Behavioral Intervention to Reduce Breast Cancer Disparity in Underserved Koreans

描述（由申请人提供）：尽管美国在癌症控制方面取得了相当大的进展，但一些少数群体并没有公平地从这些努力中受益。虽然韩裔美国人（KA）人口迅速增加，并且在所有美国出生和外国出生的亚洲亚群中，KA妇女的乳腺癌发病率增幅最大，但令人惊讶的是，很少有实证研究开展以提高KA妇女乳腺癌的生存率。先前对亚裔美国人乳腺癌幸存者的研究表明，ka的生活质量（QOL）评分明显低于其他亚裔族群。此外，我们的初步研究结果还表明，由于语言和文化障碍影响了他们应对癌症和相关问题的能力，KA乳腺癌幸存者可能有高压力和低生活质量。为了解决这一关键差距并提高癌症存活率，我们将使用一项小规模随机试验设计来测试语言适当和文化敏感的六期干预计划的有效性，该计划旨在减少KA乳腺癌幸存者的感知压力，增强应对能力并改善生活质量。基于我们初步研究结果的经验证据，我们改编了Antoni的认知行为压力管理程序，并辅以与该人群相关的其他主题，以使程序更具文化敏感性。压力与应对理论指导干预措施的制定和评价措施的选择。所有的干预课程和材料将由有执照的双语临床心理学家用韩语提供。我们假设，与对照组接受四小时教育研讨会的女性相比，参加六次课程的女性在干预后会表现出压力减轻，应对能力增强，生活质量提高。此外，我们将在3个月的随访中检查这些效果是否持续。具体而言，我们将解决两个目标：(1)实施和评估语言适当和文化敏感的干预措施对KA乳腺癌幸存者的压力，应对和生活质量的影响；(2)进行过程评估，以评估干预措施的可行性和保真度，这将提供可用于改进未来干预措施的数据。拟议中的项目将是首批项目之一

DESCRIPTION (provided by applicant): Despite considerable progress made towards cancer control in the United States (U.S.), some minority groups have not equitably benefited from such efforts. While the Korean American (KA) population has increased rapidly, and KA women have experienced the largest increase in breast cancer incidence among all U.S.-born and foreign-born Asian subgroups, there has been surprisingly little empirical research conducted to improve survivorship in KA women with breast cancer. Previous research among Asian American breast cancer survivors indicated that the quality of life (QOL) scores for KAs have been reported to be significantly lower than for other Asian ethnic groups. Moreover, findings from our preliminary study also suggest that KA breast cancer survivors may have high stress and low QOL due to linguistic and cultural barriers that influence their ability to cope with the cancer and related problems. To address this critical gap and enhance cancer survivorship, we will test the effectiveness of a linguistically appropriate and culturally sensitive six-session intervention program that was developed to reduce perceived stress, enhance coping, and improve QOL in KA breast cancer survivors using a small-scale randomized trial design. Based on empirical evidence from our preliminary study results, we adapted Antoni's Cognitive-Behavioral Stress Management program, supplemented by additional topics of relevance to this population to make a more culturally sensitive program. The Stress and Coping Theory guided the intervention development and selection of evaluation measures. All intervention sessions and materials will be delivered in Korean by a licensed bilingual clinical psychologist. We hypothesize that, compared to women in the control group who receive a four-hour education seminar, women who attend the six-session program will demonstrate reduced stress, enhanced coping, and improved QOL after the intervention. In addition, we will examine whether these effects are sustained at 3-month follow-up. Specifically, we will address two aims: (1) Implement and evaluate the effects of a linguistically appropriate and culturally sensitive intervention on stress, coping and QOL among KA breast cancer survivors; and (2) Conduct a process evaluation to assess the feasibility and fidelity of the intervention, which will provide data that can be used to refine future interventions. The proposed project will be one of the first to examine the effects of a multifaceted and innovative intervention designed to enhance cancer survivorship in KA women with breast cancer. Study findings will yield new data on potential intervention effects. If proven effective, the intervention will be implemented in a larger-scale trial and used as a model program to meet the needs of underserved and understudied Korean American cancer survivors nationally as well as other socially or linguistically isolated Asian American minority groups. Therefore, the proposed study has the potential to make a significant contribution toward reducing disparities in cancer survivorship.