Asian American Breast Cancer Survivors Research Articles

Relationships Between Socio-behavioral Factors and the Symptoms Among Asian American Breast Cancer Survivors: A Structural Equation Modeling.

Despite increased research on breast cancer survivors, little is known about how socio-behavioral factors influence the symptoms among racial/ethnic minority breast cancer survivors, particularly Asian American breast cancer survivors (AABCS). This study examined the relationship between multiple socio-behavioral factors in AABCS, including attitudes, perceived barriers, and social influences, and their symptom experiences, with an emphasis on the mediating effect of self-efficacy. This secondary analysis used data collected from 195 AABCS women recruited through online and offline communities from January 2017 to June 2020. Study variables were measured using validated instruments such as the Questions on Attitudes, Self-Efficacy, Perceived Barriers, and Social Influences; the Cancer Behavior Inventory; and the Memorial Symptom Assessment Scale-Short Form. For structural equation modeling based on Bandura's self-efficacy theory, mediation analysis was performed using SPSS version 26.0 and AMOS 28. The overall fitness of the hypothetical model to the data is acceptable (χ2 = 51.36, P < .001; goodness-of-fit index = 0.95, adjusted goodness-of-fit index = 0.89, comparative fit index = 0.96, Tucker-Lewis index = 0.94, normed fit index = 0.94, and root-mean-square error of approximation index = 0.08). Both attitudes and social influences indirectly influenced symptom distress through self-efficacy (β = -0.054, P = .019, and β = -0.053, P = .017, respectively). Perceived barriers had indirect effects through self-efficacy (β = 0.121, P = .024) and significant direct effects (β = 0.605, P = .003) on symptom distress. Our findings supported that the self-efficacy for coping mediated their symptom experience among AABCS. In addition, there were significant relationships among attitudes, perceived barriers, social influences, and symptom experience. Future theory-driven interventions need to consider self-efficacy and socio-behavioral factors in symptom management among AABCS.

Five Dimensions of Needs for Help: The Efficacy of a Technology-Based Intervention Among Asian American Breast Cancer Survivors.

Cancer survivors including Asian American breast cancer survivors have reported their high needs for help during their survivorship process. With the COVID-19 pandemic, the necessity of technology-based programs to address their needs for help without face-to-face interactions has been highlighted. The purpose of this randomized intervention study was to determine the efficacy of a technology-based program in reducing various types of needs for help among this specific population. This was a randomized clinical trial with repeated measures. A total of 199 participants were included in the data analysis. The recruitment settings included both online and offline communities/groups for Asian Americans. The needs for help were assessed using the Support Care Needs Survey-34 Short Form (SCNS) subscales measuring psychological, information, physical, support, and communication needs. Data analysis was conducted through an intent-to-treat approach. In the mixed effect models, psychological needs, information needs, physical needs, and communication needs decreased over time (P < .001). However, there were no significant group * time effects. Social support significantly mediated the effects of a technology-based intervention on psychological, information, and support needs at the pre-test and the post-1month. This study supported significant decreases in the needs for help of Asian American breast cancer survivors by a technology-based intervention. Further studies are needed with other racial/ethnic groups of cancer survivors to confirm the efficacy of a technology-based intervention in reducing cancer survivors' needs for help during their survivorship process.

Abstract LB150: The effect of a technology-based intervention on various needs for help among Asian American breast cancer survivors

