Objective Little attention has been focused on Asian American breast cancer survivor's psychological needs. No outcome based psychosocial interventions have been reported to target at this population. Expressive writing interventions have been previously shown to improve health outcomes among non-Hispanic white breast cancer populations. This pilot study aimed to test the cultural sensitivity, feasibility, and potential health benefits of an expressive writing intervention among Chinese-speaking breast cancer survivors. Methods Participants (N=19) were asked to write about their deepest thoughts and feelings, their coping efforts, and positive thoughts and feelings regarding their experience with breast cancer each week for three weeks. Health outcomes were assessed at baseline, three, and six months after the intervention. A Community-Based Participatory Research Approach (CBPR) is used. Results Expressive writing was associated with medium and large effect sizes (ηp2= 0.066~0.208) in improving multiple health outcomes (quality of life, fatigue, posttraumatic stress, intrusive thoughts, and positive affect) at follow-ups. Participants perceived the study to be valuable. The study yielded high compliance and completion rates. Conclusion Expressive writing is associated with long-term improvement of health outcomes among Chinese breast cancer survivors and has the potential to be utilized as a support strategy for minority cancer survivors. In addition, CBPR is valuable in improving feasibility and cultural sensitivity of the intervention in understudied populations. Future studies employing randomized controlled trial designs are warranted.

The study challenges the implicit assumption that psychosocial interventions validated among Non-Hispanic Whites could be directly generalized to other populations. It suggests that Asians may benefit from writing instructions facilitating more cognitive than emotional processes. (PsycINFO Database Record

Purpose/Objectives To evaluate a social support intervention that was culturally tailored for Chinese Americans who face many challenges because of cultural and linguistic barriers. Design Intervention with a one-group pre- or post-test design, mixed methods, and a community-based participatory research (CBPR) approach. Setting Southern California. Sample 14 Chinese American breast cancer survivors post-treatment and eight breast cancer peer mentors. Methods The intervention was a 10-week program to provide emotional and informational support through peer mentoring and education. Health outcomes were assessed before and after the intervention. Eight weekly process evaluations and two focus group interviews also were conducted. Main Research Variables Depressive and anxiety symptoms. Findings The program was associated with a decrease in depressive symptoms. Participants valued the program highly. Inductive analysis suggested possible mechanisms for effectiveness, such as reducing stigma, empowerment, and increased sense of belonging. Conclusions The peer-mentoring and education program has the potential to serve as a model intervention for ethnic minorities. Mixed methods and CBPR are valuable in evaluating pilot interventions with minorities. Focusing on relationships may be fruitful for designing novel interventions for cancer survivors from collectivistic cultures. Implications for Nursing Peer-mentoring and education programs can be integrated into communities and clinics to improve care for underserved minority cancer survivors and to reduce health disparities.

Background Expressive writing interventions are shown to confer health benefits for Caucasian cancer survivors. However, few studies reported improved quality of life or studied ethnic minorities. Purpose The study evaluated whether a culturally sensitive expressive writing intervention improved quality of life. Methods Chinese-speaking breast cancer survivors (n = 136) in the USA were randomly assigned to one of three conditions to write three 30-min weekly essays: a cancer-fact condition to write about facts relevant to the cancer experience for three weeks; a self-regulation condition to write about deepest feelings at week 1, stress and coping at week 2, and finding benefits at week 3; or an enhanced self-regulation condition to write about stress and coping at week 1, deepest feelings at week 2, and finding benefits at week 3. Quality of life was assessed by Functional Assessment of Cancer Therapy at baseline, 1-, 3-, and 6-month follow-ups. Results Growth curve models showed that quality of life was increased in the sample from baseline to the 6-month follow-up. The enhanced self-regulation condition had a large and statistically significant effect ConclusionExpressive writing is shown to be an effective intervention to improve quality of life for ChineseAmerican cancer survivors. Future efforts are warranted to disseminate and implement this low-dose and brief intervention in community and clinical settings. Clinical Trial Registration NCT02946619.

Breast cancer survivors report persistent psychological and physical symptoms, which affect their quality of life and may challenge the recovery process. Due to social, cultural, and linguistic barriers, culturally-sensitive care is largely unavailable for Chinese Americans, and their psychological needs are not often addressed. We aimed to investigate whether the Joy Luck Academy (JLA), a psychosocial intervention providing both information and peer support, was associated with positive adjustment among Chinese American breast cancer survivors. Thirty-nine Chinese American breast cancer survivors participated in a pilot psychosocial intervention. The educational materials and lectures were delivered in the participants' native language of Chinese. All of the educators and mentors shared the same linguistic and cultural background with the participants. The program utilized a community-based participatory research (CBPR) approach to further enhance the cultural sensitivity of the intervention. Participants' post-traumatic growth and positive affect were assessed before and after the intervention. The JLA showed an improvement in positive affect, and they had a greater appreciation for life. The intervention was found to be feasible, well-accepted, and beneficial for this population. Chinese American breast cancer survivors reported improved psychological health after attending the intervention. These findings encourage the development and implementation of psychosocial interventions for Chinese breast cancer survivors. Similar programs could be integrated into other ethnic or cultural communities.