fear . Because familial risk could not be influenced directly, participants tried to find other ways to allay their fears, such as by adjusting their diet or participating in screening: ‘[…] I do have cancer in my family, and so that is what I'm afraid of.…”

“…Statements such as ‘ignorance is bliss’, and ‘what you don't know you don't worry about’ were often used to explain why they did not participate in screening . They prioritised feeling good or normal over the relative advantages of early detection and avoided screening tests because they considered them as taking an unnecessary risk of finding cancer as if spontaneously making it appear: ‘I have this fear that if I check for it and I find something then my life is gonna change. But […] if I don't check, I don't find anything and nothing changes’ .…”

“…Fears about the emotional and physical consequences of a cancer diagnosis were mentioned in more than half of included studies. In a quarter of included studies, participants mentioned fears about how to emotionally ‘handle’ a cancer diagnosis, expecting to feel devastated, anxious, sad, and depressed and having their world fall apart: ‘You can go in there [ie, screening] thinking nothing is wrong and come out with your whole life being changed’ . …”

Assessment of an interactive voice response system for identifying falls in a statewide sample of older adults

“…For example, IVR protocols are useful for collecting information on illicit or stigmatizing behavior (Burge, Becho, Ferrer, Wood, Talamantes, Katerndahl 2014; Piette et al, 2013; Possemato et al, 2012). IVR systems have also been used successfully to deliver health promotion interventions, such as weight loss programs (Steinberg et al, 2014), cancer screening (Cohen-Cline, Wernli, Bradford, Boles-Hall, Grossman 2014; Grearey et al, 2014), and chronic disease management (Heyworth et al, 2014; Piette et al, 2013). The greater reach of IVR contact does not appear to come at the expense of fidelity to standard research measures.…”

Multilevel Intervention Raises Latina Participation in Mammography Screening: Findings from ¡Fortaleza Latina!

“…Several previous investigations have articulated individual-level factors associated with screening among Latinas, including low levels of education (7), short length of time in the US (7, 8), psychosocial factors (9-11), limited health care access and use (7, 9, 10, 12-14), lack of a regular care provider (14, 15), no recent clinical visit (13, 14, 16), and having never been screened (17). Although several studies have reported on the importance of provider recommendations in women’s decisions to undergo breast cancer screening (10, 13, 18, 19), few studies have attempted to describe clinic-level factors that affect breast screening outcomes. These have identified on-site screening services, electronic medical record prompts, and reminder letters or text messages as facilitators of breast cancer screening (20-26).…”