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 and religious 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 Latino patients diagnosed with advanced cancer. Individual Meaning-Centered psychotherapy (IMCP) 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. Preliminary findings from the pilot randomized controlled trial demonstrate both the IMCP significantly reduce psychological distress and significantly increase spiritual well-being and a sense of meaning and purpose in life in predominantly non-Hispanic white advanced cancer patients. The long term goal of this study is to linguistically and culturally adapt IMCP for Spanish-speaking Latino cancer patients. The overall objective of this study is to use a mixed-method design to gain an understanding of the sources of meaning, hope, legacy and identity in advanced cancer and to explore the acceptability and feasibility of applying IMCP to Latinos diagnosed with advanced cancer. The study findings will be used to adapt the intervention manual following the Ecological Validity Model and Cultural Adaptation Process Model. To achieve these aims, we will use a two-phased convergent mixed-method design. First, we will survey 70 Spanish-speaking advanced cancer patients and 50 mental health professionals who provide services to Latino cancer patients, to assess the acceptability and feasibility of the methods, concepts and goals of IMCP. Only patients who have completed the questionnaires will be approached for the in-depth interview to triangulate the information using a convergent integration approach. Fifteen Latino patients diagnosed with advanced cancer will be interviewed to learn patients'sources of meaning following a cancer diagnosis;explore their understanding of the concepts of the IMCP model;and to help discern the acceptability and feasibility of the goals, concepts, methods and metaphors of IMCP. This will be the first therapeutic intervention adapted for Latinos diagnosed with advanced cancer. This application is responsive to the eighth priority 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. This significant contribution will address the critical lack of palliative cancer care interventions for the Spanish- speaking population. The results of this formative study will provide guidance to this specific intervention's adaptation, but will also advance the field of cultural adaptation of psychosocial interventions with medical populations. OMB No. 0925-0001/0002 (Rev. 08/12 Approved Through 8/31/2015) Page Continuation Format Page

Public Health Relevance

The proposed study is relevant to public health because ut addresses the critical lack of palliative cancer care interventions for the Spanish-speaking population. NCI recognizes that minorities and other underserved populations bear a far greater cancer burden than the general population. NCI aims to overcome cancer disparities by promoting research that aims to understand the underlying causes and contributing factors of treatment and survival disparities;and by accelerating the dissemination and implementation of interventions to address cancer health disparities. We expect that the findings of this mixed- method study will provide the foundation for the linguistic and cultural adaptation of Individual meaning Centered Psychotherapy. Latinos diagnosed with advanced cancer are at risk of poor mental health outcomes. This will be the first therapeutic intervention adapted for Spanish-speaking Latinos diagnosed with advanced cancer. OMB No. 0925-0001/0002 (Rev. 08/12 Approved Through 8/31/2015) Page Continuation Format Page

Agency
National Institute of Health (NIH)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21CA180831-01A1
Application #
8766110
Study Section
Health Disparities and Equity Promotion Study Section (HDEP)
Program Officer
Chou, Wen-Ying
Project Start
Project End
Budget Start
Budget End
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
City
New York
State
NY
Country
United States
Zip Code
10065