1 The long-term career goal of this K01 project is to gain training and mentorship that will prepare me for a career 2 as an independent and successful externally funded investigator in the field of cancer health disparities. Over 3 the next 5 years, my career objectives are to: 1) develop and lead experimental interventions; 2) gain further 4 expertise in translational science; 3) acquire skills in quantitative analysis, including social network analysis; and 5 4) enhance my ability to write competitive grant applications and increase my scholarly productivity. With my 6 primary mentor, Dr. Marian Fitzgibbon, I have assembled a strong team of co-mentors and advisors (including a 7 biostatistician) to guide me through the proposed training and research activities. The proposed career 8 development plan is structured to ensure that I achieve training milestones through didactic coursework, career 9 development workshops, and attendance at national scientific meetings. The University of Illinois at Chicago 10 (School of Public Health and Cancer Center) are committed to supporting my career development and providing 11 the protected time needed to achieve my career and research goals. The overall objective of this K01 research 12 project is to test the effectiveness of a culturally targeted video, previously developed by our research team, on 13 promoting genetic counseling attendance among African American (AA) women determined to be at high risk for 14 breast cancer through cancer genetic risk assessment at a Federally Qualified Health Center. Uptake of genetic 15 services is particularly low among high-risk AA women, who carry a disproportionate burden of breast cancer 16 mortality. Further, although testing close relatives of individuals who test positive for a pathogenic variant might 17 curtail breast cancer disparities attributable to hereditary risk, it is unclear how counseled or tested individuals 18 influence their social and familial networks. Thus, my central hypothesis is that the culturally targeted video will 19 increase genetic counseling attendance among participants compared to those who receive a genetic counseling 20 brochure. The proposed Specific Aims are to: 1) compare the effects of the video and brochure on genetic 21 counseling attendance among AA women at high risk for breast cancer; 2) test how psychosocial factors 22 (knowledge, intrinsic motivation, risk perception, distress) affect relationships between intervention exposures 23 (video/brochure) and genetic counseling attendance; and 3) compare the impact of intervention exposures 24 (video/brochure) on diffusion of knowledge through social network analysis. My prior training, coupled with the 25 skills that I will acquire during the award period, will equip me to successfully conduct the proposed research 26 and position me to continue my work to address breast cancer disparities that persist among high-risk AA women. 27 28 29 30 31 32

Project Narrative The proposed research is relevant to public health because it will equip me with the necessary skills to examine the underuse of genetic services among African American women at high risk for breast cancer and to identify tools that may increase diffusion of knowledge of genetic counseling among high-risk populations. This project is relevant to NCI's goal of ensuring that a diverse pool of highly trained scientists is available in appropriate scientific disciplines to address biomedical, behavioral, social and clinical research needs in the United States. Moreover, this project is relevant to NCI's mission of launching independent research careers and preparing early investigators to compete for federal grant funding through career development and training.