IntroductionLiterature suggests couple-based interventions that target quality of life and communication can lead to positive outcomes for patients with cancer and their partners. Nevertheless, to date, an intervention to address the needs of Latino families coping with advanced cancer has not been developed. Meta-analytic evidence suggests that culturally adapted evidenced-based intervention targeting a specific cultural group is four times more effective. Our goal is to culturally adapt a novel psychosocial intervention protocol entitled ‘Caregivers-Patients Support to Latinx coping advanced-cancer’ (CASA). We hypothesised that combine two evidence-based interventions and adapting them, we will sustain a sense of meaning and improving communication as patients approach the end of life among the patient–caregiver dyad.Methods and analysisTo culturally adapt CASA, we will follow an innovative hybrid research framework that combines elements of an efficacy model and best practices from the ecological validity model, adaptation process model and intervention mapping. As a first step, we adapt a novel psychosocial intervention protocol entitled protocol entitled ‘Caregivers-Patients Support to Latinx coping advanced-cancer’ (CASA). The initial CASA protocol integrates two empirically based interventions, meaning-centred psychotherapy and couple communication skills training. This is an exploratory and prepilot study, and it is not necessary for a size calculation. However, based on recommendations for exploratory studies of this nature, a priori size of 114 is selected. We will receive CASA protocol feedback (phase 1b: refine) by conducting 114 questionnaires and 15 semistructured interviews with patients with advanced cancer and their caregivers. The primary outcomes of this study will be identifying the foundational information needed to further the develop the CASA (phase IIa: proof-of-concept and phase IIb: pilot study).Ethics and disseminationThe Institutional Review Board of Ponce Research Institute approved the study protocol #1907017527A002. Results will be disseminated through peer-reviewed publications.

Objective: The purpose of this study was to determine the prevalence of psychiatric diagnoses among a sample of breast reconstruction patients and measure the association between these diagnoses and reconstruction-related, patient-reported outcomes. Background: The impact of psychiatric disorders in conjunction with breast cancer diagnosis, treatment, and reconstruction have the potential to cause significant patient distress but remains not well understood. Methods: A retrospective review of postmastectomy breast reconstruction patients from 2007 to 2018 at Memorial Sloan Kettering Cancer Center was conducted. Patient demographics, comorbidities, cancer characteristics, psychiatric diagnoses, and BREAST-Q Reconstruction Module scores (measuring satisfaction with breast, well-being of the chest, psychosocial, and sexual well-being) at postoperative years 1 to 3 were examined. Mixed-effects models and cross-sectional linear regressions were conducted to measure the effect of psychiatric diagnostic class type and number on scores. Results: Of 7414 total patients, 50.1% had at least 1 psychiatric diagnosis. Patients with any psychiatric diagnoses before reconstruction had significantly lower BREAST-Q scores for all domains at all time points. Anxiety (50%) and depression (27.6%) disorders were the most prevalent and had the greatest impact on BREAST-Q scores. Patients with a greater number of psychiatric diagnostic classes had significantly worse patient-reported outcomes compared with patients with no psychiatric diagnosis. Psychosocial (β: −7.29; 95% confidence interval: −8.67, −5.91), and sexual well-being (β: −7.99; 95% confidence interval: −9.57, −6.40) were most sensitive to the impact of psychiatric diagnoses. Conclusions: Mental health status is associated with psychosocial and sexual well-being after breast reconstruction surgery as measured with the BREAST-Q. Future research will need to determine what interventions (eg, screening, early referral) can help improve outcomes for breast cancer patients with psychiatric disorders undergoing breast reconstruction.

Background: The Bedford-Stuyvesant (BS) and Bushwick (BW) communities of central Brooklyn, New York, are located within the 50-mile core radius of Memorial Sloan Kettering's main catchment area. Cancer is the second leading cause of death among the predominantly African American and Hispanic neighborhoods, with BS and BW having higher prostate cancer and colorectal mortality rates than New York City as a whole. There is significant opportunity to design cancer interventions that leverage the accessibility and acceptability of mobile health (mHealth) tools among the BS and BW communities. Methods: The Cancer Health Impact Program (CHIP) is a collaborative that was formed for this purpose. Through CHIP, we used a tablet-based, Health Information National Trends (HINTS)-based multimodality survey to collect and analyze social and demographic patterns of prostate cancer and colorectal cancer screening, as well as mHealth access, among BS and BW residents. Results: Among 783 participants, 77% reported having a smartphone, 40% reported access to a mobile health application, 17% reported blood stool kit testing, and 26% of men reported PSA test screening. Multivariable logistic regression models results demonstrated that participants who reported owning smartphones, but were unsure whether they had access to a health app, were also significantly more likely to report blood stool kit testing compared with participants without smartphones. In fully adjusted models, access to a health app was not significantly associated with PSA testing. Non-Hispanic white participants were 86% less likely to report blood stool kit testing when compared with non-Hispanic black participants [OR ¼ 0.15; 95% confidence interval (CI) 0.02-0.49]. Participants with a prior history of cancer were three times more likely to report blood stool kit testing when compared with those without cancer history (OR ¼ 3.18; 95% CI, 1.55-6.63). Conclusions: For blood stool kit testing, significant differences were observed by race/ethnicity, cancer history, age, and smartphone use; for PSA screening, only age was significant in fully adjusted models. Impact: Our results demonstrate that while access to smartphones and mobile health apps may be prevalent among minority communities, other social and demographic characteristics are more likely to influence screening behaviors.

Minorities and older adults represent an intersection of populations that are particularly vulnerable to suboptimal care. The US population is aging and growing more diverse. Dementia afflicts minority populations more than Caucasians. Many people in the community with mild cognitive impairment (MCI) and Alzheimer’s disease do not recognize cognitive, functional or behavioral impairment as abnormal. Several barriers to treatment exist within both the older and minority populations. The Health Resources and Services Administration (HRSA), is the primary Federal agency for improving health and achieving health equity. Queens County in New York City is a multicultural, ethnically diverse urban area with 48% of its population being foreign born. Funded by a grant from HRSA, in collaboration with the South Asian Council for Social Services (SACSS), the Geriatric Resource Interprofessional Program (GRIP) at Memorial Sloan Kettering Cancer Center (MSKCC) developed and conducted educational lectures on “Memory Loss & Dementia” at 7 different community centers in Queens. Between November 2015 and January 2019 eight sessions were conducted. A total of 182 people attended. Their mean age was 68, 59% were women. 71% were born in South Asia. Consecutive interpretation of the lecture was performed; the written materials were translated beforehand. Pre and post-test questionnaires were administered to measure understanding of the topic, and qualitative comments collected. The developmental process, results of the study and challenges we faced in developing and applying the educational initiative will be presented.