Research Discovery: Co-Designing Breast Cancer Outreach with Rural Women

Pravesh Sharma, Ph.D., and colleagues recently published findings in the Journal of Clinical and Translational Science describing the development of the Mayo Clinic Health System WeCARE (Women’s Engagement for Cancer Awareness, Resources, and Education) intervention. The study, titled Community-informed Development of an In-Person Forum to Promote Breast Cancer Screening and Research Preparedness in Rural and Low-Socioeconomic Status Women, highlights how community members helped shape an educational forum designed to improve breast cancer screening participation and research preparedness among rural and underserved women.

What it is

Women living in rural areas and women with low socioeconomic status often face challenges that contribute to lower breast cancer screening rates, delayed diagnoses, and reduced participation in clinical research. To address these challenges, Mayo Clinic Health System developed the WeCARE intervention using a community-engaged approach that centered the voices and lived experiences of women from the target population. Members of a study Community Advisory Board (CAB) partnered with researchers to help design an educational forum and related support services aimed at increasing awareness of breast cancer screening and clinical research opportunities.

How it Works

The WeCARE intervention was developed through collaboration among healthcare providers, community organizations, and a 14-member Community Advisory Board that included rural and low-income women, healthcare professionals, and community leaders. Through structured feedback sessions, CAB members reviewed forum content, messaging, logistics, and support services. Researchers used the Consolidated Framework for Implementation Research (CFIR 2.0) to organize and analyze feedback, identify challenges and facilitators to participation, and guide changes to the intervention before implementation. The forum serves as the initial entry point into a broader program that includes ongoing navigation support, assistance addressing structural challenges, and follow-up engagement over three months.

Key Findings

• Community Advisory Board members emphasized that trust and credibility are critical, recommending that breast cancer survivors and community members help deliver forum content alongside clinicians. This led to a mixed community-clinical presenter model.

• Participants preferred the forum to be held in a trusted community setting rather than a healthcare facility. Based on this feedback, researchers selected a rural church as the planned forum location.

• CAB members recommended scheduling the event in mid-September and providing childcare support to reduce challenges related to weather, school schedules, and family responsibilities.

• Community members highlighted the need for Spanish-language accessibility, leading the research team to incorporate real-time Spanish interpretation during the forum.

• Feedback emphasized the importance of trauma-informed communication, including trigger warnings, supportive language, and allowing participants to step away if discussions became emotionally difficult.

• CAB members recommended simplifying medical terminology and rearranging content so less distressing information, such as screening rates, would be presented before survival statistics.

• Community feedback prompted revisions to research education materials, focusing on participant safety, voluntariness, and physician oversight using clear, accessible language.

• Members stressed that education alone is not enough to improve screening participation. As a result, the intervention includes ongoing follow-up calls, mailed reminders, and assistance with transportation, childcare, insurance navigation, and appointment scheduling.

• Most Community Advisory Board recommendations were incorporated into the final intervention design, demonstrating the value of involving community partners as active co-developers rather than passive advisors.

Community Impact

This study demonstrates how community engagement can strengthen the design of programs intended to improve breast cancer screening and research participation among rural and underserved women. By directly incorporating feedback from community members, the WeCARE intervention was tailored to address practical, cultural, language, and trust-related challenges that often prevent women from accessing preventive care and research opportunities.

The findings reinforce the importance of partnering with communities to develop health interventions that are acceptable, accessible, and relevant to the populations they are intended to serve. As WeCARE moves into implementation, researchers hope the program will increase breast cancer screening uptake, improve awareness of clinical research, and help reduce differences in cancer prevention and early detection among rural and low socioeconomic status women.