Table 2.
Pilot 1.5-day in-person workshop activities and descriptions
| Pilot activity/topic | Description |
|---|---|
| Day 1 | |
| Welcome & making connections | • Trainees introduce themselves and then mingle & discuss questions on nametags (e.g., “What do you think are the biggest challenges to discussing cancer risk with Latinas?”) |
| Introduction & why is family history important? | • Sharing of a personal story by a Latina breast cancer survivor who tested positive with BRCA1 • Scripted role play between a Latina breast cancer survivor and her physician eliciting family history and introducing idea that patient’s cancer could be due to BRCA1/2 pathogenic variants • Group discussion with questions and answers followed by Spanish-language video about family history, genes, and HBOC |
| Genetics 101 | • Lecture on genetics designed to convey basic genetic concepts and appropriate for trainees with limited prior knowledge of genetics • Small group activity: create models of the double helix using candy to help reinforce concepts from genetics lecture |
| Hereditary breast & ovarian cancer | • Trainees instructed in how to draw family histories using pedigree symbols and then draw their own family tree; discussion of how certain traits and/or health conditions are passed between generations • Discuss case example of patient in the introductory role play to highlight importance of family history of breast and ovarian cancer • Trainees work in pairs to practice taking a fictitious family history. Pairs share experience with small group and discuss whether/why the family histories they provided are/are not suggestive of HBOC • Introduce/reinforce different concepts important in referral-level competencies related to HBOC including genetic counseling, genetic testing, initiating genetic testing in a proband, defining “affected” and “unaffected,” risk factors related to young age of cancer onset or triple negative breast cancer, and how other genes beyond BRCA1/2 may also be involved in HBOC. Concepts conveyed through case presentations of family pedigrees and provision of glossary with terms in English and Spanish |
| Introduction to HBOC risk management | • Introduce risk management approaches with presentation describing surveillance and prophylactic surgery options • Questions and answers with physician and genetic counselors who care for high risk Latina patients |
| Debrief day 1 experiences | • Breakout groups (of 6–7 trainees) to discuss and then report back to larger group to debrief from day 1 and elicit trainees’ professional experiences related to community education, risk assessment, referrals to specialists, and navigation with health services • Large group discussion of trainees’ prior experiences of working with patients with HBOC within their communities and organizations |
| Day 2 | |
| Greeting & ice breaker activity | • Place small signs on trainees’ backs that have words or definitions on them (e.g., affected/diagnosed with breast or ovarian cancer; proband/first person in the family to be tested.) Participants find the match of their word/definition by asking questions and providing hints to one another |
| Genetic Counseling and Testing | • Presentation about what genetic counseling is, the goals and typical components. Introduce concepts of panel testing vs. single-site testing • Lay-level presentation about current evidence related to population frequency of BRCA1/2 variants and other known deleterious variants related to breast cancer risk in Latinas |
| Risk assessment skills | • -Role play to demonstrate how promotora might initiate and conduct risk assessments • Overview, discussion and practice using risk assessment tools available in Spanish and English |
| Ethical, legal, & social issues | • Discuss ethical, legal, and social issues using case examples relevant to Latinas including: communication about family history and potential stigma of cancer or passing along deleterious pathogenic variants; sharing of genetic test results with family members living in woman’s country of origin; costs of testing and resources for women without insurance or high deductibles • Introduction to the Genetic Information & Nondiscrimination Act • Discussion of issues relevant to confidentiality |
| Making connections with- and navigation to- genetic resources | • Review different types of genetic services (genetic counseling, genetic education, genetic testing, panel testing) • Group discussion/Q&A about what happens during a genetic counseling appointment via panel of genetic counselors • Demonstration of navigating national online genetics resources |
| Communication about HBOC | • Group discussion of how trainees might apply the information and skills discussed during training • Discussion of training assignment for implementation of information and skills |
| Workshop evaluation & wrap-up | • Complete evaluation about satisfaction with content and format • Orient trainees to upcoming online learning sessions |