Article

Evaluating a Culturally Tailored Peer-Mentoring and Education Pilot Intervention Among Chinese Breast Cancer Survivors Using a Mixed-Methods Approach

Qian Lu

Jin You

Jenny Man

Alice Loh

Lucy Young

psychosocial intervention, social support, peer mentorship, culturally tailored, Chinese American, breast cancer survivors
ONF 2014, 41(6), 629-637. DOI: 10.1188/14.ONF.629-637

Purpose/Objectives: To evaluate a social support intervention that was culturally tailored for Chinese Americans who face many challenges because of cultural and linguistic barriers.

Design: Intervention with a one-group pre- or post-test design, mixed methods, and a community-based participatory research (CBPR) approach.

Setting: Southern California.

Sample: 14 Chinese American breast cancer survivors post-treatment and eight breast cancer peer mentors.

Methods: The intervention was a 10-week program to provide emotional and informational support through peer mentoring and education. Health outcomes were assessed before and after the intervention. Eight weekly process evaluations and two focus group interviews also were conducted.

Main Research Variables: Depressive and anxiety symptoms.

Findings: The program was associated with a decrease in depressive symptoms. Participants valued the program highly. Inductive analysis suggested possible mechanisms for effectiveness, such as reducing stigma, empowerment, and increased sense of belonging.

Conclusions: The peer-mentoring and education program has the potential to serve as a model intervention for ethnic minorities. Mixed methods and CBPR are valuable in evaluating pilot interventions with minorities. Focusing on relationships may be fruitful for designing novel interventions for cancer survivors from collectivistic cultures.

Implications for Nursing: Peer-mentoring and education programs can be integrated into communities and clinics to improve care for underserved minority cancer survivors and to reduce health disparities.