Abstract Purpose: Asian American breast cancer survivors reportedly have high needs for help during their cancer survivorship process. Especially, the recent COVID19 pandemic with Anti-Asian racism exacerbated their situation with lack of information and support. To address their needs for help, there is a clear necessity for an innovative method of delivering information and coaching/support mainly due to their cultural stigma attached to breast cancer. A technology-based approach would work well for this specific population because of non-face-to-face interactions. Thus, a technology-based information and coaching/support program was developed based on the Bandura’s self-efficacy theory and pilot-tested among this specific population. In this study, the effect of the technology-based program was examined on various needs for help among a larger group of Asian American breast cancer survivors. Methods: This study used a randomized clinical trial design with repeated measures. The study included 199 participants who were recruited through both online and offline communities/groups for Asian Americans. With multiple measurement scales related to background characteristics and theory-based mediators, the Support Care Needs Survey-34 Short Form (SCNS) was used to measure various needs for help. The SCNS included five subscales on psychological, information, physical, support, and communication needs. Data were analyzed using an intent-to-treat approach and mediation analyses. Results: All types of needs except support needs decreased over time (p &amp;lt; .001). However, there were no significant group * time effects. Among all the theory-based mediators, only social support significantly mediated the effects of the program on psychological, information, and support needs at the pre-test and the post-1 month. Conclusions: This study supported significant effects of the technology-based program on various needs for help among Asian American breast cancer survivors. Future research needs to be conducted with other racial/ethnic minority groups of cancer survivors to confirm the findings reported in this presentation. Citation Format: Eun-Ok Im, Wonshik Chee, TICAA Research Team. The effect of a technology-based intervention on various needs for help among Asian American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB150.

Risk Groups by the Needs for Help: Asian American Breast Cancer Survivors.

To supply proper and sufficient information and coaching through cancer education, it is important to decide who are risk groups among a target population. A decision tree analysis could help decide the characteristics of the risk groups. This study aimed to identify the combined characteristics of Asian American breast cancer survivors that were closely linked to high needs for help during their breast cancer survivorship process. The data on the needs for help among 185 Asian American breast cancer survivors from a parent clinical trial were included in this analysis. The instruments included the Supportive Care Needs Survey-Short Form 34 (SCNS-SF34) and multiple scales to measure the factors influencing the women's needs for help. The data were analyzed using latent profile analyses and decision tree analyses. The characteristics of the group with the highest needs for help were different depending on the types of needs. For instance, the group with the highest patient care/support needs for help score had high global symptom distress scores (cut point = 2.25) and high physical symptom distress (cut point = 1.57) and did not have regular access to health care (mean = 95.00; node 10). The findings suggest several risk groups to target in future interventions for cancer education to reduce the needs for help among this specific population. Multiple factors that could influence the needs for help among Asian American breast cancer survivors need to be considered in future intervention development for cancer education.

Changes in Symptom Clusters Among Asian American Breast Cancer Survivors in Technology-Based Coaching Intervention.

Limited research studies have focused on examining the impact of technology-based interventions in changing symptom clusters among Asian American breast cancer survivors. The aim of this study was to understand the longitudinal impact of a technology-based program on the symptom cluster experience of Asian American breast cancer survivors. This is a secondary data analysis that used exploratory factor analysis at each time point (baseline, post-1 month, post-3 months) for the control and intervention groups (N = 199). The number of symptom clusters remained the same, and the same symptoms remained in similar clusters across the 2 groups. The control group experienced psychological cluster, fatigue cluster, and neck/skin cluster at baseline; psychological cluster, fatigue/dizzy cluster, and neck/skin cluster at post-1 month; and psychological cluster, fatigue/dizzy cluster, and somatic cluster at post-3 months. The intervention group experienced psychological cluster, neck cluster, and appetite/itching cluster at baseline; somatic/anticholinergic cluster, psychological/sexual cluster, and appetite cluster at post-1 month; and psychological cluster, neck cluster, and itching cluster at post-3 months. The psychological and neck clusters shared similar core symptoms of feeling nervous, dry mouth, and cough between the control and intervention groups. The different symptom cluster experiences may be due to the technology-based intervention where the intervention group receives individual/group coaching/support that may have changed symptom clusters over time. Yet, the true efficacy of the intervention on symptom clusters warrants further investigation. Clinicians should understand the changes in symptom clusters as well as the presence of core symptoms and take a targeted symptom cluster approach in clinical settings.

