The CD36 scavenger receptor Bez regulates lipid redistribution from fat body to ovaries in Drosophila.

Lipid distribution in an organism is mediated by the interplay between lipoprotein particles, lipoprotein receptors and class B scavenger receptors of the CD36 family. CD36 is a multifunctional protein mediating lipid uptake, mobilization and signaling at the plasma membrane and inside of the cell. The CD36 protein family has 14 members in Drosophila melanogaster, which allows for the differentiated analysis of their functions. Here, we unravel a role for the so far uncharacterized scavenger receptor Bez in lipid export from Drosophila adipocytes. Bez shares the lipid binding residue with CD36 and is expressed at the plasma membrane of the embryonic, larval and adult fat body. Bez loss of function lowers the organismal availability of storage lipids and blocks the maturation of egg chambers in ovaries. We demonstrate that Bez interacts with the APOB homolog Lipophorin at the plasma membrane of adipocytes and trace the Bez-dependent transfer of an alkyne-labeled fatty acid from adipocytes to Lipophorin. Our study demonstrates how lipids are distributed by scavenger receptor-lipoprotein interplay and contribute to the metabolic control of development.

Breaking self-focused orientation in people who perceive economic scarcity: The influence of transcendent motivation to promote an abstract mindset and prosocial behavioral intentions.

Previous research shows that being in a situation of economic scarcity promotes a more concrete mindset that motivates behavioral decisions based on action difficulty and their short-term outcomes, which frequently entails negative consequences. However, a concrete mindset can be counteracted by inducing an abstract mindset to help people focus on final broad goals. We explored how focusing on transcendent motives (vs. self-oriented) promotes a more abstract mindset facilitating prosocial behavioral intentions. Study 1 (pre-post design) explored whether focusing on transcendent motives for engaging in activities promoted a more abstract mindset compared to focusing on self-oriented motives. Using a 2 × 2 design with two consecutive opposing primes, Study 2 tested how inducing a transcendent orientation could reverse the effect caused by perceiving economic scarcity, promoting greater orientation toward others and prosocial behavioral intentions. In Study 1 participants who generated transcendent motives for behaviors presented a greater increase in the abstraction of construal level, compared to those who only generated self-oriented motives for the same behaviors. Study 2 demonstrated that, when participants who perceived economic scarcity were focused on transcendent motives (vs. self-oriented) to promote a more abstract mindset, their orientation toward others increased. Interestingly, for people perceiving economic scarcity, whose own difficulties could reduce prosocial behaviors, the greater orientation toward others promoted a greater intention to engage in demanding prosocial behaviors. We provide evidence of new strategies to promote abstraction in individuals and increase their involvement in prosocial behavioral intentions, especially for those perceiving economic scarcity.

Advancing health equity: A qualitative study assessing barriers and facilitators of implementing hereditary breast and ovarian cancer risk screening tools in community-based organizations.

Genetic counseling and testing (GCT) inform cancer management for persons at risk for hereditary breast and ovarian cancer (HBOC). Community-based organizations (CBOs) may play a role in identifying at-risk Latinx individuals to connect them to GCT but data are lacking. Two academic centers and their four CBO partners planned to implement a validated questionnaire for HBOC risk screening ("HBOC risk screening tool"). This study aimed to assess CBO's preferences for HBOC risk screening tools, as well as the barriers and facilitators anticipated for future implementation. Pre-implementation focus groups were conducted with CBO's staff. Discussions centered on current practices to identify and refer at-risk patients. During the discussion, staff were asked to select one out of five validated HBOC risk screening tools to implement and to discuss anticipated barriers/facilitators for implementation. The four focus groups were coded and qualitative analyzed following the Consolidated Framework for Implementation Research (CFIR) and Health Equity domains. All CBOs chose the Family History Screen 7 (FHS-7). Participants (N = 35) highlighted how the FHS-7 was easy to adapt to better fit the target population and changing guidelines. They had positive attitudes toward implementing the screening tool, stressed how the culture of the organization positioned them to reach the target population, and noted barriers in different CFIR domains (e.g., low knowledge about HBOC and GCT referrals; scarce available resources). Participants pointed to barriers related to health equity domains including limited access to GCT and follow-up care for uninsured and underinsured populations, challenges obtaining accurate family history, and immigration-related barriers. CBOs highlighted the importance of partnering with other stakeholders to overcome barriers. Findings emphasize the need to develop multi-level implementation strategies to overcome barriers and leverage facilitators. This study can inform the development of implementation toolkits for CBOs to implement HBOC screening tools to advance health equity.

