Abstract C159: Advancing equity in hereditary cancer risk reduction: Social determinants of health and genetic counseling and testing uptake among Latinas

Abstract Background: Latinas face disproportionately high barriers to accessing genetic counseling and testing (GCT) for hereditary breast cancer risk, due in part to the intersection of biological risk and adverse social determinants of health (SDOH). Despite the promise of precision prevention, few models effectively integrate SDOH screening and navigation within GCT delivery. This study evaluates the impact of SDOH burden, measured by PRAPARE scores, on GCT uptake among Latina participants in a community-engaged randomized controlled trial (RCT). Methods: Latinas Lideres en Salud (LaLiSa) is a completed RCT in a 14-site FQHC in Chicago led by a FQHC-community-academic partnership. Participants (N=120) self-identified as Latina, were aged ≥18, had a personal or family history of breast/ovarian cancer, and had not previously accessed GCT. Participants were randomized into one of two phone-based interventions delivered by a community agency. Both interventions offer personalized BC education, SDOH screening and navigation, and free/low-cost GCT services. “Educate” offers education on risk reduction (diet, exercise) while “Empower” offers skills training on sharing precision cancer prevention information with family and other network members. SDOH burden was assessed at baseline using PRAPARE, and outcomes included GCT referral and completion, extracted from navigation records. Results: Among enrolled participants, 86% had an income 200% below the federal poverty level (FPL), 46% faced additional risks (e.g., housing instability, transportation insecurity, lack of insurance, etc.), and 92% had PRAPARE scores ≥5. GCT referrals were initiated for 78% of participants, with 46% completing risk-appropriate GCT services. After adjusting for age and social desirability bias, Empower participants were more likely than Educate participants to complete GCT (51% vs 33%, aOR = 2.10, p=0.001). Among participants with high SDOH burden (PRAPARE ≥3), those in the Empower intervention showed an increase in GCT uptake compared to those in the Educate intervention. Discussion: Findings support the feasibility and effectiveness of integrating SDOH-informed, network-based interventions into FQHC settings to improve GCT uptake among Latinas with an elevated hereditary cancer risk. High SDOH burden remains a critical barrier to precision prevention, but culturally tailored Empower approaches that include SDOH navigation can reduce inequities in GCT uptake. Future implementation efforts should prioritize systems that embed structural risk assessment and navigation in precision cancer prevention programs. Citation Format: Paola Torres, Carolina Bujanda, Celeste Charcalac-Zapeta, Juanita Arroyo, Araceli Lucio, Pamela Ganschow, Vivian Pan, Nathan Stackhouse, Sage Kim, Yamile Molina. Advancing equity in hereditary cancer risk reduction: Social determinants of health and genetic counseling and testing uptake among Latinas [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C159.