Joy Luck Academy: A Culturally Sensitive Social Support Intervention

喜福学院：文化敏感的社会支持干预

• 批准号: 8919304
• 负责人: Qian Lu
• 金额: $ 29.57万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8919304
• 关键词: Academy; Address; Affect; Asian Americans; Asians; Attention; Breast Cancer survivor; Cancer Survivor; Chinese American; Color; Communities; Control Groups; Country; Data; Data Analyses; Education; Emotional; Ethnic group; Evidence based program; Fatigue; Health; Health Benefit; Healthcare; Hydrocortisone; Incidence; Individual Differences; Intervention; Linguistics; Mainstreaming; Malignant Neoplasms; Mediator of activation protein; Mental Health; Mentors; Methods; Outcome; Participant; Pathway interactions; Personal Satisfaction; Pilot Projects; Population; Qualitative Methods; Quality of life; Randomized; Randomized Controlled Trials; Research; Resources; Self Efficacy; Social Interaction; Social support; Stress; Subgroup; Testing; Underserved Population; Woman; Work; arm; base; cancer care; community based participatory research; coping; cost; depressive symptoms; design; health disparity; improved; innovation; malignant breast neoplasm; optimism; peer; physical conditioning; post intervention; primary outcome; programs; psychologic; psychosocial; response; satisfaction; secondary outcome; social; social stigma; theories; treatment as usual

DESCRIPTION (provided by applicant): Despite the increasing size of the Asian American population (17.3 million) and their growing rate of breast cancer, little attention is focused on Asian American (AA) breast cancer survivors' informational and psychological needs. More notably, we have located no randomized controlled trial conducted in this population to address the unmet needs of this understudied and underserved population. Due to their social, cultural, and linguistic barriers, culturally competent mental health care is largely unavailable. The lack o both the availability of culturally competent mental health care and studies to identify and address the physical, emotional, and social needs of Asian American cancer survivors' constitute unnecessary and avoidable disparities in cancer care. Chinese Americans comprise the largest subgroup (24 percent) among the estimated 17.3 million Asian Americans in the U.S. Our research and community partner team have designed a culturally sensitive social support intervention called the "Joy Luck Academy (JLA)" that provide education and peer mentor support for Chinese American breast cancer survivors (BCS). A single-arm pilot study recently completed by our team has shown that the JLA is highly valued by participants and is associated with better quality of life among Chinese American BCS. This study proposes a randomized controlled trial (RCT) to test the health benefits of the JLA program and to identify for whom and why the JLA works using a community based participatory research (CBPR) approach, and mixed deductive and inductive methods. Chinese American breast cancer survivors who have completed primary treatment (N=210) will be randomly assigned to either the JLA group or a control group to receive enhanced usual care while waiting for the JLA. Health outcomes are assessed at baseline, immediately post intervention, and 1 and 4 months follow-ups. We will use deductive quantitative methods to test health outcomes, theorized mediators, and baseline individual differences. We use inductive and deductive qualitative methods to explore and understand mechanisms explaining the benefits of the intervention and to enhance the interpretation of the quantitative data. Few tested psychosocial interventions exist for diverse ethnic groups. One of the major hypothesized barriers is the lack of understanding of unique cultural differences in the meaning of and appropriate emotional and social responses to breast cancer. Even fewer studies have tested evidence-based programs for their feasibility, applicability, and sustainability in communities of color. Existing communit efforts are often the result of trial and error without theoretical guidance and lack of scientific rigor. This proposed study is the first RCT social support intervention among AA BCSs. The intervention is innovative as it is culturally relevant to an AA group, using a theoretically grounded and CBPR approach, and mixed methods design. We expect that the proposed research guided by both theory and methods with an underserved and understudied population will inspire new directions in future research to address these scientific and practical needs in health disparities research.

描述（由申请人提供）：尽管亚裔美国人人口规模不断增加（1730万），乳腺癌发病率不断上升，但很少有人关注亚裔美国人（AA）乳腺癌幸存者的信息和心理需求。更值得注意的是，我们尚未发现在该人群中进行的随机对照试验，以解决这一研究不足和服务不足的人群未满足的需求。由于他们的社会、文化和语言障碍，在文化上胜任的精神卫生保健在很大程度上是不可用的。缺乏文化上胜任的精神卫生保健和研究来确定和解决亚裔美国人癌症幸存者的身体，情感和社会需求的可用性构成了癌症护理中不必要和可避免的差异。在美国约1730万亚裔美国人中，华裔美国人是最大的群体（24%）。我们的研究和社区合作伙伴团队设计了一个具有文化敏感性的社会支持干预措施，称为“喜福学院（JLA）”，为华裔美国人乳腺癌幸存者（BCS）提供教育和同伴导师支持。我们的团队最近完成的一项单臂试点研究表明，JLA受到参与者的高度重视，并与华裔美国BCS的生活质量有关。本研究提出了一项随机对照试验（RCT），以测试JLA计划的健康益处，并确定谁和为什么JLA工程使用基于社区的参与性研究（CBPR）的方法，混合演绎和归纳的方法。已完成初级治疗的华裔美国乳腺癌幸存者（N=210）将被随机分配到JLA组或对照组，在等待JLA期间接受增强的常规护理。在基线、干预后立即以及1个月和4个月随访时评估健康结果。我们将使用演绎定量方法来测试健康结果，理论化的介质和基线个体差异。我们使用归纳和演绎定性方法来探索和理解解释干预的益处的机制，并加强对定量数据的解释。针对不同族裔群体的经测试的心理社会干预措施很少。其中一个主要的假设障碍是缺乏对乳腺癌的意义和适当的情感和社会反应的独特文化差异的理解。更少的研究已经测试了基于证据的方案在有色人种社区的可行性，适用性和可持续性。现有的社区努力往往是在没有理论指导和缺乏科学依据的情况下试错的结果。 僵硬这项研究是第一个随机对照试验的社会支持干预AA BCS。干预是创新的，因为它是文化相关的AA组，使用理论接地和CBPR的方法，混合方法设计。我们希望，在理论和方法的指导下，对服务不足和研究不足的人群进行拟议的研究，将激发未来研究的新方向，以解决健康差异研究中的这些科学和实践需求。