A culturally targeted video to promote genetic counseling in a community sample of at-risk US Latina women: The role of the concrete mindset.

Latina women, who are at increased risk of hereditary breast and ovarian cancer (HBOC), have lower use of genetic counseling and testing (GCT) than non-Hispanic White women. In a recent study, culturally targeted video improved psychosocial outcomes related to GCT. Additional analyses examine whether the culturally targeted video improved positive reactions in women who focus on difficulties (concrete mindset) versus women who focus on the final goals (abstract mindset). Participants (N = 32) completed surveys before and immediately after watching the video. The surveys measured attitudes, emotions, and women's mindset. Before watching the video, women with a concrete mindset reported more negative attitudes and negative emotions about GCT than women with an abstract mindset. After watching the video, women with a concrete mindset reported negative attitudes and feelings at levels comparable to those of women with an abstract mindset, reflecting a reduction in their negative attitudes and emotions. The sample size limits the power to find statistically significant differences. Results support the relevance of considering the audience's mindset in the development and testing of public health messages to promote the use of GCT.

Process evaluation of a culturally targeted video for Latinas at risk of hereditary breast and ovarian cancer.

This paper presents a process evaluation of a culturally targeted narrative video about hereditary breast and ovarian cancer (HBOC) for Latina women at risk for HBOC. Spanish-speaking Latina women at risk for HBOC participated in a single arm study (n = 40). Participants watched the video developed by the authors and responded to surveys. We used mixed methods to assess theoretical constructs that are hypothesized mediators of narrative interventions (i.e., transportation or engagement, identification with characters, emotions) and implementation outcomes (e.g., acceptability). Descriptive statistics summarized theoretical constructs and implementation outcomes. We conducted Mann-Whitney U tests to assess the differences in theoretical and implementation outcomes between participants who were affected versus. unaffected and participants with different levels of education and health literacy. We used the consensual qualitative research framework to analyze qualitative data. Participants' mean age was 47.1 years (SD = 9.48). Most participants were high school graduates or less (62.5%). Acceptability of the video was extremely high (Md = 10.0, IQR = 0.2, scale 1-10). Most (82.5%) suggested video dissemination be through social media. Participants were highly engaged (Md = 5.7, IQR = 1.5, scale 1-7), strongly identified with the main character (Md = 8.7, IQR = 2.6, scale 1-10), and reported experiencing mostly positive emotions (Md = 9.5, IQR = 2.8, scale 1-10). Participants with low health literacy and affected participants reported a significantly higher identification with the main character (p<.05). Qualitative data reinforced the quantitative findings. Women reported gaining knowledge, correcting misconceptions, and feeling empowered. Our culturally targeted video is highly acceptable and targets mechanisms of behavior change for narrative interventions. The video is easily disseminable and can be used as an education tool for patients including affected and unaffected women and patients with different education and health literacy levels. Future studies should test the impact of the video in enhancing genetic counseling and testing uptake.

Applying the theory of planned behavior to examine adjuvant endocrine therapy adherence intentions.

OBJECTIVE: Adherence to adjuvant endocrine therapy (AET) in breast cancer survivors is suboptimal. Using the theory of planned behavior (TPB), this study aimed to identify the strongest predictors from the TPB of AET intentions and past behavior and assessed whether ambivalence and anticipatory emotions increased the predictive capacity of TPB. METHODS: Two hundred eighty women diagnosed with hormone positive (HR+) breast cancer who filled at least one prescription of AET responded to a survey measuring TPB constructs, attitudinal ambivalence, and anticipatory emotions. The outcomes were intentions to adhere to AET and past medication adherence (previous 2 weeks). RESULTS: The TPB explained 66% of intentions to adhere to AET (P < 0.001). Ambivalence did not improve the TPB model's predictive value. When emotions were included with TPB, the model explained 70% of adherence intentions F11,226  = 52.84, P < 0.001 (R2c  = .70). This increase of 4% in predictability was statistically significant (ΔR2  = 0.04), F6, 226  = 7.90, P < 0.001. Women who self-reported nonadherence in the past 2 weeks differed significantly in the TPB variables, ambivalence, and anticipatory emotions from adherent women. Nonadherent participants reported lower-future intentions to adhere F1, 236  = 5.63, P = 0.018. CONCLUSIONS: Results suggest key concepts, such as anticipatory positive emotions that should be addressed in future interventions to enhance AET adherence and survivorship.

