No abstract

Latinas are less likely to participate in genetic counseling (GC) and genetic testing (GT) than non‐Hispanic Whites. A multisite, randomized pilot study tested a culturally targeted educational intervention to increase uptake of GC/GT among Latina breast cancer (BC) survivors (N = 52). Participants were recruited in Tampa, FL and Ponce, PR and randomized to: (a) fact sheet about BC survivorship (control) or (b) a culturally targeted educational booklet about GC/GT (intervention). Participants in the intervention condition were also offered no‐cost telephone GC followed by free GT with mail‐based saliva sample collection. Participants self‐reported hereditary breast and ovarian cancer (HBOC) knowledge and emotional distress at baseline and 1‐ and 3‐month follow‐ups. We used logistic regression to examine differences in GC/GT uptake by study arm (primary outcome) and repeated measures ANOVA to examine the effects of study arm and time on HBOC knowledge and emotional distress (secondary outcomes). Compared to the control arm, intervention participants were more likely to complete GC (ORIntervention = 13.92, 95% CI = 3.06–63.25, p < .01) and GT (ORIntervention = 12.93, 95% CI = 2.82–59.20, p < .01). Study site did not predict uptake of GC (p = .08) but Ponce participants were more likely to complete GT (ORPonce = 4.53, 95% CI = 1.04–19.72, p = .04). ANOVAs demonstrated an increase in HBOC knowledge over time across both groups (F(2,88) = 12.24, p < .01, ηp2 = 0.22). We also found a significant interaction of study arm and time, such that intervention participants demonstrated a greater and sustained (to the 3‐month follow‐up) increase in knowledge than control participants (F(2,88) = 3.66, p = .03, ηp2 = 0.08). No other main or interaction effects were significant (all p’s> .15). Study findings demonstrate the potential of our culturally targeted print intervention. Lessons learned from this multisite pilot study for enhancing GC/GT in Latinas include the need to attend to both access to GC/GT and individual factors such as attitudes and knowledge.

Background: Latino cancer patients are at risk of poor psychological adjustment. Therapeutic effectiveness in treating Latino cancer patients with advanced cancer requires managing distress, therapeutic skill, and cultural competency. This mixed-methods study explored mental health providers’ perceptions of the challenging aspects of counseling and caring for Latino patients with advanced cancer. Methods: Mental health providers providing services to Latino or Hispanic cancer patients received an emailed web-based survey with open- and closed-ended questions. Providers included psychiatrists, psychologists, social workers, counselors, and other mental health professionals. We invited 154 providers to participate from July 2015 to January 2017. One hundred and four accessed the survey, and 66 eligible providers responded, for a response rate of 43%. Analyses were used to explore whether clinical experience factors and training characteristics were associated with perceiving conversations about cancer (diagnosis, prognosis, and end-of-life) as challenging. Second, the challenging aspects of these conversations were explored qualitatively. Four independent coders coded responses; an inductive content analysis was utilized to analyze the data. Results: Mental health providers describe encountering many challenges in their therapeutic discussions with Latino cancer patients. Conclusions: It is imperative to understand the factors associated with the perceived difficulty of these conversations, as well as the characteristics of these conversations, to develop culturally sensitive interventions and programs for patients and training interventions for providers.

According to the field of affective neuroscience, grief has been identified as one of the seven primary emotions necessary for human survival. However, maladaptive grief could cause significant impairment in an individual’s life, leading to psychopathologies such as major depressive disorder. Research on grief has shifted to a biopsychosocial approach, leaving behind outdated models—such as the Kübler-Ross theory—that have shown poor consistency. The field of psychoneuroimmunology has identified adverse life events such as social loss as being associated with major depressive disorder, and inflammatory processes in chronic health conditions. Likewise, scientists in the field of affective neuroscience have theorized that prolonged and sustained activation of the grief neurological pathway can cause a cascade of neurotransmitters that inhibits the reward-seeking system, causing symptoms of depression. The objective of this review is to highlight findings on the grief process using a biopsychosocial approach to explore grief’s impact on psychopathophysiology.

Objective: This study compares barriers to psychosocial services use between Latina and non Latina White survivors after receiving a diagnosis of breast cancer and examines the association of these barriers with use of psychosocial services. Methods:A sample of 265 Latina and non-Latina White survivors who received treatment in a comprehensive cancer center in New York City completed a mailed questionnaire. The questionnaire measured quality of life, interest in help for distress, psychosocial services use, and barriers to use of psychosocial services. Bivariate and adjusted logistic regression models were conducted analyze the data.Results: More than half of the sample reported preferring to return to their normal routine, felt that they could take care of their emotional problems themselves, and preferred to seek support from their family or friends. Latinas were more likely to seek counseling from a spiritual leader and report that there are no counselors who speak their language and understand their values or background and that mental health services are too expensive. Conclusions:It is crucial to study and address potential barriers that contribute to health disparities and discrepancies in patient's access and use of psychosocial healthcare.Findings highlight the need to educate providers about patients' psychosocial needs; patients need to receive information about the benefits of psychosocial and mental health services, to normalize mental health service use and diminish stigma. Finally, culturally and linguistic sensitive services for Latina patients are warranted.