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Ng W, Baik SH, Razavi M, Clark K, Lee J, Loscalzo M, Folbrecht J. Differences of biopsychosocial distress and requests for psychological assistance between Asian American and non-Hispanic White oncology patients. Psychooncology 2023; 32:1660-1666. [PMID: 37700725 DOI: 10.1002/pon.6214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVE The purpose of this study was to compare Asian American (AA) to non-Hispanic White (NHW) cancer patients regarding biopsychosocial distress and requests for psychological assistance. METHODS This retrospective study included 5627 eligible patients, newly diagnosed with cancer, who completed the 30-item SupportScreen® survey of biopsychosocial distress. The top 10 sources of high distress were assessed. Distress domains (Emotional, Physical/Functional, and Practical) were examined by race/ethnicity. Requests for psychological assistance were also explored by ethnic groups. RESULTS Overall, the top 10 sources of high distress were similar between groups and approximately half consisted of concerns regarding physical symptoms. All patients preferred "talking" as their method of receiving assistance for these items. Ratings of emotional, practical, and physical/functional distress were similar between AA and NHW patients. However, AAs (vs. NHWs) requested more assistance regarding physical/functional and practical distress. No difference was observed between these two groups regarding requests for emotional support. CONCLUSIONS Overall, our study suggests that healthcare providers should be aware of the physical and practical needs of AA cancer patients and provide culturally sensitive care that addresses these needs.
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Affiliation(s)
- Winnie Ng
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sharon H Baik
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Karen Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Jonathan Lee
- Azusa Pacific University, Azusa, California, USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Jeanelle Folbrecht
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Lui F, Lewicka M, Bao GC, Moyer A, Boyce L, Leng J. A systematic review and meta-analysis of psychosocial interventions for immigrant and limited English proficient cancer patients. Psychooncology 2023; 32:516-557. [PMID: 36792931 PMCID: PMC10410571 DOI: 10.1002/pon.6110] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/02/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Immigrants, particularly those who are less acculturated and limited English proficient (LEP), often lack access to culturally and linguistically appropriate psychosocial care in cancer survivorship. We sought to determine what psychosocial interventions are available for immigrant and/or LEP cancer patients and to assess treatment and patient factors that may correlate with better psychosocial outcomes for this population. METHODS We conducted a systematic review and meta-analysis of studies published through August 2022 of interventions conducted with immigrant and/or LEP cancer patients aimed at improving psychosocial outcomes (i.e., quality of life, depression, cancer-related distress, and anxiety). Using Covidence, a software program for systematic review management, four independent raters screened 16,123 records with a systematic process for reconciling disagreement, yielding 48 articles (45 studies) for systematic review and 21 studies for meta-analysis. RESULTS Most studies were conducted with Spanish-speaking patients with breast cancer. Study participants (N = 5400) were primarily middle-aged (mean = 53 years old), female (90.0%), and Hispanic (67.0%). The weighted average effect size (g) across studies was 0.14 (95% CI 0.03-0.26) for quality of life (18 studies), 0.04 (95% CI -0.08 to 0.17) for depression (8 studies), 0.14 (95% CI -0.03 to 0.31) for cancer-related distress (6 studies), and 0.03 (95% CI -0.11 to 0.16) for anxiety (5 studies). CONCLUSION The interventions under review had small but beneficial effects on psychosocial outcomes for immigrant and LEP cancer patients. Notably, effect sizes were smaller than those found in previous meta-analyses of psychosocial interventions conducted in majority U.S.-born, non-Hispanic White, English-speaking cancer patient samples. More research is needed to identify key components and adaptations of interventions that benefit immigrant and LEP cancer patients to strengthen their effects for this growing yet underserved population.
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Affiliation(s)
- Florence Lui
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center; Department of Psychiatry, Weill Cornell Medical College
| | - Malwina Lewicka
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - George C. Bao
- Department of Medicine, Weill Cornell Medical College
| | - Anne Moyer
- Department of Psychology, Stony Brook University
| | - Lindsay Boyce
- Medical Library, Memorial Sloan Kettering Cancer Center
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center; Department of Healthcare Policy and Research, Weill Cornell Medical College
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Seven M, Marie Moraitis A. Community-based interventions designed to optimize health behaviors among cancer survivors: an integrative systematic review. Support Care Cancer 2022; 30:8405-8415. [PMID: 35524870 DOI: 10.1007/s00520-022-07097-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/27/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE The purpose of this review was to synthesize the evidence on community-based health behavior optimization interventions (physical activity, nutrition, weight management) with a focus on cancer survivors at risk for poor health outcomes. METHODS This integrative review followed the methods and protocol outlined by the Joanna Briggs Institute Methods Manual for systematic reviews and was reported using PRISMA-Scr. Four databases, namely, PubMed, CINAHL, Web of Science, SportDiscus, were searched in March 2021 to identify articles addressing health behaviors among cancer survivors. RESULTS The review included 43 articles describing unique interventions developed through community-based participatory research (CBPR). The majority of community-based interventions were designed to optimize exercise/physical activity (76.7%) exclusively or in combination with nutrition. Non-Hispanic White persons constituted most participants. Most interventions took place as a part of an established community program and recruited from existing community programs to evaluate intervention effects on specific health outcomes. Of the interventions, 88.3% improved at least one outcome measurement. CONCLUSION The current studies have built on the strengths and resources of the community using existing programs. There was a lack of diversity in socioeconomic status and racial/ethnic background among participants of most interventions and inputs from partners such as cancer survivors, community, and healthcare organizations. Multiple health behavior interventions with longitudinal studies are needed for racial/ethnic minoritized cancer survivors. Future research should focus on achieving mutual benefits through iterative processes to develop sustainable community/research partnerships, ensuring long-term commitment, and disseminating knowledge gained from CBPR to and by all involved partners to improve health behaviors.