Debris buster is a Drosophila scavenger receptor essential for airway physiology.

Scavenger receptors class B (SR-B) are multifunctional transmembrane proteins, which in vertebrates participate in lipid transport, pathogen clearance, lysosomal delivery and intracellular sorting. Drosophila has 14 SR-B members whose functions are still largely unknown. Here, we reveal a novel role for the SR-B family member Debris buster (Dsb) in Drosophila airway physiology. Larvae lacking dsb show yeast avoidance behavior, hypoxia, and severe growth defects associated with impaired elongation and integrity along the airways. Furthermore, in dsb mutant embryos, the barrier function of the posterior spiracles, which are critical for gas exchange, is not properly established and liquid clearance is locally impaired at the spiracular lumen. We found that Dsb is specifically expressed in a group of distal epithelial cells of the posterior spiracle organ and not throughout the entire airways. Furthermore, tissue-specific knockdown and rescue experiments demonstrate that Dsb function in the airways is only required in the posterior spiracles. Dsb localizes in intracellular vesicles, and a subset of these associate with lysosomes. However, we found that depletion of proteins involved in vesicular transport to the apical membrane, but not in lysosomal function, causes dsb-like airway elongation defects. We propose a model in which Dsb sorts components of the apical extracellular matrix which are essential for airway physiology. Since SR-B LIMP2-deficient mice show reduced expression of several apical plasma membrane proteins, sorting of proteins to the apical membrane is likely an evolutionary conserved function of Dsb and LIMP2. Our data provide insights into a spatially confined function of the SR-B Dsb in intracellular trafficking critical for the physiology of the whole tubular airway network.

FOXO-dependent regulation of innate immune homeostasis.

The innate immune system represents an ancient host defence mechanism that protects against invading microorganisms. An important class of immune effector molecules to fight pathogen infections are antimicrobial peptides (AMPs) that are produced in plants and animals. In Drosophila, the induction of AMPs in response to infection is regulated through the activation of the evolutionarily conserved Toll and immune deficiency (IMD) pathways. Here we show that AMP activation can be achieved independently of these immunoregulatory pathways by the transcription factor FOXO, a key regulator of stress resistance, metabolism and ageing. In non-infected animals, AMP genes are activated in response to nuclear FOXO activity when induced by starvation, using insulin signalling mutants, or by applying small molecule inhibitors. AMP induction is lost in foxo null mutants but enhanced when FOXO is overexpressed. Expression of AMP genes in response to FOXO activity can also be triggered in animals unable to respond to immune challenges due to defects in both the Toll and IMD pathways. Molecular experiments at the Drosomycin promoter indicate that FOXO directly binds to its regulatory region, thereby inducing its transcription. In vivo studies in Drosophila, but also studies in human lung, gut, kidney and skin cells indicate that a FOXO-dependent regulation of AMPs is evolutionarily conserved. Our results indicate a new mechanism of cross-regulation of metabolism and innate immunity by which AMP genes can be activated under normal physiological conditions in response to the oscillating energy status of cells and tissues. This regulation seems to be independent of the pathogen-responsive innate immunity pathways whose activation is often associated with tissue damage and repair. The sparse production of AMPs in epithelial tissues in response to FOXO may help modulating the defence reaction without harming the host tissues, in particular when animals are suffering from energy shortage or stress.

Can empathic concern be generalized from one person to others? Another positive side of the 'one-among-others' effect.

Previous research on the one-among-others effect has shown that inducing empathic concern towards a victim presented among other individuals in need enhances: (1) awareness of these others and (2) the willingness to help them individually. In this work, we test that these outcomes are linked by an additional process: the generalization of empathic concern felt for the victim towards the others in need. Study 1 revealed that inducing empathic concern for a victim presented as one-among-others led to see the others as separate and different individuals, not as a unitary group. Study 2 showed that the one-among-others presentation (vs. only-one-victim) increased empathic concern towards those presented along with the main victim. Study 3 showed that the one-among-others presentation (vs. a single-victim or a statistical presentation) increased the empathic concern felt for other individuals in need. Therefore, the one-among-others presentation does not weaken empathic concern but, instead, it leads to its generalization from one to others.

