AATP Journals

Expanding the frontier of Asian American cancer control and survivorship research. In recent years, there has been a significant growth and expansion of research in cancer control and survivorship with Asian American populations. This special issue highlights seven articles as examples of how research can inform evidence-based programs to improve cancer screening behaviors, patient–provider communication during clinical encounters, and the delivery of supportive care. This special issue demonstrates the importance of understanding the cultural, social, and structural factors contributing to cancer-related disparities within the Asian American population and addressing these factors in interventions. Recommendations are provided to inform future multifaceted strategy and multilevel interventions to effectively improve cancer control and survivorship outcomes in this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 03 Oct 2024 00:00:00 GMT

A community-based cervical cancer education and navigation program for Korean American women. In the United States, rates of cervical cancer screening among Asian American women (notably Korean American women) lag far behind other populations. Thus, guided by the health belief model, we developed a multicomponent intervention to enhance Korean American women’s knowledge and beliefs about screening and to increase screening uptake. The intervention group (N = 341) received a culturally relevant cancer education program and navigation services. The control group (N = 335) received a similar program on cervical cancer risk and screening, along with information about free/low-cost screening sites. Women’s knowledge and beliefs were measured at baseline and postprogram, and screening behavior was assessed at 12-month postprogram. It was hypothesized that the intervention would lead to positive changes in health beliefs and knowledge about cervical cancer and screening, which were then evaluated as potential mediators of the intervention on screening behavior. From pre- to post-program, the intervention group reported significantly greater increases in knowledge (p < .01) and perceived risk (p = .02) and significantly greater decreases in perceived barriers (p < .001) compared to the control group. However, changes in knowledge and health beliefs did not mediate intervention effects on screening behavior. The use of navigation services was associated with greater odds of obtaining screening (OR = 3.15, 95% CI [2.28, 4.01], p < .001) and attenuated the significant effect of group assignment (intervention vs. control) on screening behavior to nonsignificance. In conclusion, although our intervention program was effective in improving women’s knowledge and beliefs about screening, delivery of navigation services was the critical component in increasing cervical cancer screening rates in this underserved population. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 03 Oct 2024 00:00:00 GMT

Patient COUNTS: A pilot navigation program for Asian American cancer patients. Many Asian American cancer patients face barriers to cancer care but little is known about their navigational needs. We designed and implemented a pilot study to provide culturally- and linguistically-appropriate navigation for Asian American cancer patients. We recruited Asian American adults age 21+ years, who spoke English, Cantonese, Mandarin, or Vietnamese, with newly diagnosed, Stages I–III colorectal, liver, or lung cancer in the Northern California Bay Area. Participants were assigned a language-concordant patient navigator who provided support and resources over 6 months. Surveys were administered at baseline, 3, and 6 months to assess sociodemographic characteristics, health care access, quality of life (Functional Assessment of Cancer Therapy–General [FACT-G]), and cancer care needs. Participants’ mean age was 65 years (range 38–81); 62% were men, 67% spoke Chinese, and 75% reported limited English proficiency. Forty-two percent of participants had lung, 38% colorectal, and 21% liver cancer. Of 24 participants who enrolled, 67% completed the program and 75% completed standard of care cancer treatment. The average total FACT-G score was 72.6 (SD = 17) at baseline, 68.0 (SD = 20) at 3 months, and 69.9 (SD = 22) at 6 months. All participants reported that the program was culturally appropriate and would recommend it. Asian American cancer patients in a patient navigation program reported lower quality of life compared to the general adult cancer population. Even with navigation, 75% of participants reported completing standard of care treatment. While participants were satisfied with the program, more research is needed to address the quality of cancer care Asian American cancer patients receive. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 03 Oct 2024 00:00:00 GMT

Socioeconomic status, stress, and cancer-related fatigue among Chinese American breast cancer survivors: The mediating roles of sleep. Sleep-related issues may be one significant pathway through which socioeconomic disadvantages are associated with worse self-reported states in cancer. The present study examined the relationships between socioeconomic status (SES; income and education level) and two important biobehavioral factors (cancer-related fatigue and perceived stress), as well as mediation through sleep-related problems (sleep medication use, daytime dysfunction, and sleep quality) among a sample of Chinese American breast cancer survivors. One hundred thirty-six Chinese American breast cancer survivors completed a self-reported questionnaire. We found that relative to those with the lowest annual household income, those with the highest income have lower perceived stress. This relationship was mediated by lower sleep quality. Relative to those with a high school degree or less, those with graduate degrees have lower daytime dysfunction, and in turn lower cancer-related fatigue. Our findings point to the importance of addressing sleep-related issues, perceived stress, and cancer-related fatigue among Chinese American breast cancer survivors with low SES backgrounds. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 03 Oct 2024 00:00:00 GMT

