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

点击翻译按钮获取中文摘要

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.