Future-oriented emotions in the prediction of binge-drinking intention and expectation: the role of anticipated and anticipatory emotions.

The Theory of Planned Behavior (TPB) offers a parsimonious explanation of purposive behavior, but in the study of healthy and risk behaviors its sufficiency may be questioned. Working with binge-drinking, a very common risk behavior in Spanish undergraduate students, we used two strategies for improving predictions from TPB: using behavioral intention (BI) and behavioral expectation (BE) as proximal antecedents of behaviors and adding as new predictors two future-oriented emotions (anticipated and anticipatory). Hierarchical regression analyses show that while anticipated emotions improved TPB explanations of BI, anticipatory emotions improved the explanations of BE. The present results show the influence of future emotions in the prediction of behavioral intention and behavioral expectation.

From aesthetics to ethics: Testing the link between an emotional experience of awe and the motive of quixoteism on (un)ethical behavior.

According to the awe-quixoteism hypothesis, one experience of awe may lead to the engagement in challenging actions aimed at increasing the welfare of the world. However, what if the action involves damaging one individual? Across four experiments (N = 876), half participants were induced to feel either awe or a different (pleasant, activating, or neutral-control) emotion, and then decided whether achieving a prosocial goal (local vs. global). In the first three experiments this decision was assessed through a dilemma that involved to sacrifice one individual's life, additionally in Experiments 2 and 3 we varied the quality of the action (ordinary vs. challenging). In Experiment 4, participants decided whether performing a real helping action. Overall, in line with the awe-quixoteism hypothesis, the results showed that previously inducing awe enhanced the willingness to sacrifice someone (Experiments 1, 2 and 3) or the acceptance to help (Experiment 4) when the decision involved engaging in challenges aimed at improving the welfare of the world.

The links among relative financial scarcity, thinking style, fatalism, and well-being.

In the present research, we examined the links among relative financial scarcity, thinking style, fatalism, and well-being and their roles in predicting protective behaviors against COVID-19. Study 1 (N = 120) revealed that after an experimental manipulation to induce the perception of relative financial scarcity (versus financial abundance), people who perceived higher relative financial scarcity changed their thinking style to a more concrete mindset. In Study 2 (N = 873), the relative financial abundance-scarcity situation was measured, and the results showed that the greater the perceived relative financial scarcity was, the more concrete the mindset and the lower the sense of well-being. Importantly, we found that individuals who felt poorer but maintained an abstract thinking style reported higher well-being. Study 3 (N = 501) examined the influence of a concrete thinking style in people who perceived that their economic situation had worsened with the pandemic. The results showed that when this vulnerable population presented a more concrete mindset, they reported lower well-being, higher fatalism, and lower protective behavior against COVID-19. Thus, maintaining an abstract mindset promotes higher well-being, lower fatalism, and greater protective behaviors against COVID-19, even under economic difficulties. Because thinking style can be modified, our results encourage the development of new social intervention programs to promote an abstract mindset when people face important challenges.

Disentangling Emotions during the Coronavirus Outbreak in Spain: Inner Emotions, Descriptive Feeling Rules and Socioemotional Conventions.

For constructionism, language is the link among different levels of analysis of emotional events, from individual to interpersonal and macrosocial. The interaction among these emotional levels allows us to construe an emotional episode and label it with an emotion word, coordinate with the emotions perceived in others, and represent events as a society. Across two studies, we found similarities and differences among inner emotions experienced (individual level), emotions perceived in others (descriptive feeling rules, interpersonal level) and emotions shared on the internet (socioemotional conventions, macrosocial level), with all these emotional targets focused on the COVID-19 outbreak. The results indicate a similarity between the emotional meaning of COVID-19 in society and the descriptive feeling rules, whereas the reported inner emotions were clearly distinct: Joy was irrelevant at the interpersonal and macrosocial levels but clearly important at the individual level. A mismatch also appeared for fear and hope. While fear was the most predominant emotion at the interpersonal and macrosocial levels during most of the phases, it was moderately predominant at the individual level. Hope followed the opposite pattern, being the most relevant emotion at the individual level but less relevant at the interpersonal and macrosocial levels. Each level might have different consequences: Mixed emotions at the individual level might promote resilience; fear perceived in other people might motivate protective behaviors; and sadness socially shared during Christmas might generate greater empathy. These results support the complexity of emotional concepts and the suitability of exploring them at different levels of analysis.