Abstract B075: Developing a population-based study of South Asian American breast cancer survivors in New Jersey

Abstract Background: South Asian Americans (SAA) are the largest Asian American subgroup in New Jersey (NJ). Breast cancer is a growing health concern among SAA women, who tend to have young age at onset, regional or distant stage disease, and triple negative subtype. However, there is limited health and genetic data from these women to gain fruitful insights into the drivers of their adverse disease characteristics. Purpose: To address the breast cancer-related data gap among SAA women, we recently launched the Cancer Analytics and South Asian Health – Breast Cancer (CANSAH-BC) Study at Rutgers University. This ongoing study is designed to evaluate the impact of lifestyle, reproductive, medical, and germline genetic factors on tumor characteristics and health-related quality-of-life among SAA women. Here, we describe our recruitment and data collection methods, and summarize the characteristics of participants who have completed the study. Methods: We are partnering with the NJ State Cancer Registry (NJSCR) to recruit SAA breast cancer survivors. Eligible women are those identified as SAA by NJSCR, diagnosed with malignant breast cancer in 2018-2020, and age 18-80 years at diagnosis. We are using a validated structured questionnaire to collect data on lifestyle, reproductive, family history, and medical factors, breast cancer treatment history, and health-related quality of life. We are sending saliva sampling kits with a return postage pre-paid envelope to participants, who return their saliva samples to be stored for future genetic studies. To demonstrate feasibility of recruitment and data collection, we are conducting the pilot phase of the CANSAH-BC study with a target sample size of 100 participants. We started the pilot phase in English language and are currently expanding to other South Asian languages. Results: As of May 2023, NJSCR identified 375 eligible women, among which 119 (32%, 95% confidence interval (CI): 27.0% - 36.7%) agreed to participate. Initial contact by NJSCR began in September 2022 and is continuing. Data collection began in December 2022 and has been completed from 26 (22%) of 119 women. Data collection from the remaining participants is underway. Of the 26 participants, 25 (96%, 95% CI: 80.4% - 99.9%) provided a saliva sample. The average age at diagnosis of breast cancer in the 26 participants is 50.9 (SD = 11.8) years, 10 (38%) have at least one family member with breast cancer, 23 (88%) were born in a South Asian country and moved to the U.S. at an average age of 29 years, 7 (27%) have a history of hypertension, and 21 (81%) are either overweight or obese. Conclusion: Our preliminary study showed a relatively high participation rate in the saliva sample component of the CANSAH-BC study. The data suggest evidence of family history of breast cancer, hypertension, overweight or obesity among SAA women with a high percentage first-generation immigrants. This ongoing study represents a unique resource to better understand the drivers of adverse prognosis among South Asian American women diagnosed with breast cancer. Citation Format: Tina Dharamdasani, Prachi Trivedi, Nur Zeinomar, Bo Qin, Lisa Paddock, Antoinette Stroup, Gregory Riedlinger, Shridar Ganesan, Hao Liu, Anita Y. Kinney, Elisa V. Bandera, Jaya M. Satagopan. Developing a population-based study of South Asian American breast cancer survivors in New Jersey [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B075.

A Decision Tree Analysis on Symptom Experience of Asian American Breast Cancer Survivors.

Mainly due to their cultural attitudes toward symptoms and breast cancer, Asian American breast cancer survivors tend to suffer from symptoms and often delay in getting treatments, information, and support. To improve their symptom management, it would be important to determine risk groups among them. Decision tree analyses reportedly help determine risk groups by identifying the characteristics that are directly associated with target health outcomes. Using a decision tree analysis, this study aimed at identifying the characteristics that were closely linked to the symptom experience of Asian American breast cancer survivors. This was a part of a parent randomized controlled trial among Asian American breast cancer survivors. Only the data from 135 women at the pre-test were included. Multiple instruments were used to collect the data: the Memorial Symptom Assessment Scale-Short Form, the Cancer Behavior Inventory, the PRQ-2000, the Perceived Isolation Scale, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using latent profile analysis and decision tree analyses. Two most frequently found profiles included the low symptom experience profile (72.6%) and the high symptom experience profile (27.4%). The high symptom experience profile was predicted by 2 combined characteristics; (a) high psychological needs for help (over 60.00 points), and (b) low psychological needs for help (cut point = 60.00), high perceived barriers (cut point = 1.62), and high social isolation (social support) (cut point = 2.33). These characteristics linked to Asian American breast cancer survivors with high symptom experience need to be considered in future intervention development.

