Participant-Centered Strategies for Overcoming Barriers to Biospecimen Collection among Spanish-Speaking Latina Breast Cancer Survivors

Cancer Epidemiol Biomarkers Prev. 2020 Mar;29(3):606-615. doi: 10.1158/1055-9965.EPI-19-0942.

Abstract

Background: Latinos are underrepresented in biomedical research, particularly biomarker research, yet they constitute the nation's largest ethnic/racial minority. Optimal methods for obtaining biospecimens for biomarker research among Latinos need to be identified. To minimize barriers and enhance participation, this study developed and tested tailored strategies for collecting biomarkers of chronic stress and premature aging among Spanish-speaking Latina breast cancer survivors.

Methods: This study used a community-based participatory approach and selected hair and saliva as noninvasive biospecimens to assess telomere length, the cortisol awakening response (CAR), and hair cortisol concentration. We developed bilingual multimedia instructional materials, and community health workers assisted in collections. Telephone surveys assessed willingness to participate in future studies, barriers to sample collection, and recommendations for improving the strategies.

Results: A total of 103 participants were recruited over 18 months from two rural sites in California, and 88 were retained at 6-month follow-up. At baseline, rates of donating salivary DNA for telomere length measurement, saliva for CAR analysis, and hair for cortisol concentration were 98%, 89%, and 52%, respectively. At follow-up, rates were 83%, 76%, and 55%, respectively. The majority of participants reported being very willing to provide hair (72%) or saliva (74%) for future studies.

Conclusions: Our results support the feasibility of including minorities in biomedical research. We report excellent rates of saliva collection when community partners are engaged in the process, and when patient-centered and culturally tailored recruitment methods are implemented.

Impact: The development of methods to facilitate the inclusion of minorities in biomedical research is critical to eliminate racial/ethnic health disparities.

Trial registration: ClinicalTrials.gov NCT02931552.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / genetics*
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / genetics
  • California
  • Cancer Survivors / psychology*
  • Cancer Survivors / statistics & numerical data
  • Community-Based Participatory Research
  • Culturally Competent Care / methods
  • Culturally Competent Care / organization & administration
  • Culturally Competent Care / statistics & numerical data
  • DNA / genetics
  • DNA / isolation & purification
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Hair / chemistry
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Middle Aged
  • Minority Groups / psychology
  • Minority Groups / statistics & numerical data
  • Patient Participation / psychology*
  • Patient Participation / statistics & numerical data
  • Patient-Centered Care / methods
  • Program Evaluation
  • Saliva / chemistry
  • Specimen Handling / psychology
  • Specimen Handling / statistics & numerical data

Substances

  • Biomarkers, Tumor
  • DNA

Associated data

  • ClinicalTrials.gov/NCT02931552