Anticipated emotions and personal experience for predicting behavioral intentions and behavioral expectations.

We tested how anticipated emotions interact with personal experience in risk behavior to improve predictions from TPB on behavioral intention (BI) and behavioral expectation (BE) for sex without condom (Study 1) and excessive drinking (Study 2). In the moderate-high experience group, anticipated emotional profiles (AEPs) improve TPB prediction from 28% to 45% in the case of BI and from 19% to 40% in that of BE in relation to sexual risk behavior (Study 1), and from 23% to 36% in the case of BI and from 17% to 31% in that of BE in relation to binge drinking (Study 2). However, in the low-experience group (Study 2) AEPs improve TPB predictions for BI (12% to 34%) but not for BE, showing that in less experienced people BI and BE are not equivalent: anticipated emotions have different relevance in their prediction. These results were replicated using a general negative anticipated emotion index (averaging emotional categories).

Self-Transcendent Emotions and Their Social Effects: Awe, Elevation and Kama Muta Promote a Human Identification and Motivations to Help Others.

Abundant literature shows the effects of negative emotions on motivations to engage in collective action (i.e., to collectively mobilize personal resources to achieve a common objective), as well as their influence on the creation of shared identities. In this proposal, we focus on the possible role of Self-Transcendent Emotions (STEs) defined as positive-valence emotions that have been key in the creation and maintenance of collective identities, as well as in promoting individuals well-being. In detail, we examine their influence in (a) strengthening a global identification, (b) increasing willingness to collectively help others, and (c) improving people's wellbeing. For this reason, we conducted a preliminary literature review of k = 65 independent studies on the effects of STEs on connection to others. Through this review (fully available in Supplementary Materials), we selected a sample of STEs (Awe, Elevation, and Kama Muta) and elicitors to conduct a video-base study. In it, 1,064 university students from 3 different cultural regions (from Spain and Ecuador) were randomized to answer one of three STE scales (i.e., each measuring one of the selected STEs), and evaluate three videos in random order (i.e., each prototypical for the selected STEs). Participants also answered a measure of global identification and intentions to collectively help others (after each video), as well as self-transcendent and well-being (at the end of the survey). Results from SEM analyses show these STEs motivated a fusion of identity with all humanity, as well as collective intentions to help others, even controlling for individuals' value orientations. In addition, the three of them indirectly increased participants' well-being through a higher global identity. While there are differences among them, these three STEs share common elements and their effects are constant across the different cultural regions. It is concluded that Awe, Elevation, and Kama Muta, even individually experienced, have a significant potential to influence people's behavior. Specifically, in various forms of collective action aimed at helping others.

Mixed emotional appeals in emotional and danger control processes.

Negative emotional appeals do not always help to reduce risk behaviors. We report two studies about a new strategy based on the presentation of appeals with mixed sequential emotions (e.g., sadness/fear-joy/relief). Study 1 shows that a mixed message generates lower post-message discomfort than an exclusively negative message; moreover, in this first study, reported probability of performing the risk behavior, binge drinking, in the future is also lower in the mixed condition. Study 2 replicates these results and relates them to the extended parallel process model (EPPM) (Witte, 1992). Here, the mixed emotional message again generates lower post-message discomfort than the negative one, and participants are motivated to control the danger (response efficacy is evaluated more positively in the mixed condition).

Using abstractness to confront challenges: How the abstract construal level increases people's willingness to perform desirable but demanding actions.

Previous research has shown that while considering future behavioral intentions, desirability is more salient in making decisions in an abstract mindset than in a concrete one. Based on this premise, we test whether behavioral intentions to engage in desirable but difficult actions are more likely in an abstract mindset than a concrete mindset. We experimentally manipulated (Studies 1 through 4 using cognitive primes) and measured as a personal disposition (Study 5 using the Behavioral Identification Form) the construal level to evaluate its influence on the willingness to perform challenges. The behaviors tested focused on self-benefits (Studies 4 and 5) and benefits to others (Studies 1 through 3 and 5). Studies 1 and 2 included only demanding behaviors, whereas Studies 3 through 5 included both difficult and easy conditions. In Studies 1 and 2, the participants were more motivated to attempt a difficult task when they were in an abstract mindset. In Studies 3 through 5, the participants in the abstract (compared to concrete) mindset reported a greater willingness and commitment to attempt desirable but demanding behaviors. Finally, in Study 5, the influence of the construal level on the global behavioral plan index (three behaviors) was moderated by feasibility. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Relationships between Economic Scarcity, Concrete Mindset and Risk Behavior: A Study of Nicaraguan Adolescents.

