Grant Number:	5R01CA203719-06 Interpret this number
Primary Investigator:	Im, Eun-Ok
Organization:	Emory University
Project Title:	To Enhance Breast Cancer Survivorship of Asian Americans
Fiscal Year:	2020

 DESCRIPTION (provided by applicant): To Enhance Breast Cancer Survivorship of Asian Americans Despite few studies on Asian American breast cancer survivors, it is well known that these women shoulder unnecessary burden of breast cancer because they rarely complain about symptoms or pain, delay seeking help, and rarely ask or get support due to their cultural values and beliefs and language barriers. This demonstrates a definite need for support in this specific population. However, survivorship programs that are increasingly instituted at cancer centers have serious impediments to providing information and coaching/support because of the lack of staff time and insurance reimbursement. Furthermore, the pressure of fast-paced clinical patient-provider interactions leaves little time for health care providers to provide up-to-date information and coaching or support for these women based on their cultural attitudes. All these circumstances necessitate an innovative and creative delivery method of information and coaching/support. A technology- based approach using computers and mobile devices (smart phones and tablets) promises to meet this necessity with high flexibility and accessibility, and minimizes the cost of the intervention in busy and costly health care settings. Also, a technology-based intervention that does not involve face-to-face interactions could work better for many women from cultures where breast cancer is still a stigmatizing experience. Therefore, based on Preliminary Studies (PSs), the research team has developed and pilot-tested a theory-driven technology-based information and coaching/support program that is culturally tailored to Asian American breast cancer survivors using multiple features. The purpose of the proposed randomized intervention study is to test the efficacy of the technology-based information and coaching/support program for Asian American breast cancer survivors (TICAA) in enhancing the women's breast cancer survivorship experience. The specific aims are to: a) determine whether the intervention group will show significantly greater improvements than the control group in primary outcomes (needs for help, physical and psychological symptoms, and quality of life) from baseline (pre-test) to Time Points 1 (post 1-month) and 2 (post 3-months); b) identify theory-based variables (attitudes, self-efficacy, perceived barriers, and social influences related to breast cancer survivorship) that mediate the intervention effects of the TICAA on the primary outcomes; and c) determine whether the effects of the TICAA on the primary outcomes are moderated by background characteristics and disease factors. The proposed study will be guided by the Bandura's Theory of Behavioral Change. This study adopts a randomized repeated measures pretest/posttest control group design in 330 Asian American breast cancer survivors. The long-term goals are to: (a) implement the program into various health care settings; (b) determine if the TICAA will lead to long-term improved health outcomes; and (c) fundamentally enhance the methodology/paradigm of culturally tailored technology-based interventions for ethnic minority groups of breast cancer survivors.




The Characteristics of Asian American Breast Cancer Survivors with Low Quality of Life: a Decision Tree Analysis.
Authors: Im E.O. , Yi J.S. , Chee W. .
Source: Journal of cancer education : the official journal of the American Association for Cancer Education, 2023 Aug; 38(4), p. 1277-1285.
EPub date: 2023-01-11.
PMID: 36627471
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Immigration Transition and Symptom Distress Changes by a Technology-Based Intervention: Asian American Breast Cancer Survivors.
Authors: Im E.O. , Yi J.S. , Chee W. .
Source: Computers, informatics, nursing : CIN, 2023-05-01; 41(5), p. 316-322.
EPub date: 2023-05-01.
PMID: 35797029
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Lessons from a Customer Discovery Study: a Technology-Based Cancer Support Program for Asian American Breast Cancer Survivors.
Authors: Chee W. , Kim S. , Jang M. , Im E.O. .
Source: Journal of cancer education : the official journal of the American Association for Cancer Education, 2023 Feb; 38(1), p. 248-254.
EPub date: 2021-10-26.
PMID: 34704170
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Sub-Ethnicity and Survivorship Experience: Asian American Breast Cancer Survivors.
Authors: Chee W. , Im E.O. .
Source: Western journal of nursing research, 2022 Dec; 44(12), p. 1108-1116.