A qualitative exploration of the continuum of help-seeking among Asian American breast cancer survivors

ABSTRACT Breast cancer rates among Asian American women are increasing. Despite this, there are limited studies on help-seeking among this population. Through a qualitative exploration, this paper examines the help-seeking experiences of Asian American breast cancer survivors. Asian American women (n = 52) with early-stage breast cancer were interviewed. Findings illustrate a continuum of experiences including: keeping diagnosis personal and not asking for help, keeping diagnosis personal but asking for limited help, and sharing diagnosis and seeking support. Results indicate that seeking support is a complex process for Asian Americans with breast cancer, with implications for survivorship and quality of life.

Immigration Transition and Symptom Distress Changes by a Technology-Based Intervention: Asian American Breast Cancer Survivors.

Technology-based programs using computers and mobile devices are known to be effective in providing information and support to marginalized populations including immigrants. Yet, little is still known on the factors that may influence the effectiveness of technology-based programs in improving symptom experience, including immigration transition, especially among Asian American breast cancer survivors. This study aimed to identify the characteristics related to immigration transition that significantly affected the symptom distress changes by a technology-based information and coaching/support program among Asian American breast cancer survivors. This secondary analysis was conducted with the data from 102 Asian American breast cancer survivors from a randomized clinical trial in progress. Multiple instruments were used: the questions on background characteristics and immigration transition and the Memorial Symptom Assessment Scale-Short Form. The data were analyzed using repeated-measurement analyses and decision tree analyses. The mean changes in the symptoms distress scores were as follows: -0.12 (SD, 0.47) in the Global Distress Index scores; -0.08 (SD, 0.43) in the physical symptom distress scores; and -0.15 (SD, 0.65) in the psychological symptom distress scores. The characteristics with the highest impact on the symptom distress score changes included the immigration age for Global Distress Index and physical symptom distress score and the level of acculturation for psychological symptom distress score.

Abstract LB145: The relationship of socio-behavioral factors to the symptom experience of Asian American breast cancer survivors: a structural equation model

Abstract Background: Despite an increasing number of studies among breast cancer survivors, little is known about how socio-behavioral factors influence the symptom experience of racial/ethnic minority breast cancer survivors, especially Asian American breast cancer survivors. The identified socio-behavioral factors could give directions for development of unique intervention components that are tailored to a specific population in needs. Purpose: This study examined the relationship of multiple socio-behavioral factors including attitudes, perceived barriers, social influences, and self-efficacy to the symptom experiences of Asian American breast cancer survivors. Methods: This secondary analysis was conducted using data collected from 195 Asian American female breast cancer survivors. Subjects were recruited from January 2017 to June 2020 through online and offline communities and groups. The study variables were measured using validated instruments such as the Questions on Attitudes, Self-Efficacy, Perceived Barriers, and Social Influences (QASPS); the Cancer Behavior Inventory (CBI); and the Memorial Symptom Assessment Scale-Short Form (MSAS-SF). The hypothetical model was built based on Bandura’s self-efficacy theory. Mediation analysis was conducted using structural equation modeling with SPSS version 26.0 and Amos 28. Results: The overall fitness of the hypothetical model to the data was acceptable (χ2=51.36, p&amp;lt;.001, the goodness of fit index [GFI] = .95, adjusted GFI [AGFI] = .89, comparative fit index [CFI] = .96, Tucker-Lewis index [TLI] = .94, normed fit index [NFI] = .94, and root mean square error of approximation [RMSEA] = .08 Attitude and perceived barrier and social influence had a significant direct effect on self-efficacy (direct effect, β = 0.247, p =.003; β = -0.552, p =.003; β = 0.241, p =.002, respectively). Attitudes indirectly influenced symptom distress scores through self-efficacy (β =-0.054, p = .019). Perceived barriers had a significant direct effect (β = 0.605, p=.003), indirect effect (indirect effect, β = 0.121, p =.024), and a total effect on symptom distress scores (total effect, β = 0.726, p =.004). In addition, social influence had an indirect effect on symptom distress scores through self-efficacy (β = -0.053, p = .017) Conclusions: The findings supported that the self-efficacy for coping had a mediating effect on their symptom experience among Asian American breast cancer survivors as well as identified meaningful associations with attitudes, perceived barriers and social influences and symptom experience. Future research and practice should consider socio-behavioral factors, especially self-efficacy, in symptom management of Asian American breast cancer survivors. Acknowledgments: The parent study was funded by the National Institutes of Health (NCI/NINR; 1R01CA203719). Citation Format: Seo Yun Kim, Heejung KIM, Wonshik Chee, Eun-ok Im. The relationship of socio-behavioral factors to the symptom experience of Asian American breast cancer survivors: a structural equation model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB145.

