Awareness help Latinos steer clear of cancer

Program developed from grant

The message of cancer prevention is the same for all people; however, the delivery of that message must be culturally appropriate or the target population will not understand how to apply it, says Amy M.B. Deshler, MSW. Deshler is a team leader for the Cancer Education Program at the Mayo Clinic Cancer Center in Rochester, MN. That’s why she assembled a team of culturally appropriate advisors and experts when creating a 15-minute video and a brochure on cancer prevention for the Latino population.

Latino focus groups provided information about health care beliefs and cultural issues to help shape the video’s content. A bilingual scriptwriter who traveled extensively in Spanish-speaking countries took the information from the focus groups and incorporated it into the script. The Latino actors, who volunteered to play the parts in the video, provided further feedback along with the Mayo Clinic International Medicine Department and a bilingual public health nurse from the health care institution.

The idea for creating cancer prevention materials for an underserved population came about
at a chamber of commerce meeting that Deshler attended when the topic was how to obtain employees in the current work force environment.

The manager from The Turkey Store Co., a plant that processes turkeys, stated that his company had an incentive program where employees would receive up to $400 cash back toward their health care benefits if they attended four sessions annually on a variety of health topics. The plant employed a lot of Spanish speaking people and non-English speaking people from Somalia

"A light went off, and I thought this is the perfect place to do cancer prevention for an underserved population; I wrote a grant and received funding," explains Deshler. The grant came from the Atlanta-based American Cancer Society.

Because Deshler believed that a general cancer prevention program in Spanish would already have been created, she decided to target the Somalian population but first conducted a nationwide needs assessment. The results surprised her: there were no materials for general cancer prevention for Spanish speaking audiences.

Therefore, she changed her focus and created a video titled Mas Vale Prevenir Que Lamentar (It’s Better to Prevent Than Regret) and a coordinated brochure titled Siete Estrategias Para Ayudarie a Evitar el Cancer (Seven Strategies to Help you Steer Clear of Cancer).

In this material, she discussed becoming tobacco-free, enjoying a healthful diet, staying active and maintaining a healthful weight, drinking alcohol in moderation, being sun-sensible, knowing when to see a doctor, and soliciting assistance with translation if that is an issue at their health care facility.

Make message culturally appropriate

To convey a culturally appropriate message for the Latino culture, Deshler used a family unit with a grandmother, mother and father, and children. She also provided the education in a show-and-tell fashion using culturally appropriate foods and activities.

For example, when discussing physical activity, the father and son played soccer together, the grandmother gardened, and the entire family took a walk after dinner. The cancer prevention messages were intertwined as well with the grandmother wearing a hat for sun protection in the garden and the mother applying sunscreen to her son before the soccer match.

To ensure that the correct message was conveyed, the brochure and video script were first written in English, translated into Spanish, and then translated into English again. "At each step of the process we had someone who was fluent in that language review the material to make sure we were consistent," says Deshler.

During the shooting of the video, a bilingual person was always on the set, and at its completion, content was reviewed by Mayo’s International medicine department, the translator, and an advocate from the community to make sure it was accurate and culturally relevant.

When the video and brochure were pilot-tested at The Turkey Store Co., 26 employees attended the educational session. The number was good, considering that employees had worked an extra long day due to a machine malfunction, says Deshler. Interpreters at the class helped participants with a pre- and post-test and with questions about cancer prevention.

Since its debut, Deshler concentrates on making the video available to others who are working with the Latino population. Therefore, it is available at all the education centers at the Mayo Clinic. Also, an educational package is being sent to appropriate parties that include the Bethesda, MD-based National Cancer Institute’s designated cancer centers around the country and health care professionals who have an interest in providing prevention education to the Latino population. The educational package includes the video, 25 brochures, and an evaluation card.

"During my needs assessment, people said that they would like to have a copy of the materials I developed. So I sought additional grant money and received funding to disseminate 1,000 copies of this educational package free of charge across the country, and that is currently where we are," says Deshler. If response is good, she will consider making more copies to distribute. n

For more information about the project to create general cancer prevention materials for the Latino population, contact:

Amy M.B. Deshler, MSW, Team Leader, Cancer Education Program, Mayo Clinic Cancer Center, 200 First St. S.W., WF-521, Rochester, MN 55905. Telephone: (507) 266-4855. Fax: (507) 284-1544. E-mail: Deshler.amy@mayo.edu.