Abstract A041: Informing future adaptive interventions to address breast cancer screening disparities: Baseline predictors of informal breast health promotion among participants overdue for screening

Abstract

Numerous evidence-based intervention strategies exist in research and practice to address alarming low breast cancer screening among minoritized populations. Recent studies have found that minoritized participants promote breast health and catalyze screening among their networks – even when unprompted to do so. Formative work is needed to identify strategies for maximizing adaptive intervention delivery (e.g., SMART, MOST). We sought to identify predictors of breast health promotion at baseline among Latinas who were non-adherent to US Preventive Services Task Force (USPSTF) breast cancer screening guidelines. The current study uses baseline survey / self-report data, using validated survey measures, among enrolled study participants in the MADRE trial. Eligibility criteria focused on non-adherence to USPSTF guidelines and a lack of history in promoting health as formal health volunteer / employee. The outcome variables were promotion of (1) breast health overall (e.g., prevention, screening, diagnostic follow-up, treatment) and (2) evidence-based screening messages (i.e., promoting mammography). Predictors include (1) breast cancer screening knowledge, including endorsement of evidence-based information and cultural misconceptions; (2) breast health promotion self-efficacy, including perceived acceptability, feasibility, and pressure to be a role model; (3) history of non-health volunteerism; and (4) linkages to health advocates / professionals, who could help with mammography services. Environmental-dependent data (e.g., message content, location, modality) and validated measures were used to measure and account for social desirability and recall bias. Modified Poisson regressions with robust standard errors modeled participant likelihood to promote breast health and promote evidence-based BC screening specifically. Overall, 40% of participants were 42-49 years old, 40% had less than $20,000 annual household income, and 71% spoke Spanish. About 35% had promoted breast health and 13% had promoted evidence-based screenings. Breast health promotion was predicted by breast health promotion self-efficacy (Prevalence Ratio (PR) = 1.13, 95%CI [1.02, 1.25], p =.02) and linkages to health advocates / professionals (PR = 1.62, 95%CI [1.23, 2.14], p = .001), after adjusting for covariates. Evidence-based screening promotion was predicted specifically by linkages to linkages to health advocates / professionals (PR = 1.82, 95%CI [1.05, 3.15], p = .03). Early findings suggest that some Latinas act as breast health promoters within their networks, despite personal non-adherence with BC screening recommendations and lack of formal training. Our findings have major implications for designing interventions that can optimize efficacy and diffusion of interventions at the population level, through assignment that considers baseline assets (e.g., self-efficacy, pre-existing connections with health infrastructure). Ezra B. Wright, Garth H. Rauscher, John Dziak, Jocelyn Perez-Ahlgrain, Tatiana Lopez, Mariana Tellez, Heidi Parra, Emely Moreno, Monica Jocelinne Padilla, Karyme Huerta, Viviana Bahena, Sheryl Lawrence, Irlanda Estrada Sanchez, Carolina Bujanda, Paola Torres, Elizabeth de la Paz, Juanita Arroyo, Silvia Montoya, Araceli Lucio, Pamela Ganschow, Kristen Andersen, Maria J. Perez, Nathan Stackhouse, Erin I. Neuschler, Candyce H. Kroenke, Jennifer Watling Neal, Yamile Molina. Informing future adaptive interventions to address breast cancer screening disparities: Baseline predictors of informal breast health promotion among participants overdue for screening [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr A041.