Behavioral Intervention to Reduce Breast Cancer Disparity in Underserved Koreans

描述（由申请人提供）：尽管美国（U.S.）在癌症控制方面取得了相当大的进展，一些少数群体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，但KA妇女的乳腺癌发病率在所有美国人中增幅最大。出生和外国出生的亚洲亚组，令人惊讶的是，很少有实证研究进行，以提高KA妇女乳腺癌的生存率。以前在亚裔美国人乳腺癌幸存者中的研究表明，据报道，KA的生活质量（QOL）评分显着低于其他亚裔群体。此外，我们的初步研究结果还表明，KA乳腺癌幸存者可能有高压力和低生活质量，由于语言和文化障碍，影响他们的能力，以科普癌症和相关问题。为了解决这一关键差距，提高癌症生存率，我们将测试语言适当和文化敏感的六次干预计划的有效性，该计划旨在减少感知压力，增强应对能力，并使用小规模随机试验设计改善KA乳腺癌幸存者的生活质量。根据我们初步研究结果的经验证据，我们调整了安东尼的认知行为压力管理计划，并补充了与这一人群相关的其他主题，以制定一个更具文化敏感性的计划。压力与应对理论指导了干预措施的制定和评估措施的选择。所有的干预课程和材料将由持牌双语临床心理学家以韩语提供。我们假设，与对照组中接受四小时教育研讨会的女性相比，参加六次会议计划的女性将在干预后表现出压力减轻，应对能力增强和生活质量改善。此外，我们将在3个月随访时检查这些影响是否持续。具体来说，我们将解决两个目标：（1）实施和评估的压力，应对和生活质量KA乳腺癌幸存者的语言适当和文化敏感的干预措施的影响;（2）进行过程评估，以评估干预的可行性和保真度，这将提供数据，可用于完善未来的干预措施。拟议的项目将是第一个 审查 一项旨在提高KA乳腺癌妇女癌症生存率的多方面创新干预措施的效果。研究结果将产生关于潜在干预效果的新数据。如果证明有效，干预措施将在更大规模的试验中实施并使用 作为一个模式计划，以满足全国服务不足和研究不足的韩裔美国人癌症幸存者以及其他社会或语言孤立的亚裔美国人少数群体的需求。因此，这项研究有可能为减少癌症生存率的差异做出重大贡献。

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.