CULTURAL IMPACT ON ADAPTATION BETWEEN CHINESE AND WHITE BREAST CANCER SURVIVORS

文化对中国人和白人乳腺癌幸存者之间适应的影响

• 批准号: 7642928
• 负责人: Judy Huei-yu Wang
• 金额: $ 21.2万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7642928
• 关键词: Acculturation; Address; Affect; Aftercare; Age; Aging; Area; Asians; Belief; California; Cancer Center; Cancer Survivor; Cancer Survivorship; Caring; Chinese American; Chinese People; Chronic Disease; Clinical; Cognitive; Communities; Community Health; Continuance of life; Data; Development; Diagnosis; Diagnostic Neoplasm Staging; Diet; Disease; Distress; Education; Emotional; Equilibrium; Face; Family; Feeling; Focus Groups; Health behavior; Healthcare; Herb; Immigrant; Incidence; Individual; Institute of Medicine (U.S.); Intervention; Intervention Studies; Interview; Knowledge; Laboratories; Language; Lead; Life; Malignant Neoplasms; Mediating; Methods; Minority; Modeling; Motivation; National Cancer Institute; Natural Remedy; Not Hispanic or Latino; Outcome; Participant; Patients; Perception; Persons; Phase; Philosophy; Pilot Projects; Play; Population; Population Growth; Process; Published Comment; Quality of life; Questionnaires; Race; Recommendation; Recording of previous events; Recruitment Activity; Research; Research Design; Role; Self Care; Social Network; Social support; Societies; Staging; Stress; Stress and Coping; Structure; Surveys; Survivors; Telephone Interviews; Testing; Woman; base; body-mind; cancer diagnosis; cancer health disparity; coping; cultural values; design; effective intervention; experience; high risk; improved; lymph nodes; malignant breast neoplasm; neoplasm registry; population based; preference; public health relevance; social; survivorship

DESCRIPTION (provided by applicant): There are an estimated 2.2 million breast cancer survivors alive today in the US including a significant number of Asian survivors. Breast cancer is the most common cancer in Chinese women, the largest Asian population, of which 70% are immigrants. Chinese women's breast cancer incidence rates have been steadily increasing and will considerably increase in the coming decades as this population rapidly grows and ages. Many Chinese with a cancer diagnosis are stigmatized and face cultural and language barriers to adjust their problems of distress and this may lead to their low quality of life. Research suggests that Chinese breast cancer survivors have poorer adaptation and much smaller social networks to seek for supports than White breast cancer survivors. However, we know little about this population and we even know less about Chinese survivors' quality of life and how cultural factors affect their survivorship. To fill this gap in knowledge, the aims of this study are to use the Transactional Model of Stress and Coping to 1) understand the impact of culture on self- appraisal of stress, use of coping strategies, and adaptation to daily life among Chinese and White breast cancer survivors and 2) examine whether interventions for Chinese need to be culturally tailored. To achieve these aims, we have assembled an experienced interdisciplinary, multi-cultural, and bilingual investigative team to conduct a mixed, two-phased research design. In the first phase, we will conduct 2 focus groups among Chinese and 2 among Whites (each with 8 women) to gain an in-depth understanding of survivorship experience, needs, preferences for intervention approaches and whether model constructs are differently defined in each cultural group. In addition, we will individually interview 10 Chinese women to include those who are stigmatized and unwilling to discuss their survivorship issues in person. We will use the qualitative data to refine our survey instruments. The refined surveys will be finalized through Chinese community health advisors' comments and cognitive lab testing. In the second phase, we will conduct structured telephone interviews with 100 Chinese and 100 White breast cancer survivors who are 1-3 post treatments to examine cultural differences in stress appraisal, coping, and adaptation between the two racial groups. In each phase, we will examine whether a culturally tailored intervention is needed to promote Chinese cancer survivorship. We will recruit participants from the Greater Bay Area Cancer Registry, operated by the Northern California Cancer Center. Based on the population-based survey data, this study will advance our conceptual and methodological knowledge about the role of culture in breast cancer survivorship. This study addresses the top priority of the NCI and the Institute of Medicine for improving survivorship care in minority populations. Interventions based on the study results will have the potential to optimize healthy life of Chinese breast cancer survivors and promote overall cancer survivorship in this large growing population. PUBLIC HEALTH RELEVANCE: The proposed pilot study examine the role of culture in an individual's perception of stress, use of coping strategies, and adaptation to daily life among Chinese breast cancer survivors in comparison with White breast cancer survivors. Chinese and White women who were diagnosed with early-stage breast cancer will be invited from a population-based cancer registry in Northern California to participate in our qualitative and quantitative assessment. The results of this study will contribute to our understanding of cultural impact in cancer survivorship and inform the development of effective interventions to promote Chinese survivors' quality of life.

描述(申请人提供)：美国目前估计有220万乳腺癌幸存者，其中包括相当数量的亚洲幸存者。乳腺癌是中国女性最常见的癌症，中国是亚洲人口最多的国家，其中70%是移民。中国女性乳腺癌发病率一直在稳步上升，并将在未来几十年内随着人口的快速增长和老龄化而大幅增加。许多被诊断为癌症的中国人被污名化，面临着文化和语言障碍，以适应他们的痛苦问题，这可能导致他们的生活质量低下。研究表明，与白人乳腺癌幸存者相比，中国乳腺癌幸存者的适应能力更差，寻求支持的社交网络也要小得多。然而，我们对这一群体知之甚少，对中国幸存者的生活质量和文化因素如何影响他们的生存更是知之甚少。为了填补这一知识空白，本研究的目的是使用压力和应对的交易模型来1)了解文化对中国人和白人乳腺癌幸存者的压力自我评估、应对策略的使用和日常生活适应的影响，以及2)检验针对中国人的干预措施是否需要根据文化定制。为了实现这些目标，我们组建了一支经验丰富的跨学科、跨文化和双语的调查团队，进行混合的、分两个阶段的研究设计。在第一阶段，我们将在中国人和白人中分别进行两个焦点小组(每组8名女性)，以深入了解生存经验、需求、干预方法的偏好以及每个文化群体是否有不同的模式构建。此外，我们将单独采访10名中国女性，包括那些被羞辱并不愿亲自讨论她们的生存问题的女性。我们将使用定性数据来改进我们的调查工具。精细化的调查将通过中国社区健康顾问的评论和认知实验室测试来完成。在第二阶段，我们将对100名中国人和100名白人乳腺癌幸存者进行结构化的电话采访，他们是治疗后的1-3人，以考察两个种族群体在压力评估、应对和适应方面的文化差异。在每个阶段，我们将研究是否需要文化定制的干预措施来提高中国癌症的存活率。我们将从北加州癌症中心运营的大湾区癌症登记中心招募参与者。基于基于人群的调查数据，这项研究将促进我们对文化在乳腺癌生存中的作用的概念和方法的认识。这项研究阐述了NCI和医学研究所在改善少数民族人口生存护理方面的首要任务。基于研究结果的干预措施将有可能优化中国乳腺癌幸存者的健康生活，并在这个庞大的不断增长的人口中提高总体癌症存活率。公共卫生相关性：这项拟议的初步研究考察了文化在中国乳腺癌幸存者和白人乳腺癌幸存者个人的压力感知、应对策略的使用和日常生活适应方面的作用。被诊断为早期乳腺癌的中国女性和白人女性将从北加州基于人群的癌症登记中被邀请参加我们的定性和定量评估。这项研究的结果将有助于我们理解文化对癌症生存的影响，并为开发有效的干预措施来提高中国幸存者的生活质量提供参考。