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    Research Grants Awarded

    Improving Quality of LIfe among Low Literate Asian American Breast Cancer Survivors

    Study Section:
    Breast Cancer Disparities

    Scientific Abstract:
    The effects of literacy on the quality of life among Asian American breast cancer survivors are unexplored. Breast cancer patients with limited English skills, in addition to low literacy in their native language, are particularly vulnerable to receiving sub-optimal care and may experience different health outcomes due to these barriers. The 2-year pilot project is to develop and test the efficacy of culturally appropriate intervention to improve quality of life for low literate newly diagnosed Asian American breast cancer patients. The target population is Chinese and Vietnamese women diagnosed with breast cancer age 18 or older living in Houston. The objectives include: 1) identifying and exploring the factors associated with quality of life among Asian American breast cancer survivors through use of interviews with 125-150 breast cancer survivors and with 35-50 key informants; and 2) developing and pilot testing the efficacy of a culturally appropriate intervention that utilizes peer navigators for 35-50 newly diagnosed Asian American breast cancer patients. Translated versions of REALM (Rapid Estimate of Adult Literacy in Medicine) and QOL-BC (Quality of Life-Breast Cancer Patient Version) in Chinese/Vietnamese will be used to determine reading level and quality of life, respectively. The intervention will address quality of life and will focus on improving patient and provider communication. After development during the second phase of the study, participants will be randomly assigned to intervention group, who will receive newly developed education materials for low literate patients and a one time education session done individually by trained bilingual peer navigators; or non-intervention group, who will receive the current and standard patient education materials from their providers. The change in quality of life from baseline and at 4 months post-intervention will be assessed to determine the effects of the educational program on well-being. It is hypothesized that a carefully designed and conducted education program will increase a newly diagnosed woman?s knowledge of strategies for making important medical decisions as well as her knowledge of available resources for dealing with her diagnosis. Following the intervention, participants will be invited to participate in a semi-structured telephone follow-up interview concerning the usefulness of and improvement on the program. Results from pilot tests will be analyzed, reviewed, and used for future studies to enhance cancer recovery in a community setting. Process evaluation will include development of templates for each project component to be used by others wishing to replicate the project elsewhere.

    Lay Abstract:
    Although increase in survival rates has promoted greater interest in the quality of life among breast cancer survivors, very little information is known about the well-being of low literate Asian American survivors. Asian American breast cancer patients with limited English skills, in addition to low literacy in their native language, are particularly vulnerable to receiving sub-optimal care and may experience different health outcomes due to these barriers. The 2-year pilot project is aimed at developing and testing the efficacy of culturally appropriate intervention to improve quality of life for low literate, newly diagnosed Asian American breast cancer patients. The target population is Chinese and Vietnamese women diagnosed with breast cancer age 18 and older living in Houston. The objectives of this study are: 1) to identify and explore the factors associated with quality of life among Asian American breast cancer survivors through use of interviews with 125-150 breast cancer survivors and with 35-50 key informants; and 2) to develop and pilot test the efficacy of a culturally appropriate intervention that utilizes peer navigators for 35-50 newly diagnosed Asian American breast cancer patients. Findings from the first objective will be used to develop culturally and linguistically appropriate intervention for newly diagnosed breast cancer patients, especially those with limited literacy skills. Participants will be randomly assigned to intervention group, who will receive newly developed educational materials for low literate patients and a one time education session done individually by trained bilingual peer navigators, or non-intervention group, who will receive the current and standard patient educational materials from their providers. The intervention will be designed to address the physical, psychological, social, and spiritual dimensions of quality of life and will focus on providing the patient with information about treatment options and improving patient and provider communication. The change in quality of life from baseline and at 4 months post-intervention to determine the effects of the educational program on well-being will be assessed. Findings from this study will provide insight into disease or treatment problems that may have gone undetected due to failure of many studies to accommodate the unique needs of Asian American breast cancer patients with limited literacy skills. Understanding quality of life of Asian American breast cancer survivors with low literacy skills will enhance patient-provider communication, will help determine the long-term effects of breast cancer, and may help improve the quality of life for future cancer survivors. The proposed study will provide the foundation for a long term research program for understanding cancer survivorship among Asian Americans.