Abstract LB147: The mediating effects of socio-behavioral factors on the needs for help among Asian American breast cancer survivors

Abstract Background: Breast cancer survivors often report their high needs for help during the transition to cancer survivorship. During the COVID-19 pandemic, technology-based programs are increasingly popular because of their high flexibility and accessibility in delivering information and coaching/support to address the current needs for help among cancer survivors. Yet, little is known about how socio-behavioral factors influence the effects of a technology-based intervention on the needs for help of racial/ethnic minority breast cancer survivors, especially Asian American breast cancer survivors. Purpose: The purpose of this secondary analysis was to examine the multiple socio-behavioral factors (including attitudes, self-efficacy, perceived barriers, and social influences related to breast cancer survivorship) mediated the effects of a technology-based intervention on the needs for help among Asian American breast cancer survivors. Methods: This analysis was conducted with the data from 199 Asian American breast cancer survivor women who were recruited from January 2017 to June 2020 through online and offline communities/groups. The needs for help were measured using the Support Care Needs Survey-34 Short Form (SCNS) with five domains on psychological, information, physical, support, and communication needs. Mediation analysis was conducted using the PROCESS macro within SPSS. The analysis determined the mediating effects of four socio-behavioral mediators on the needs for help at pre-test [T0], post 1-month [T1], and post 3-months [T2] of a technology-based intervention. Results: Overall, all the mediators had statistically significant mediation effects on all types of needs for help (p &amp;lt; .05) at different points. Attitudes and social influence presented statistically significant mediation effects on the total needs for help score over 3 months (T0, T1, and T2). Perceived Barriers had mediation effects on all types of needs for help over 1 month (T0, T1). Self-efficacy mediated the effects on all types of needs for help only at post 1 month (T1). Conclusions: The findings supported that all the socio-behavioral factors (attitudes, self-efficacy, perceived barriers, and social influences) mediated the effects of a technology-based intervention on the needs for help of Asian American breast cancer survivors. Future research and practice should consider socio-behavioral factors to reduce their needs for help during their survivorship process Acknowledgments: The parent study was funded by the National Institutes of Health (NCI/NINR; 1R01CA203719). Citation Format: Seo Yun Kim, Eun-ok Im, Wonshik Chee, TICAA Research Team. The mediating effects of socio-behavioral factors on the needs for help among Asian American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB147.

The Characteristics of Asian American Breast Cancer Survivors with Low Quality of Life: a Decision Tree Analysis.

To provide appropriate and adequate information and support for Asian American breast cancer survivors, it would be essential to identify risk groups among them to target in future cancer education interventions. In this secondary analysis, the characteristics of risk groups within Asian American breast cancer survivors who had low quality of life were identified using a decision tree analysis. For this analysis, only the pre-test data of 185 women from a parent study were selected. Multiple instruments including the Functional Assessment of Cancer Therapy Scale-Breast Cancer (FACT-B) were used in the parent study. The data were analyzed using descriptive and inferential statistics and decision tree analyses. The decision tree analyses showed six combined characteristics associated with lower quality of life scores than the total mean quality of life scores. For instance, the women with lower quality of life scores (than the total mean quality of life scores) had high perceived barriers (cut point = 1.84), low self-efficacy for coping (cut point = 81.50), and high global symptom distress (cut point = 2.27). Also, the characteristics linked to the lowest quality life scores were different depending on the dimensions of the quality of life. The characteristics associated with the quality of life of Asian American breast cancer survivors need to be considered in future education programs for this specific population.

