CNP: Health Benefits of Expressive Writing among Chinese Breast Cancer Survivors

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DESCRIPTION (provided by applicant): Despite the significantly increasing size of Asian American population (> 13 million) and the fact that they are only ethnic group with a significantly increasing rate of breast cancer in this population, little attention is focused on Asian American breast cancer survivor's psychological needs. Due to social, cultural, and linguistic factors, culturally competent mental health care is largely unavailable for these women, and only eight studies have been published that document the unmet psychological needs of Asian American breast cancer survivors: clearly an understudied and underserved population. With hundreds of diverse subgroups and different languages in the Asian American population, the need is critical to develop and validate culturally appropriate and acceptable intervention efforts for these women. Expressive writing interventions are modalities validated in Caucasian Americans that allow women to express themselves privately, and have the potential to be easily adapted and targeted for a particular ethnic group in their primary language. Experimental written emotional disclosure has been reported to confer physical and psychological benefits "or a variety of populations, including Caucasian breast cancer survivors. As a first step of this line of research, the proposed study aims to test the cultural sensitivity and efficacy of an intervention of expressive writing among Chinese-speaking breast cancer survivors in southern California using a community-based participatory research approach. Over 400,000 Chinese Americans live in Los Angeles, CA. Asian American women are the only group with a statistically significant increase in incidence for the State, and breast cancer rates have risen steadily over the last 30 years. By evaluating the cultural fit of the intervention to promote the overall well-being of survivors, the study may directly benefit Chinese American breast cancer survivors, and if the intervention proves to be effective, this technique could inform the development of a culturally appropriate support strategy for other Asian Americans. The pilot study will generate preliminary data for a R01 application to evaluate the effects of a randomized controlled trial of expressive writing to improve physical and psychological health among Chinese American breast cancer survivors, a group burdened by unnecessary and avoidable cancer health disparities. The design and methods of this study embody the missions and goals of AANCART and CNP to reduce these cancer health disparities through the community-based participatory model.