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Affiliation(s)
- Memnun Seven
- University of Massachusetts Amherst, Elaine Marieb College of Nursing, Amherst, MA, USA.
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Bandera EV, Alfano CM, Qin B, Kang DW, Friel CP, Dieli-Conwright CM. Harnessing Nutrition and Physical Activity for Breast Cancer Prevention and Control to Reduce Racial/Ethnic Cancer Health Disparities. Am Soc Clin Oncol Educ Book 2021; 41:1-17. [PMID: 33989021 DOI: 10.1200/edbk_321315] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
There are well-known racial/ethnic disparities in the prevalence of obesity and physical inactivity, as well as breast cancer risk and survival. However, most of the current scientific evidence that serves as a foundation for nutrition and physical activity guidelines is based on studies conducted in predominantly non-Hispanic White populations. Similarly, exercise, diet, or lifestyle intervention trials for breast cancer prevention and survivorship are scarce in racial/ethnic minority populations. We review the current evidence for racial/ethnic disparities in obesity and breast cancer risk and survival (we are focusing on obesity, because this is considered an ASCO priority, and studies conducted in the United States), discuss the evolution of nutrition/physical activity guidelines for cancer prevention and control, and provide an overview of lifestyle interventions, including barriers and facilitators in implementation and dissemination science among minority populations underrepresented in research. There is a critical need to include racially/ethnically diverse populations in cancer prevention and control research or to specifically target minority populations in which disparities are known to exist to achieve much needed health equity.
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Affiliation(s)
- Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Catherine M Alfano
- Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, NY.,Northwell Health Cancer Institute, New York, NY.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY
| | - Bo Qin
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Dong-Woo Kang
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Ciarán P Friel
- Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, NY
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Wu TM, Liu JB, Liu Y, Shi Y, Li W, Wang GR, Ma YS, Fu D. Power and Promise of Next-Generation Sequencing in Liquid Biopsies and Cancer Control. Cancer Control 2021; 27:1073274820934805. [PMID: 32806937 PMCID: PMC7791471 DOI: 10.1177/1073274820934805] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Traditional methods of cancer treatment are usually based on the morphological
and histological diagnosis of tumors, and they are not optimized according to
the specific situation. Precision medicine adjusts the existing treatment
regimen based on the patient’s genomic information to make it most suitable for
patients. Detection of genetic mutations in tumors is the basis of precise
cancer medicine. Through the analysis of genetic mutations in patients with
cancer, we can tailor the treatment plan for each patient with cancer to
maximize the curative effect, minimize damage to healthy tissues, and optimize
resources. In recent years, next-generation sequencing technology has developed
rapidly and has become the core technology of precise targeted therapy and
immunotherapy for cancer. From early cancer screening to treatment guidance for
patients with advanced cancer, liquid biopsy is increasingly used in cancer
management. This is as a result of the development of better noninvasive,
repeatable, sensitive, and accurate tools used in early screening, diagnosis,
evaluation, and monitoring of patients. Cell-free DNA, which is a new
noninvasive molecular pathological detection method, often carries
tumor-specific gene changes. It plays an important role in optimizing treatment
and evaluating the efficacy of different treatment options in clinical trials,
and it has broad clinical applications.
