Understanding Hispanic and Latino Perceptions on Ancestry-Targeted Screening for Hereditary Breast and Ovarian Cancer Syndrome via Democratic Deliberation.

Guided by the community empowerment theory, this study utilized the Democratic Deliberation (DD) approach to gather informed opinions from communities of Hispanic and Latino ancestry to understand barriers and facilitators for targeted screening for Hereditary Breast and Ovarian Cancer Syndrome (HBOC) screening. We recruited 33 Spanish-speaking Hispanic and Latino community members living in the state of Georgia and conducted a half-day, in-person democratic deliberation in Spanish. Through the DD process, participants generated and prioritized pros and cons related to the question, deliberating with members in small group sessions to reach a consensus on what is best for the community as a whole after viewing pre-recorded expert testimonies. During the conference style DD, six group sessions were audio-recorded, transcribed, and analyzed thematically using the empowerment theory framework. Participants completed pre- and post-deliberation surveys, with descriptive analyses conducted in SAS. Participants rated deliberations highly satisfactory and change in self-efficacy to deliberate was statistically significant post deliberation. They identified barriers and facilitators across individual, community, and environmental domains. Key facilitators included increased awareness of HBOC risk and prevention, enhanced support for the Latino community, and improved early cancer detection and treatment. Major concerns were at the community and environmental levels, including high costs, lack of insurance, legal status issues, inadequate transportation, and the need for culturally congruent care and representation. Our study highlights the feasibility of DD for engaging Spanish speaking Hispanic/Latino community members in public health policy discussions. Study findings highlight the need for targeted efforts to address the community and societal level barriers affecting HBOC screening access and effectiveness within these communities.