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.
Although considerable progress has been made towards cancer control in the United States, not all minority groups have equitably benefited from such efforts. The goal of this R21 award application is to evaluate the effectiveness of a linguisticall appropriate and culturally sensitive intervention program to reduce stress, enhance coping, and improve quality of life in underserved Korean American breast cancer survivors. The proposed project will be one of the first to examine the effects of a multifaceted and innovative interventin program for underserved and understudied Korean American breast cancer survivors, and has the potential to make a significant contribution toward reducing disparities in cancer survivorship.