Writing to Heal: A Culturally Based Brief Expressive Writing Intervention for Chinese Immigrant Breast Cancer Survivors

项目摘要/摘要 中国移民乳腺癌幸存者无法获得有文化能力的精神卫生保健 他们未得到满足的心理需求是中国移民经历的健康差距的特征 乳腺癌幸存者。乳腺癌是中国人发病率最高的癌症。 人群和中国移民乳腺癌幸存者的生活质量低于他们的非 西班牙裔白人。然而，其中缺乏改善生活质量的干预措施。 移民人口。表现性写作干预使用写作提示，通过促进 情感和认知过程。以西方和东方的理论和初步研究为指导 这项研究在中国移民中展示了表达写作的好处，并建议测试他们的健康状况 在中国移民乳腺癌幸存者中进行创新和简短的书面干预的效果 采用随机对照试验和混合方法设计。中国移民乳腺癌幸存者 (n=240)将被随机分配到控制条件以撰写关于中性主题的文章，或者被随机分配到两个中的一个 干预条件、自我调节和自我修养，都是为了促进适应性认知 过程，但在如何实现这一目标方面有所不同。自律干预结合了传统的 西方表现主义写作范式，修身干预融入亚洲文化 价值观。所有这三个条件的参与者将被要求在每周三个30分钟的时间内用中文写作 会话。主要结果将是生活质量，次要结果将是感知到的压力，压力 生物标记物和癌症相关疾病的医疗预约。自我报告的健康结果(QOL 和感觉到的压力)将在基线和6个月和12个月的随访中进行评估。应激生物标志物 (唾液皮质醇和α-淀粉酶)将在基线和6周的随访中进行评估，并 在为期6周的随访中，还将自我报告压力。12个月随访前的医疗预约 将自行记录，并通过医疗记录进行核实。我们假设这两种干预条件将 提高生活质量，减少癌症相关疾病的压力和就诊时间，以及 使压力生物标志物正常化。很少有研究在有色人种社区中测试循证程序， 更少的人测试了基于文化的干预措施，这些干预措施采纳了 服务不足的社区。我们期望拟议的研究在理论、实践和方法的指导下 并为服务不足的人群量身定做，将激励研究的新方向，以解决这些问题 健康差距研究的科学性和实用性需求。

Project Summary/Abstract The unavailability of culturally competent mental health care for Chinese immigrant breast cancer survivors and their unmet psychological needs characterize the health disparity experienced by Chinese immigrant breast cancer survivors. Breast cancer is the cancer with the highest incidence rate among the Chinese population and Chinese immigrant breast cancer survivors have lower quality of life compared to their non- Hispanic white counterpart. However, interventions to improve quality of life are lacking among this immigrant population. Expressive writing intervention uses writing prompts to promote health by facilitating emotional and cognitive processes. Guided by Western and Eastern theories and preliminary studies showing the benefits of expressive writing among Chinese immigrants, this study proposes to test the health effects of an innovative and brief writing intervention among Chinese immigrant breast cancer survivors using a randomized controlled trial and mixed methods design. Chinese immigrant breast cancer survivors (N=240) will be randomly assigned either to a control condition to write about neutral topics or to one of two intervention conditions, self-regulation and self-cultivation, which both aim to promote adaptive cognitive processes but differ in how they achieve this goal. The self-regulation intervention incorporates a traditional Western expressive writing paradigm, whereas the self-cultivation intervention incorporates Asian cultural values. Participants in all three conditions will be asked to write in Chinese during three weekly 30-minute sessions. The primary outcome will be QOL, and the secondary outcomes will be perceived stress, stress biomarkers, and medical appointments for cancer-related morbidities. Self-reported health outcomes (QOL and perceived stress) will be assessed at baseline and 6- and 12-month follow-ups. Stress biomarkers (salivary cortisol and alpha-amylase) will be assessed at baseline and 6-week follow-up, and perceived stress will also be self-reported at the 6-week follow-up. Medical appointments up to the 12-month follow-up will be self-recorded and verified by medical record. We hypothesize that the two intervention conditions will improve quality of life, reduce perceived stress and medical appointments for cancer-related morbidities, and normalize stress biomarkers. Few studies have tested evidence-based programs in communities of color, and even fewer have tested culturally based interventions that adopted the cultural values of the underserved communities. We expect that the proposed study, guided by theory, practices, and methods and tailored for an underserved population, will inspire new directions in research to address these scientific and practical needs in health disparities research.