Illuminating Black, Hispanic, and Asian Women’s Breast Cancer-related Cognitive Impairment Symptom Experience: An Integrative Review

Background: Cancer-related cognitive impairment (CRCI) affects up to 75% of breast cancer survivors (BCSs). Biopsychosocial stressors contribute to CRCI. Thus, given the socioeconomic disparities and discrimination experienced by racial/ethnically minoritized women in the Unites States, it is important to understand how these women experience CRCI when diagnosed with breast cancer. Objective: To synthesize and evaluate published literature from 2000 to 2021 addressing the CRCI symptom experience throughout breast cancer survivorship for racial/ethnically minoritized women in the United States. Methods: Systematic search of PubMed, PsycINFO, CINAHL, Google Scholar, Embase, and Scopus and review following Whittemore and Knafl’s methodology. Results: Of 970 identified articles, 13 were included. Literature primarily focused on Black BCSs. Black and Hispanic BCSs were more likely than White BCSs to experience cognitive impairment pre- and postchemotherapy. Black BCSs consistently perceived greater CRCI than White BCSs contributing to overall symptom burden and challenging quality of life. Conclusions: Studies describing the CRCI experience of Black, Hispanic, and Asian American BCSs are limited with few focused on CRCI as the primary variable of interest, delineating minoritized women’s data from others’, or assessing via neurological batteries or brain imaging, pointing to gaps in this field. Implications for Practice: Health practitioners should assess Black, Hispanic, and Asian BCSs for CRCI throughout their cancer trajectory and intervene to reduce the contribution of co-occurring symptoms and institutional racism to CRCI. What is Foundational: This review identifies knowledge gaps and limitations in the existing body of evidence to support future research on CRCI among Black, Hispanic, and Asian BCSs.

Abstract CT512: A technology-based intervention using computers and mobile devices: To improve symptom experience of Asian American breast cancer survivors

Abstract Purpose: Especially with the COVID19 pandemic, the necessity of technology-based interventions using computers and mobile devices has increased in cancer survivorship management including symptom management. However, little is known about the effectiveness of a technology-based intervention in improving symptom experience of racial/ethnic minorities including Asian American breast cancer survivors. The purpose of this study was to examine the efficacy of a technology-based intervention in improving symptom experience of Asian American breast cancer survivors. Methods: This study was conducted as a part of an ongoing randomized clinical trial among 199 Asian American breast cancer survivors. The technology-based intervention included three sub-ethnic specific social media sites, interactive online educational sessions, and online resources. Both groups (intervention and control groups) used the American Cancer Society’s website on breast cancer, and only the intervention group used the technology-based intervention. Only the data collected using the questionnaire on background characteristics and health/disease status and the Memorial Symptom Assessment Scale-Short Form (MSAS) were analyzed for this study. The data were analyzed using separate intent-to-treat growth curve models. Results: While both groups reported decreases in symptom scores from the pre-test to post 3-months (p&amp;lt;.01), the intervention group had larger decreases in symptom scores compared with the control group (p&amp;lt;.01). There existed significant group * time interactive effects on the Global Distress Index (β = - 0.234), the Physical Symptom Distress scores (β = -0.266), the psychological symptom distress scores (β = - 0.212c), the total number of symptoms (β = -0.261), and the total symptom distress scores ( β = -0.261). Conclusions: The findings of this study clearly indicated symptom improvement among Asian American breast cancer survivors by a technology-based intervention using computers and mobile devices. Further studies with diverse racial/ethnic minorities are warranted to confirm the effectiveness of technology-based interventions in improving symptom experience of cancer survivors across different types of cancer. Citation Format: Eun-Ok Im, Gayeong Kim, Ruiqi Jin, Mi-Yong Choi, Sudeshna Paul, Wonshik Chee. A technology-based intervention using computers and mobile devices: To improve symptom experience of Asian American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT512.