Background: Nicaragua is one of the poorest countries in Latin America, with an extremely low human development index (HDI). Fifty-two percent of the Nicaraguan population are children and adolescents under 18 years of age. Nicaraguan adolescents present several risk behaviors (such as teenage pregnancies, consumption of alcohol, tobacco, cannabis). Our study examines the links between risk behaviors, fatalism, real economic scarcity, and concrete construal level for adolescents with low and middle-low socioeconomic status in Nicaragua. Methods: Nicaraguan adolescents (N = 834) from schools located in especially vulnerable areas (low economic status) or in neighborhoods with middle-low social class completed several scales and questions to evaluate fatalism (SFC-social fatalism scale), construal level (BIF) and their past and future risk behaviors (smoking cigarettes, smoking cannabis, unsafe sex, and alcohol consumption). Results: We identified that the poorest individuals who maintained a concrete style of thinking had the highest rates of past and future risk behaviors. This vulnerable group also reported the highest levels of fatalism, i.e., negative attitudes and feelings of helplessness. Encouragingly, the adolescents who were able to maintain an abstract mindset reported healthier past and future habits and lower fatalism, even when they belonged to the lowest social status. In the middle-low economic group, the construal level was not as relevant to maintaining healthy habits, as adolescents reported similar rates of past and future risk behavior at both construal levels. Conclusions: All these results support the importance of considering construal level when studying vulnerable populations and designing risk prevention programs.

The Bright Side of Abstraction: Abstractness Promoted More Empathic Concern, a More Positive Emotional Climate, and More Humanity-Esteem After the Paris Terrorist Attacks in 2015.

ANTECEDENTS: Previous research on citizens' reactions after terrorist events has shown that positive reactions can also emerge alongside pain and horror. Positive emotions have been widely associated with an abstract style of thinking. In the context of the Paris terrorist attacks in 2015, we explored Spanish citizens' positive reactions - empathic concern, positive emotional climate, and esteem for humanity - and examined the relationships of these responses with an abstract (vs. concrete) style of thinking. METHOD: A longitudinal study was designed involving an online questionnaire that was administered 10 days, 3 weeks, and 2 months after the attacks (N = 253). RESULTS: Empathic concern and personal distress toward Parisians decreased from the weeks following the attacks to 2 months later, with empathic concern always being more intense than personal distress. Emotional climate was perceived as more hostile than positive, although positive feelings persisted. People reported moderately positive esteem for humanity. Individuals with a more abstract style of thinking reported greater empathic concern, a more positive emotional climate, and more esteem for humanity. CONCLUSIONS: Our results support and extend previous research showing that abstraction enhances people's resilience, even under traumatic circumstances such as those surrounding a terrorist attack.

Developing a culturally targeted video to enhance the use of genetic counseling in Latina women at increased risk for hereditary breast and ovarian cancer.

Disparities for genetic cancer risk assessment (GCRA) for hereditary breast and ovarian cancer (HBOC) persist between Latina and non-Hispanic Whites. There are few tested culturally targeted interventions. We developed a culturally targeted video to enhance GCRA uptake in at-risk Latinas. Interviews with healthcare providers (n = 20) and at-risk Latinas (n = 20) were conducted as formative research to inform the development of the video. Findings from the formative research, health behavior conceptual models, and evidence-based risk communication strategies informed the messages for the script. Then, we conducted a focus group with at-risk Latinas (n = 7) to obtain feedback for final refinement of the script. The final video was piloted for acceptability and potential dissemination in a sample of Latino community health workers (CHWs) (n = 31). Providers and at-risk Latinas suggested using simple language and visual aids to facilitate comprehension. Participants in the focus group identified areas for further clarification (e.g., cost). The result was an 18-min video that illustrates "Rosa's" story. Rosa learns about HBOC risk factors and overcomes barriers to attend genetic counseling. CHWs reported high overall satisfaction with the video (M = 9.61, SD = .88, range 1-10). A culturally targeted video has the potential to reach underserved populations with low literacy and English proficiency.