Abstract: Let’s Chat: Leveraging Social Media Messaging Apps to Increase Cancer Prevention Behaviors among Vietnamese American Families
Group chat applications such as iMessage, WhatsApp and Facebook Messenger are increasingly common platforms used to stay connected among Vietnamese American families. Family group chats can be leveraged as an opportunity for sharing information about cancer prevention, however, there is a lack of research in this area. Late-stage cancer is particularly prevalent among the Vietnamese community and can be prevented through early screening and/or vaccination. This study assessed the feasibility of a 4-week family group chat intervention to increase cancer screening discussions and intent to schedule missed cancer screenings among Vietnamese families. The study aimed to increase cancer screening for two cancers prevalent in the Vietnamese community: colorectal and cervical cancer. Secondary outcomes included increasing family acceptability and comfort discussing cancer prevention. Using a lay health worker outreach model, a young adult family member was trained as family health advocate (FHA) to introduce cancer prevention messages into family group chats. The Health Belief model guided design of cancer screening messages shared with family members. Cultural grounding guided the intervention approach to having family members adapt and co-create cancer prevention messages. Ten families and 31 individuals participated in the intervention. Themes that emerged from analyzing screen captures and exit interviews with FHAs included: (a) the occurrence of cultural brokering in family group chats (e.g. young adults helping older adults navigate the American health care system and translating the meaning of cancer screening information), (b) communication accommodation (e.g. using simple language to explain medical information), and (c) differing levels of family engagement. After the intervention, 42% of participants self-reported having received at least one of the recommended screenings; 83% reported intent to schedule CRC, Pap test, or HPV vaccination; 61% reported discussing cancer screenings with people outside of their group chat; 84% felt comfortable discussing screenings with family; and 68% agreed that the group chat discussions helped their family feel more comfortable talking about cancer screenings. The majority of family members responded positively and were engaged in group chat conversations. Family members conveyed the intervention made them feel closer to their family and helped open a discussion about cancer prevention that was not previously openly discussed. Challenges to implementing the intervention included: (a) sustaining conversations, (b) finding the ideal time of day to share messages (c) navigating family dynamics and cancer prevention conversations, (d) explaining medical details, and (e) engaging all family members. Study findings indicate that implementing such a family group chat intervention is feasible and shows promise as a complementary strategy for increasing cancer screening in addition to physician recommendation. Lessons learned include: (a) limiting cancer screening discussions to one cancer type, (b) limiting group chats to similar age groups, (c) preparing for varying family group chat dynamics when multiple generations are involved, and (d) presenting cancer screening information using a range of engagement strategies such as polls/myth busters, video stories, and personalized voice messages.