Abstract 5881: The efficacy of a technology-based support program on survivorship experience: Asian American breast cancer survivors

Abstract Purpose: A technology-based intervention without face-to-face interactions could work better for many women from cultures where breast cancer is still a stigmatizing experience. Also, a technology-based intervention could meet the necessity of information and support without time and/or geographical restrictions. The purpose of this study was to test the efficacy of a technology-based support program for Asian American breast cancer survivors (TICAA) in enhancing the women’s breast cancer survivorship experience. Methods: This was a randomized controlled intervention with repeated measures (pretest [Time Point 0; T0], post 1-month [T1], and post 3-months [T2]). A total of 199 Asian American breast cancer survivors were recruited/retained through online and offline settings and included in the data analysis. While the intervention group was requested to use the TICAA and the American Cancer Society (ACS) website on breast cancer for 3 months, the control group was requested to use the ACS website for 3 months. Multiple instruments were used: the Cancer Behavior Inventory (CBI), the Personal Resource Questionnaire (PRQ), the Perceived Isolation Scale (PIS), the Support Care Needs Survey-34 Short Form (SCNS), the Memorial Symptom Assessment Scale-Short Form (MSAS), and the Functional Assessment of Cancer Therapy Scale-Breast Cancer (FACT-B). The data were analyzed using growth curve models, fitted within the framework of mixed effects modeling, and mediation analyses. Results: Within the mixed-effect model, there were significant decreases in the needs for help scores (SCNS scores) from T0 to T2 (β = -3.0236, p = .005) and the symptom distress scores (MSAS scores) from T0 to T1 and T2 (β = -2.8131, p &amp;lt; .001; β = -3.0356, p &amp;lt; .001). Yet, the change over time in the quality-of-life scores (FACT-B scores) was not statistically significant although the fixed effect of time was significant (β = -1.0476, p = .004). All the theory-based mediators (attitudes, self-efficacy, perceived barriers, and social influences) had statistically significant mediating impact on all outcome variables (needs for help, symptom distress, and quality-of-life; all p &amp;lt; .001), but there were differences in the mediating effects among different individual outcome variables. Conclusions: The findings supported the efficacy of the technology-based program in reducing the need for help and symptoms of Asian American breast cancer survivors. Further studies are needed on the differences in the effects of theory-based mediators on different outcome variables. Citation Format: Eun-Ok Im, Wonshik Chee, Sudeshna Paul, TICAA Research Team. The efficacy of a technology-based support program on survivorship experience: Asian American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5881.

The Preliminary Efficacy of a Technology-Based Cancer Pain Management Program Among Asian American Breast Cancer Survivors

Chee, Wonshik PhD; Lee, Yaelim PhD, MSN, RN; Ji, Xiaopeng PhD, MSN, RN; Chee, Eunice BSE; Im, Eun-Ok PhD, MPH, RN, CNS, FAAN Author Information

Characteristics of Asian-American Breast Cancer Survivors Retained in a 3-Month Technology-Based Intervention.

Technology-based intervention programs are known to be effective in approaching socially excluded groups or racial/ethnic minorities, including this specific population. However, the retention of participants in technology-based intervention studies is far more complicated and challenging compared with conventional studies targeting racial/ethnic minorities. This study aimed to identify the complex characteristics of the groups within Asian American breast cancer survivors who were successfully retained in a 3-month technology-based intervention study. This secondary analysis of the data from a larger ongoing intervention study included 155 Asian American breast cancer survivors. Major variables were measured using multiple instruments including the questions on characteristics of the participants, the Personal Resource Questionnaire, perceived isolation, Memorial Symptom Assessment Scale-Short Form, Cancer Behavior Inventory, 34-item Supportive Care Needs Survey Short Form, and Functional Assessment of Cancer Therapy Scale-Breast Cancer. Data analyses were done through χ2 tests, t tests, and decision tree analyses. The retention rates differed by subethnicity (P = .025), immigration age (P < .001), and stage of breast cancer (P = .003). The decision tree indicated four groups with the highest probability of retention: (a) those who were diagnosed with stage II, III, or IV breast cancer, (b) those who immigrated to the United States after turning 31 years old, and (c) those who had high perceived barriers. This study provides directions for future retention strategies for technology-based interventions among Asian American breast cancer survivors. Participants' characteristics need to be considered in developing retain strategies for technology-based interventions among Asian American breast cancer survivors.