Discussion of emotions among newly diagnosed non-Hispanic White and Chinese American patients with breast cancer and their oncologists. This qualitative study analyzed how Chinese American (CA) and non-Hispanic White (NHW) breast cancer patients and their oncologists communicated about patients’ emotional concerns. Data included twenty-four recordings of clinical encounters between oncologists and four CA and eight NHW women with a new breast cancer diagnosis between 2013 and 2015. Using an interactional sociolinguistics approach to discourse analysis, we examined how CA and NHW patients and their oncologists initiated conversations about patients’ emotions. We also categorized oncologists’ responses by whether oncologists turned toward, turned away, or remained neutral to patients’ emotions. When bringing up emotions with oncologists, NHW patients brought up social and personal life topics, whereas CA patients only brought up biomedical topics. We also observed that oncologists initiated discussions about emotions with only English-speaking patients of both racial groups. There were no observed differences in how oncologists remained neutral to or turned away from both CA and NHW patients’ emotional expressions. When oncologists turned away from patients’ emotions, they did so to solve administrative or biomedical problems. In conclusion, the findings suggest that CA patients’ racial backgrounds and the language spoken during the encounters may influence how patients and oncologists initiate discussion about patients’ emotions. Furthermore, the findings suggest that oncologists remain neutral and turn away from CA and NHW patients’ emotions in similar ways. This study provides preliminary data for more comprehensive investigations of Asian American cancer patients’ actual communication with their providers regarding emotions and treatment decisions to facilitate patient–provider communication quality. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 03 Oct 2024 00:00:00 GMT

Health care professionals’ views of supportive care needs for Chinese, Korean, and Vietnamese Americans with metastatic cancer. The supportive care needs of people with metastatic cancer, particularly Asian Americans, are understudied. Distinct psychosocial support needs may exist across ethnocultural groups with Confucian-heritage values and norms. Cultural factors may shape how adults approach their oncologic care. This qualitative study represents the perspectives of 15 experienced health care professionals, about the supportive care needs of Chinese-, Korean-, and Vietnamese-heritage (CKV) adults with metastatic solid cancers. Reflexive thematic analysis was conducted with transcripts from three semistructured focus groups and five parallel-format individual interviews. Inductive coding and iterative theme development resulted in four themes describing the types of needs (basic, care-related, mental health, relational trust) that should be met for CKV patients with metastatic cancer, which may fall through the gaps when health care systems’ and patients’ differing cultural contexts collide. In conclusion, greater involvement of psychosocial care specialists with cultural expertise is essential to promote patients’ and families’ well-being, prevent care disparities, and to better support the health care team. Systemic changes that increase workforce diversity, reduce language and insurance barriers, and allow health care professionals to build relational trust with patients are needed to improve the quality of life of CKV patients with metastatic cancer. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 03 Oct 2024 00:00:00 GMT

A systematic review of the impact of cancer survivorship interventions with Asian American cancer survivors. As the number of Asian cancer survivors continues to increase, there is a growing need for interventions to address their physiological and psychosocial needs. The aim of our systematic review was to assess the types and the impact of psychosocial or behavioral interventions for cancer survivorship among Asian Americans and Asian immigrants globally. The review included 18 articles reporting data from eight interventions, of which five were randomized controlled trials and three were one-group design interventions. All interventions were conducted with Asian Americans and fell into three categories: (a) expressive writing interventions that facilitated individual cognitive and emotional processing, (b) educational and social support interventions, and (c) healthy lifestyle interventions. Expressive writing studies that involved writing tasks facilitating emotional and stress disclosure and cognitive reappraisal were most beneficial for Chinese American survivors, and both in-person and longer virtual educational and social support interventions yielded improvements for survivors. The healthy lifestyle intervention was more beneficial for the mental health than the physical health of survivors. The small number of interventions in the United States and the lack of interventions with Asian immigrants outside of the United States highlights the need for more survivorship interventions for Asian cancer survivors. Successful cultural adaptation of cancer survivorship interventions often required multiple studies and extensive time and resources. The early success of culturally adapted interventions shows the path forward in developing effective survivorship interventions for Asian Americans and for testing and disseminating interventions among various cancer types and Asian subgroups in future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 27 Apr 2023 00:00:00 GMT

Developing the meaning-centered program for Chinese Americans with advanced cancer: Applying cultural adaptation frameworks. Asian Americans have surpassed Hispanics as the fastest-growing racial/ethnic group in the United States and Chinese Americans are the largest Asian American subgroup. Cancer is the leading cause of death among Chinese Americans while heart disease remains the leading cause of death in the United States overall. Foreign-born immigrants are more likely to be diagnosed with advanced-stage cancers than their native-born counterparts. Patients with advanced cancer have specific psychosocial needs, such as end-of-life concerns and existential distress. Meaning-centered psychotherapy (MCP), which enhances a sense of meaning-in-life to increase quality of life, is among the most promising psychosocial treatments for advanced cancer patients, having demonstrated efficacy in several randomized controlled trials. Our preliminary qualitative work suggested a meaning-centered intervention was acceptable but required adaptation to ensure ecological validity among Chinese cancer patients. This article presents the cultural and linguistic adaptation of Meaning-Centered Program for Chinese Americans with advanced cancer (MCP-Ch), which was informed by the Ecological Validity Model and Psychotherapy Adaptation and Modification Framework for cultural adaptation of evidence-based interventions. Implementation considerations, which will be assessed in the next phase of the project, are also discussed. MCP-Ch is used as a case example to illustrate how to adapt culturally syntonic and sustainable evidence-based psychosocial interventions for racial/ethnic minority cancer populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
View Thu, 03 Oct 2024 00:00:00 GMT