In Your Genes: Communicating with Ashkenazi Jewish Women about Hereditary Breast Cancer Risk

Theoretical Background and research questions/hypothesis:  In 2009, Congress established the Education and Awareness Requires Learning Young (EARLY) Act. The legislation directed the creation of an education and outreach campaign to increase knowledge of breast health and breast cancer among young women. In response, CDC’s Division of Cancer Prevention and Control (DCPC) is launching a public education campaign titled ‘Bring Your Brave’. ‘Bring Your Brave’ is being executed through digital and social media. The campaign targets women ages 18- 44 at both average and increased risk for breast cancer.   Ashkenazi Jewish women are at increased risk for developing breast cancer at a young age, primarily due to a high prevalence of BRCA1 and BRCA2 gene mutations. Reaching Ashkenazi Jewish young women is challenging, given the small size of the population, a lack of published literature to provide insights on tailoring health messages to this audience, and no available market research data to guide dissemination. DCPC conducted qualitative formative research to determine their knowledge, attitudes, and behaviors around breast cancer and to ascertain their opinions on specific campaign materials.

Methods:  DCPC conducted four focus groups with Ashkenazi Jewish women segmented by age (18-29, 30-44) and presence of a family medical history of breast cancer. Groups took place in New York City, New York and Chicago, Illinois and lasted two hours each. Research staff analyzed transcripts using the constant comparative method. Staff also compared findings to results from previous DCPC focus groups, interviews, literature reviews, and social media listening.

Results:  Few young Ashkenazi Jewish women were familiar with BRCA gene mutations and their relationship to breast cancer, despite a generally increased awareness of hereditary diseases compared to general audience young women. Health beliefs and messaging/dissemination preferences were influenced by; Age, if the respondent had a family history of breast cancer, and if they self-identified as “religious/practicing” or “cultural/non-practicing”. Nearly all respondents endorsed the importance of providing clear, obvious indicators that campaign materials were meant specifically for Ashkenazi Jews, including images, statistics, and messages tailored for their families and community.

Conclusions:  Formative research findings will be important to the creation and dissemination of tailored ads (based on personal stories) targeting Ashkenazi Jewish women for DCPC’s ‘Bring Your Brave' campaign. Findings will also help DCPC to develop social media content and video vignettes featuring Jewish women sharing their personal experiences of having a family history of breast cancer and being tested for a BRCA gene mutation.  

Implications for research and/or practice:  When planning to communicate with a population that faces health disparities based on ethnicity, it is important to research both the content to be delivered as well as the mechanism for delivery with members of the target audience. It is important to establish a baseline understanding of the health issue and related health issues and build education messages around existing knowledge. In DCPC’s efforts to communicate breast cancer risk information to young Ashkenazi Jewish women, it is important to consider personal, family, religious, and cultural influences on health knowledge, attitudes, and behaviors.