Lessons from a Customer Discovery Study: a Technology-Based Cancer Support Program for Asian American Breast Cancer Survivors.

A culturally tailored technology-based cancer support program was recently developed and tested among Asian American breast cancer survivors. To explore future opportunities to sustain the program, the research team participated in the SPeeding Research-tested INTervention (SPRINT) program sponsored by the National Cancer Institute. The purpose of this discussion paper is to share the lessons that the research team gained from a customer discovery study through the SPRINT program. During the SPRINT program, a total of 73 stakeholders were recruited through a snowball sampling across the globe. Semi-structured interviews were conducted for customer discovery through WebEX, phone calls, and in-person visits (50 in-person interviews, 4 phone interviews, and 19 WebEx interviews). All the interviews were recorded using audio-taping or writing memos. Also, the research team wrote memos on the issues/concerns related to the project during the interview process. Then, the transcripts and memos were analyzed using a content analysis to provide evidence for the lessons. The themes reflecting the lessons from the customer discovery study included (a) "who are the stakeholders"; (b) "depending on stakeholders"; (c) "what works or not"; (d) "personal versus family responsibilities"; and (e) "depending on countries' situations." These lessons could provide directions for future development and implementation of technology-based cancer support programs for Asian American breast cancer survivors.

A Decision Tree Analysis on the Impact of a Technology-Based Program on Symptom Distress: Asian American Breast Cancer Survivors.

Using a decision tree analysis, this study aimed to identify the characteristics of the groups within Asian American breast cancer survivors whose symptom distress scores were effectively improved by a technology-based program. This was a secondary analysis of the data from an ongoing randomized controlled trial among 115 Asian American breast cancer survivors. The instruments were questions on background factors; the Memorial Symptom Assessment Scale-Short Form; the Cancer Behavior Inventory; the Questions on Attitudes, Subjective Norm, Perceived Behavioral Control, and Behavioral Intention; and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using chi-square tests, t tests, repeated measurement analyses, and decision tree analyses. The decrease in the global distress index scores was the largest (1.253 points) among those with high psychological support needs. The decrease in the physical symptom distress scale scores was the largest (1.133 points) among those with high physical and daily living support needs who had a short US residence period and who were young. The decrease in the psychological symptom distress scores was the largest (1.511) among those with high psychological support needs. The findings suggest several characteristics of the groups within Asian American breast cancer survivors whose symptom distress could be highly improved by a technology-based intervention.

Survivorship Care Plan Preferences and Utilization Among Asian American Breast Cancer Survivors.

The survivorship care plan (SCP) is an individualized document with cancer diagnosis, treatment, surveillance, and health promotion recommendations. This integrative review synthesizes the extant literature to understand preferences and utilization of SCPs among Asian American survivors. The CINAHL®, Embase®, PsycINFO®, and PubMed® databases were searched for articles about Asian American women with breast or cervical cancer and SCPs. Two independent reviewers evaluated 481 titles and abstracts according to inclusion and exclusion criteria. Of those 481 titles and abstracts, 14 articles were selected for inclusion. There was little evidence surrounding utilization of SCPs. Articles identified addressed only survivors of breast cancer, predominately of Southeast Asian descent. Asian American women with breast cancer reported preferences surrounding their survivorship needs. Barriers to delivery of the SCP were related to socioeconomic factors. There is a paucity of information guiding evidence-based delivery of SCPs in the vastly heterogenous population of Asian American survivors. More work is needed to provide high-quality care to these survivors.