Jump to a section

    References

    Allen, J. D., Savadatti, S., & Levy, A. G. (2009). The transition from breast cancer ‘patient’ to ‘survivor’. Psycho-Oncology, 18, 71-78. doi:10.1002/pon.1380
    Andersen, B. L., Yang, H. C., Farrar, W. B., Golden-Kreutz, D. M., Emery, C. F., Thornton, L. M., … Carson, W. E. (2008). Psychologic intervention improves survival for breast cancer patients. Cancer, 113, 3450-3458. doi:10.1002/cncr.23969
    Ashing-Giwa, K., Padilla, G., Tejero, J., & Kagawa-Singer, M. (2003). Understanding the breast cancer experience of Asian American women. Psycho-Oncology, 12, 38-58. doi:10.1002/pon.632
    Burgess, C., Cornelius, V., Sharon, L., Graham, J., Richards, M., & Ramirez, A. (2005). Depression and anxiety In women with early breast cancer: Five-year observational cohort study. BMJ, 330, 702-705. doi:10.2307/25459257
    Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum.
    Derogatis, L. R., & Spencer, M. S. (1982). The Brief Symptom Inventory (BSI): Administration, scoring, and procedures manual-1. Baltimore, MD: Johns Hopkins University School of Medicine, Clinical Psychometrics Research Unit.
    Fielding, R., & Hung, J. (1996). Preferences for information and involvement in decisions during cancer care among a Hong Kong Chinese population. Psycho-Oncology, 5, 321-329. doi:10.1002/(SICI)1099-1611(199612)5:4<321::AID-PON226>3.0.CO;2-K
    Gomez, S. C., Quach, T., Horn-Ross, P. L., Pham, J. T., Cockburn, M., Change, E. T., … Clarke, C. A. (2010). Hidden breast cancer disparities in Asian women: Disaggregating incidence rates by ethnicity and migrant status. American Journal of Public Health, 100, 125-131.
    Helgeson, V. S., Cohen, S., Schulz, R., & Yasko, J. (1999). Education and peer discussion group interventions and adjustment to breast cancer. Archives General Psychiatry, 56, 340-347. doi:10.1001/archpsyc.56.4.340
    Helgeson, V. S., Cohen, S., Schulz, R., & Yasko, J. (2001). Long-term effects of educational and peer discussion group interventions on adjustment to breast cancer. Health Psychology, 20, 387-392. doi:10.1037/0278-6133.20.5.387
    Hodgkinson, K., Butow, P., Hunt, G., Pendlebury, S., Hobbs, K., & Wain, G. (2007). Breast cancer survivors' supportive care needs 2-10 years after diagnosis. Supportive Care in Cancer, 15, 515-523. doi:10.1007/s00520-006-0170-2
    Israel, B. A., Schulz, A. J., Parker, E. A., & Becker, A. B. (1998). Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health, 19, 173-202. doi:10.1146/annurev.publhealth.19.1.173
    Kagawa-Singer, M. (2000). Improving the validity and generalizability of studies with underserved U. S. populations: Expanding the research paradigm. Annals of Epidemiology, 10, S92-S103. doi:10.1016/S1047-2797(00)00192-7
    Kim, H. S., Sherman, D. K., & Taylor, S. E. (2008). Culture and social support. American Psychologist, 63, 518-526. doi:10.1037/0003-066X
    Lee, S., Chen, L., Ma, G. X., & Fang, C. Y. (2012). What is lacking in patient-physician communication: Perspectives from Asian American breast cancer patients and oncologists. Journal of Behavioral Health, 1, 102-109.
    Lee, S., Chen, L., Ma, G. X., Fang, C. Y., Oh, Y., & Scully, L. (2013). Challenges and needs of Chinese and Korean American breast cancer survivors: In-depth interviews. North American Journal of Medicine and Science, 6, 1-8. doi:10.7156/najms.2013.0601001
    Lu, Q., Zheng, D., Young, L., Kagawa-Singer, M., & Loh, A. (2012). A pilot study of expressive writing intervention among Chinese-speaking breast cancer survivors. Health Psychology, 31, 548-551.
    Nilchaikovit, T. (1991). An Asian view of how illness is lived. International Psychological Oncology Society Newsletter, 1, 6-14.
    Pasick, R. J., D'Onofrio, C. N., & Otero-Sabogal, R. (1996). Similarities and differences across cultures: Questions to inform a third generation for health promotion research. Health Education Quarterly, 23(Suppl.), S142-S161. doi:10.1177/019584029602300610
    Rini, C., Lawsin, C., Austin, J., DuHamel, K., Markarian, Y., Burkhalter, J., … Redd, W. H. (2006). Peer mentoring and survivors' stories for cancer patients: Positive effects and some cautionary notes. Journal of Clinical Oncology, 25, 163-166. doi:10.1200/JCO.2006.08.8567
    Scheier, M. F., Helgeson, V. S., Schulz, R., Colvin, S., Berga, S., Bridges, M. W., & Knapp, J. (2005). Interventions to enhance physical and psychological functioning among younger women who are ending nonhormonal adjuvant treatment for early-stage breast cancer. Journal of Clinical Oncology, 23, 4298-4311.
    Schmidt, F. (1996). Statistical significance testing and cumulative knowledge in psychology: Implications for the training of researchers. Psychological Methods, 1, 115-129. doi:10.1037/1082-989x.1.2.115
    Spiegel, D., Kraemer, H. C., Bloom, J., & Gottheil, E. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 334, 888-891. doi:10.1016/S0140-6736(89)91551-1
    Stanton, A. L. (2006). Psychosocial concerns and interventions for cancer survivors. Journal of Clinical Oncology, 24, 5132-5137.
    Stanton, A. L., Ganz, P. A., Kwan, L., Meyerowitz, B. E., Bower, J. E., Krupnick, J. L., … Belin, T. R. (2005). Outcomes from the moving beyond cancer psychoeducational, randomized, controlled trial with breast cancer patients. Journal of Clinical Oncology, 23, 6009-6018.
    Tanjasiri, S. P., Kagawa-Singer, M., Nguyen, T., & Foo, M. A. (2002). Collaborative research as an essential component for addressing cancer disparities among Southeast Asian and Pacific Islander women. Health Promotion in Practice, 3, 144-154. doi:10.1177/152483990200300210
    U. S. Census Bureau. (2010). 2010 Census briefs: The Asian population: 2010. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf
    Wong-Kim, E., Sun, A., Merighi, J. R., & Chow, E. A. (2005). Understanding quality-of-life issues in Chinese women with breast cancer: A qualitative investigation. Cancer Control, 12(Suppl.), S6-S12.