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Grant Details

Grant Number: 5R01CA180896-06 Interpret this number
Primary Investigator: Lu, Qian
Organization: University Of Tx Md Anderson Can Ctr
Project Title: Joy Luck Academy: a Culturally Sensitive Social Support Intervention
Fiscal Year: 2018


Abstract

DESCRIPTION (provided by applicant): Despite the increasing size of the Asian American population (17.3 million) and their growing rate of breast cancer, little attention is focused on Asian American (AA) breast cancer survivors' informational and psychological needs. More notably, we have located no randomized controlled trial conducted in this population to address the unmet needs of this understudied and underserved population. Due to their social, cultural, and linguistic barriers, culturally competent mental health care is largely unavailable. The lack o both the availability of culturally competent mental health care and studies to identify and address the physical, emotional, and social needs of Asian American cancer survivors' constitute unnecessary and avoidable disparities in cancer care. Chinese Americans comprise the largest subgroup (24 percent) among the estimated 17.3 million Asian Americans in the U.S. Our research and community partner team have designed a culturally sensitive social support intervention called the "Joy Luck Academy (JLA)" that provide education and peer mentor support for Chinese American breast cancer survivors (BCS). A single-arm pilot study recently completed by our team has shown that the JLA is highly valued by participants and is associated with better quality of life among Chinese American BCS. This study proposes a randomized controlled trial (RCT) to test the health benefits of the JLA program and to identify for whom and why the JLA works using a community based participatory research (CBPR) approach, and mixed deductive and inductive methods. Chinese American breast cancer survivors who have completed primary treatment (N=210) will be randomly assigned to either the JLA group or a control group to receive enhanced usual care while waiting for the JLA. Health outcomes are assessed at baseline, immediately post intervention, and 1 and 4 months follow-ups. We will use deductive quantitative methods to test health outcomes, theorized mediators, and baseline individual differences. We use inductive and deductive qualitative methods to explore and understand mechanisms explaining the benefits of the intervention and to enhance the interpretation of the quantitative data. Few tested psychosocial interventions exist for diverse ethnic groups. One of the major hypothesized barriers is the lack of understanding of unique cultural differences in the meaning of and appropriate emotional and social responses to breast cancer. Even fewer studies have tested evidence-based programs for their feasibility, applicability, and sustainability in communities of color. Existing communit efforts are often the result of trial and error without theoretical guidance and lack of scientific rigor. This proposed study is the first RCT social support intervention among AA BCSs. The intervention is innovative as it is culturally relevant to an AA group, using a theoretically grounded and CBPR approach, and mixed methods design. We expect that the proposed research guided by both theory and methods with an underserved and understudied population will inspire new directions in future research to address these scientific and practical needs in health disparities research.



Publications

Self-stigma and quality of life among Chinese American breast cancer survivors: A serial multiple mediation model.
Authors: Chu Q. , Wong C.C.Y. , Chen L. , Shin L.J. , Chen L. , Lu Q. .
Source: Psycho-oncology, 2021 Mar; 30(3), p. 392-399.
EPub date: 2020-11-27.
PMID: 33175446
Related Citations

Improvement in quality of life and psychological well-being associated with a culturally based psychosocial intervention for Chinese American breast cancer survivors.
Authors: Lu Q. , Chen L. , Shin L.J. , Wang C. , Dawkins-Moultin L. , Chu Q. , Loh A. , Young L. , Wang C. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2021-01-22; , .
EPub date: 2021-01-22.
PMID: 33481114
Related Citations

Benefits of a Psychosocial Intervention on Positive Affect and Posttraumatic Growth for Chinese American Breast Cancer Survivors: A Pilot Study.
Authors: Warmoth K. , Yeung N.C.Y. , Xie J. , Feng H. , Loh A. , Young L. , Lu Q. .
Source: Behavioral medicine (Washington, D.C.), 2020 Jan-Mar; 46(1), p. 34-42.
EPub date: 2019-01-18.
PMID: 30657442
Related Citations

Self-perceived burden mediates the relationship between self-stigma and quality of life among Chinese American breast cancer survivors.
Authors: Yeung N.C.Y. , Lu Q. , Mak W.W.S. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2019 Sep; 27(9), p. 3337-3345.
EPub date: 2019-01-08.
PMID: 30617433
Related Citations

Ambivalence over emotional expression and intrusive thoughts as moderators of the link between self-stigma and depressive symptoms among Chinese American breast cancer survivors.
Authors: Tsai W. , Lu Q. .
Source: Journal of behavioral medicine, 2019 06; 42(3), p. 452-460.
EPub date: 2018-11-24.
PMID: 30474805
Related Citations

Acculturation and quality of life among Chinese American breast cancer survivors: The mediating role of self-stigma, ambivalence over emotion expression, and intrusive thoughts.
Authors: Tsai W. , Wu I.H.C. , Lu Q. .
Source: Psycho-oncology, 2019 05; 28(5), p. 1063-1070.
EPub date: 2019-03-24.
PMID: 30838727
Related Citations

Successful Strategies for Engaging Chinese Breast Cancer Survivors in a Randomized Controlled Trial.
Authors: Wu C.S. , Warmoth K.M. , Cheung B. , Loh A. , Young L. , Lu Q. .
Source: Translational issues in psychological science, 2019 Mar; 5(1), p. 51-61.
PMID: 30923730
Related Citations

Is expressive suppression harmful for Chinese American breast cancer survivors?
Authors: Lu Q. , Tsai W. , Chu Q. , Xie J. .
Source: Journal of psychosomatic research, 2018 06; 109, p. 51-56.
EPub date: 2018-03-29.
PMID: 29773152
Related Citations

Match between culture and social support: Acculturation moderates the relationship between social support and well-being of Chinese American breast cancer survivors.
Authors: Wong C.C. , Lu Q. .
Source: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2017 01; 26(1), p. 73-84.
EPub date: 2016-07-11.
PMID: 27401773
Related Citations

Using expressive writing to explore thoughts and beliefs about cancer and treatment among Chinese American immigrant breast cancer survivors.
Authors: Lu Q. , Yeung N.C. , You J. , Dai J. .
Source: Psycho-oncology, 2016 11; 25(11), p. 1371-1374.
EPub date: 2015-09-25.
PMID: 26403647
Related Citations

The link between ambivalence over emotional expression and depressive symptoms among Chinese breast cancer survivors.
Authors: Lu Q. , Man J. , You J. , LeRoy A.S. .
Source: Journal of psychosomatic research, 2015 Aug; 79(2), p. 153-8.
EPub date: 2015-01-20.
PMID: 25697586
Related Citations

Evaluating a culturally tailored peer-mentoring and education pilot intervention among Chinese breast cancer survivors using a mixed-methods approach.
Authors: Lu Q. , You J. , Man J. , Loh A. , Young L. .
Source: Oncology nursing forum, 2014-11-01; 41(6), p. 629-37.
PMID: 25355018
Related Citations

Perceived Stress as a Mediator Between Social Support and Posttraumatic Growth Among Chinese American Breast Cancer Survivors.
Authors: Yeung N.C.Y. , Lu Q. .
Source: Cancer nursing, 2018 Jan/Feb; 41(1), p. 53-61.
PMID: 27442209
Related Citations




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