Adaptation and Pilot Feasibility of a Psychotherapy Intervention for Latinos with Advanced Cancer

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PROJECT SUMMARY Latinos are at higher risk of poorer psychological and quality of life outcomes when compared to non-Hispanic white patients and other minority patients and commonly report using spiritual strategies to cope with cancer. Maintaining hope, spiritual well-being and finding meaning in the cancer experience is critical for the adjustment and well-being of advanced cancer patients. However, there are no targeted psychosocial or psychotherapeutic interventions available for Latinos diagnosed with advanced cancer. Meaning-Centered psychotherapy (MCP) is a novel psychotherapeutic intervention designed to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose as they approach the end-of-life. The objective of this study is to culturally adapt and pilot Meaning-Centered Psychotherapy with Spanish-speaking Latinos (MCP-L) diagnosed with advanced cancer. The first aim of this study is to translate and culturally adapt the Meaning Centered Psychotherapy intervention manual guided by the Ecological Validity Framework, based on our previous formative research and with information gathered by interviewing 15 key informants and a pre- pilot of key sections of MCP-L with 10 Spanish-speaking Latinos patients. The second aim is to determine its feasibility and acceptability, and to generate preliminary data on impact (improvement of spiritual well-being, quality of life and reduction of depression, anxiety, and hopelessness) of the culturally adapted version of MCP- L by conducting a randomized controlled pilot trial. My long-term goal is to become an independent clinical researcher and an expert in the cultural adaptation field of psychotherapeutic and psychosocial interventions with minority cancer patients. This application will allow me to acquire the training and mentored research experience and obtain additional training in: (1) Transcreation and cultural adaptation of interventions; (2) Psychotherapy theory research and process research, (3) Mixed methods approaches, (4) Design, implementation and evaluation of randomized controlled trials with Latino patients, and (5) Dissemination and implementation science. I am proposing a mix of guided mentoring, didactic training, coursework, webinars, seminars and tutorials, directed readings, conferences, and hands-on research activities that will facilitate the development of research skills and enable me to gain experience in these areas. This proposal is responsive to the priorities of the NCI Strategic Plan, to study and identify factors contributing to disparities, develop culturally appropriate approaches, and disseminate interventions to overcome health disparities across the cancer control continuum from disease prevention to end-of-life care. The research agenda will allow me to acquire the research skills to become a successful independent investigator in the important field of cultural adaptation of psychosocial interventions for ethnic minority cancer patients. The study findings will be used to submit a competitive NIH R01 application to conduct a large randomized controlled trial of Meaning Centered Psychotherapy with Spanish-speaking patients diagnosed with advanced cancer.