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Affiliation(s)
- Ting-Miao Wu
- Department of Radiology, 12485The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ji-Bin Liu
- Cancer Institute, 377323Nantong Tumor Hospital, Nantong, China
| | - Yu Liu
- National Engineering Laboratory for Rice and By-product Deep Processing, College of Food Science and Engineering, 12571Central South University of Forestry and Technology, Chaha, China
| | - Yi Shi
- National Engineering Laboratory for Rice and By-product Deep Processing, College of Food Science and Engineering, 12571Central South University of Forestry and Technology, Chaha, China
| | - Wen Li
- National Engineering Laboratory for Rice and By-product Deep Processing, College of Food Science and Engineering, 12571Central South University of Forestry and Technology, Chaha, China
| | - Gao-Ren Wang
- Cancer Institute, 377323Nantong Tumor Hospital, Nantong, China
| | - Yu-Shui Ma
- Cancer Institute, 377323Nantong Tumor Hospital, Nantong, China.,Central Laboratory for Medical Research, Shanghai Tenth People's Hospital, 12476Tongji University School of Medicine, Shanghai, China
| | - Da Fu
- Department of Radiology, 12485The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China.,Central Laboratory for Medical Research, Shanghai Tenth People's Hospital, 12476Tongji University School of Medicine, Shanghai, China
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Cao W, Cho H. Culture in Cancer Survivorship Interventions for Asian Americans: A Systematic Review and Critical Analyses. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2021; 12:65-75. [PMID: 33959222 PMCID: PMC8095673 DOI: 10.1037/aap0000225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Frequently hard to reach and underserved, Asian Americans are the racial group whose chief cause of mortality is cancer. Efficacious survivorship care is important, but little is known about extant intervention efforts for this community and how culture has been integrated into these efforts. This study examined cancer survivorship interventions for Asian Americans and how culture has been addressed, using an integrated framework consisting of goals, theory, methods, and cultural concordance in the persons of the interventions. Mixed methods comprising a systematic review and critical analyses were employed. Results indicate that only 13 interventions have been delivered to this community, with six of them pilot studies, and that they used a narrow range of focus on cancer type, with all interventions focusing on breast cancer survivorship. Applications of theory and methods were incongruent with cultural valuation of emotion expression and help seeking behavior. Cultural concordance was operationalized mostly as the racial ethnic match between interventionists and survivors. Deep culture factors including cultural beliefs and values were rarely specified. Theory and research should move beyond the currently prevalent definition of culture as race, ethnicity, or language, and interventions should consider the role of culture in their goals, theory, methods, and persons. Advances in theory and research are needed, as neither reliance on the Western paradigm nor assumptions about Asian Americans can be appropriate for achieving cultural validity. Future conceptualization and operationalization should consider culture more than race, ethnicity, or language.
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Affiliation(s)
- Weidan Cao
- Department of Biomedical informatics, The Ohio State University, Columbus, OH
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Beasley JM, Wagnild JM, Pollard TM, Roberts TR, Ahkter N. Effectiveness of diet and physical activity interventions among Chinese-origin populations living in high income countries: a systematic review. BMC Public Health 2020; 20:1019. [PMID: 32600296 PMCID: PMC7322842 DOI: 10.1186/s12889-020-08805-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/29/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This review examines the effectiveness of diet and physical activity interventions to reduce cardiometabolic risk among Chinese immigrants and their descendants living in high income countries. The objective of this review is to provide information to help build future interventions aimed at improving diet and increasing physical activity levels among Chinese immigrants. METHODS Outcomes included BMI, weight, waist circumference (WC), waist-hip ratio (WHR), cholesterol (LDL, HDL), systolic and diastolic blood pressure (SBP, DBP), hemoglobin A1c (HgbA1c), fasting blood glucose (FBG), and HOMA-IR. Six databases were systematically searched from database inception to date of search (February 2020). Meta-analyses used random effect models to estimate pooled effects of outcomes with 95% confidence intervals. The outcomes assessed were changes in mean outcomes (post-intervention versus baseline) among the intervention group versus control groups. RESULTS Twenty-one articles were included for synthesis, and eight of these were included in the meta-analysis. Among children/adolescents, there were no significant effects of intervention for any of the outcomes having sufficient data for meta-analysis (BMI, WHR, SBP, and DBP). Among adults, the pooled effect including three studies showed significant changes in BMI (effect size = - 1.14 kg/m2; (95% CI: - 2.06, - 0.21), I2 = 31%). There were also significant effects of intervention among adults in terms of changes in SBP and DBP, as the pooled effect across three studies was - 6.08 mmHg (95% CI - 9.42, - 2.73), I2 = 0% and - 3.81 mmHg (95% CI: - 6.34, - 1.28), I2 = 0%, respectively. Among adults there were no other significant effects among the meta-analyses conducted (weight, WC, LDL, HgbA1c, and FBG). CONCLUSIONS This review is the first to summarize the effectiveness of diet and physical activity interventions specifically designed for Chinese immigrants living in high income countries. There were clinically meaningful changes in BMI and blood pressure among adults, but evidence was weak for other cardiometabolic outcomes (weight, WC, LDL, HgbA1c, and FBG), and among children, there was no evidence of effect for any cardiometabolic outcomes. Given our mixed findings, more work is needed to support the design of successful interventions, particularly those targeting children and their families. TRIAL REGISTRATION The systematic review protocol was registered in PROSPERO on December 17, 2018, the international prospective register of systematic reviews (registration number: CRD42018117842 ).
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Affiliation(s)
- Jeannette M. Beasley
- Department of Medicine, NYU Grossman School of Medicine, 462 First Avenue CD 673, New York, NY 10016 USA
| | - Janelle M. Wagnild
- Department of Anthropology, Durham University, South Road, Durham, DH1 3LE UK
| | - Tessa M. Pollard
- Department of Anthropology, Durham University, South Road, Durham, DH1 3LE UK
| | - Timothy R. Roberts
- NYU Health Sciences Library, NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Nasima Ahkter
- Department of Anthropology, Durham University, South Road, Durham, DH1 3LE UK
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