EPub date: 2021-07-14.
PMID: 34261395
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Information Needs of Asian American Breast Cancer Survivors: a Decision Tree Analysis.
Authors: Chee W. , Yi J.S. , Im E.O. .
Source: Journal of cancer education : the official journal of the American Association for Cancer Education, 2022 Dec; 37(6), p. 1902-1911.
EPub date: 2021-06-27.
PMID: 34176104
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Clusters by Menopausal Symptoms: Asian American Breast Cancer Survivors.
Authors: Im E.O. , Chee W. .
Source: Western journal of nursing research, 2022 Sep; 44(9), p. 854-862.
EPub date: 2021-05-28.
PMID: 34044672
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Characteristics of Asian-American Breast Cancer Survivors Retained in a 3-Month Technology-Based Intervention.
Authors: Yi J.S. , Chee W. , Im E.O. .
Source: Cancer nursing, 2022 Jul-Aug 01; 45(4), p. E766-E774.
EPub date: 2021-11-12.
PMID: 34661563
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A Decision Tree Analysis on the Impact of a Technology-Based Program on Symptom Distress: Asian American Breast Cancer Survivors.
Authors: Im E.O. , Yi J.S. , Chee W. .
Source: Computers, informatics, nursing : CIN, 2022-07-01; 40(7), p. 487-496.
EPub date: 2022-07-01.
PMID: 34570008
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Attitudes toward Technology-Based Cancer Support Programs Among Korean American Breast Cancer Survivors.
Authors: Im E.O. , Kim S. , Jang M. , Chee W. .
Source: Western journal of nursing research, 2021 Aug; 43(8), p. 732-741.
EPub date: 2020-11-16.
PMID: 33191877
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Components of Culturally Tailored Interventions: A Discussion Paper.
Authors: Im E.O. , Chee W. .
Source: ANS. Advances in nursing science, 2021 Apr-Jun 01; 44(2), p. 123-135.
PMID: 33181572
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A technology-based information and coaching/support program and self-efficacy of Asian American breast cancer survivors.
Authors: Im E.O. , Yi J.S. , Kim H. , Chee W. .
Source: Research in nursing & health, 2021 Feb; 44(1), p. 37-46.
EPub date: 2020-07-30.
PMID: 32729970
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The efficacy of a technology-based information and coaching/support program on pain and symptoms in Asian American survivors of breast cancer.
Authors: Im E.O. , Kim S. , Yang Y.L. , Chee W. .
Source: Cancer, 2020-02-01; 126(3), p. 670-680.
EPub date: 2019-11-12.
PMID: 31714598
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Decreasing menopausal symptoms of Asian American breast cancer survivors through a technology-based information and coaching/support program.
Authors: Im E.O. , Kim S. , Lee C. , Chee E. , Mao J.J. , Chee W. .
Source: Menopause (New York, N.Y.), 2019 Apr; 26(4), p. 373-382.
PMID: 30461556
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What to Consider in a Culturally Tailored Technology-Based Intervention?
Authors: Im E.O. , Chee W. , Hu Y. , Kim S. , Choi H. , Hamajima Y. , Chee E. .
Source: Computers, informatics, nursing : CIN, 2018 Sep; 36(9), p. 424-429.
PMID: 29927767
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The use of multiple languages in a technology-based intervention study: A discussion paper.
Authors: Im E.O. , Lee S.J. , Hu Y. , Cheng C.Y. , Iikura A. , Inohara A. , Kim S. , Hamajima Y. , Yeo S.A. , Chee E. , et al. .
Source: Applied nursing research : ANR, 2017 Dec; 38, p. 147-152.
EPub date: 2017-10-16.
PMID: 29241508
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Issues in Recruiting and Retaining Asian American Breast Cancer Survivors in a Technology-Based Intervention Study.
Authors: Im E.O. , Kim S. , Xu S. , Lee C. , Hamajima Y. , Inohara A. , Chang K. , Chee E. , Chee W. .
Source: Cancer nursing, 2020 Jan/Feb; 43(1), p. E22-E29.
PMID: 30346330
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