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Filipina Breast Cancer Support: What model is meaningful?
Breast Cancer Disparities
Background: Breast cancer among Filipina Americans represents a major but largely neglected cancer disparity. First, the Filipino population in the US is large, second among Asians only to the Chinese. Second, Filipinas have higher rates of breast cancer incidence than most other Asian subgroups. Third, resources for and data regarding Filipinas with breast cancer are almost non-existent. In a 2004 collaboration between West Bay Pilipino Multi-Service Center, the UCSF Comprehensive Cancer Center, and the SFGH Breast Care Program, the first Filipina breast cancer support group (Sinag Tala) was started. However, group attendance is uneven and the little research available suggests that a "one size fits all" approach to support group design would not be effective in this collectivist-oriented culture. The proposed study will elucidate meanings of survivorship and support in this community, and inform design of more culturally appropriate support services building upon existing community resources. Objective: This study asks: What are Filipinas's beliefs and values around cancer, survivorship, and social support? What are the strengths and weaknesses of the existing Sinag Tala Support Group? What barriers keep women from participating in the existing group? What other resources do women access for support? How does this support influence quality of life? We hypothesize that since connection with others is elemental to the quality of life in this collectivist-oriented culture, existing social connections provide a culturally appropriate basis for a meaningful support model. The formative research we propose will identify these resources. Specific Aims: The overall goal is to identify elements of Filipino culture necessary to design culturally resonant support services. The specific aims are to 1) assess the current Sinag Tala support group; 2) create a culturally resonant support model based on existing support resources and core cultural values; and 3) pretest a culturally resonant support model. Study Design: Qualitative methods will be used with Filipino community service providers and elders as key informants, support group participants and their families, former participants and their families, and breast cancer survivors who have never participated in the support group and their families. Interview formats will vary according to characteristics of respondents and the questions that will be asked. We will also participate in and observe meetings of the current Sinag Tala support group. To build the research capacity of West Bay, UCSF collaborators will train West Bay staff in qualitative methods and analysis. Outcomes and Benefits: Just as providing social support has been shown to improve the quality of life of White breast cancer patients, the development and delivery of culturally resonant support services is likely to improve the quality of life of Filipina breast cancer survivors and address survivorship disparities in this community.
Background: Filipina American women suffer a disproportionate burden of cancer than women of other Asian subgroups. The Filipino population in the US is large, second among Asians only to the Chinese. Breast cancer among Filipina American women is a major cancer disparity. Despite this, resources for and research with Filipinas with breast cancer are almost non-existent. In 2004, West Bay Pilipino Multi-Service Center (West Bay) joined with the UCSF Comprehensive Cancer Center and the San Francisco General Breast Care Program to start the first Filipina breast cancer support group (Sinag Tala) in San Francisco. However, it has been difficult to keep women coming to the group. The little research available on Filipino Americans suggests that support services need to be tailored to the social and cultural values, beliefs and norms of the community. Our study seeks to illuminate meanings of survivorship and breast cancer support in this community, and how to design culturally appropriate support services building upon existing community resources (social networks). Methods: In this study we will identify existing support resources within the Filipino community and incorporate these into a culturally resonant support model. We will participate in the current Sinag Tala breast cancer support group meetings and interview the people who know the most about breast cancer survivorship support resources and needs in the Filipino community: women and their families who take part in the support group, women and their families who stopped attending the group, and breast cancer survivors who have never gone to the support group. After review of findings from interviews and observations of the support group, we will develop a culturally appropriate support model in close collaboration with the Sinag Tala Advisory Council. This model will then be evaluated in small group interviews with breast cancer survivors and their families. Interviews and analyses of the information that results will be conducted in accordance with qualitative research methods. UCSF researchers will train staff of West Bay to conduct interviews and analyses will be conducted jointly. This systematic identification of key issues related to our research questions is called ?formative research? and precedes an intervention trial. Potential Outcomes and Benefits: We believe the development and delivery of culturally appropriate and resonant support services is likely to improve the quality of life of Filipina breast cancer survivors. In addition, through this research, we seek to increase the capacity of West Bay, an organization based in and trusted by the Filipino community since they are best positioned to reduce the breast cancer burden in their community.