Latino Cancer Survivors Research Articles

Abstract B021: Adaptation and feasibility of a Spanish language nutrition and physical activity online intervention for rural-dwelling Latinos with obesity-related chronic diseases

Abstract Methods of providing nutrition and physical activity (PA) education for individuals with obesity-related chronic illnesses can be difficult to address in a primarily agricultural region where seasonal work schedules, limited medical resources, and geographical distances are significant barriers. To examine the feasibility of a program using online live Zoom-delivered sessions and text messaging in such a setting, we adapted an evidence-informed in-person intervention previously shown to be effective in urban Latino cancer survivors. Nineteen Spanish-speaking Latino women and one man were recruited to a single-arm intervention. Over 3-months, the intervention delivered 6 biweekly 2-hour interactive sessions led by a community health educator and a trained chef plus 4 text messages per week focused on nutrition and PA. All participants were given a Fitbit for self-monitoring PA and access to the Cook for Your Life bilingual website, which provides health recipes for cancer survivors. Preliminary assessments occurred using a pre-post study design. Sixty-five percent of the sample completed at least half of the sessions, 95% completed the data collection and found the check-in phone calls somewhat or very helpful. 100% indicated the live interactive educational sessions and the text messages were somewhat or very helpful. Eighty-four percent of participants found the FitBits and 63% found the website useful. Preliminary outcomes, significant lessons learned, and adaptations implemented accommodate the rural setting and online format, insights gained by participants during an exit interview, and implications for future research such as the exclusive use of smart phones to engage in the intervention, will be discussed. Citation Format: Rachel M. Ceballos, Sofia Cobos, Eileen Rillamas-Sun, Oscar Sanchez, Jayleen Ceja, Genoveva Ibarra, Allison Silverman, Katherine Guthrie, Heather Greenlee. Adaptation and feasibility of a Spanish language nutrition and physical activity online intervention for rural-dwelling Latinos with obesity-related chronic diseases [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B021.

Overcoming Disparities in Cancer: A Need for Meaningful Reform for Hispanic and Latino Cancer Survivors.

Hispanic and Latino (HL) cancer survivors are at a critical disadvantage compared with non-Hispanic White (NHW) patients regarding sociodemographic adversities and access to equitable treatment options. By 2030, there will be about four million HL cancer survivors in the U.S., representing nearly 20% of survivors in this country. Hispanics and Latinos are subjected to significant challenges in accessing and receiving equitable care relative to NHWs. Hispanics and Latinos also experience lower rates of health insurance and financial resources, limiting health care options. These disparities often originate from disparate social determinants of health, including lower funding for education and school programs, greater neighborhood stressors and violence, lower access to healthy and affordable food, and greater barriers to community health and exercise opportunities. Even among HL cancer survivors with proper access to health care, they experience disparate treatment options, including low inclusion in clinical trials and/or access to experimental therapies. A solution to these barriers necessitates complex and systemic changes that involve, for example, investing in public health programs, increasing the diversity and cultural awareness of the medical workforce, and promoting research opportunities such as clinical trials that are inclusive of HLs. Only through meaningful reform will equitable cancer care be available for all in the U.S. regardless of racial and/or ethnic background. This article reviews some of the critical social determinants of health and biases relevant to HL cancer survivors and provides recommendations for achieving cancer health equity. IMPLICATIONS FOR PRACTICE: Hispanics and Latinos experience a significant and often disproportionate cancer-related burden compared with non-Hispanic and Latino White individuals and other racial and ethnic groups. Meaningful reform to achieve health equity in oncology should focus on approaches to gaining trust among diverse patients, cultural and community sensitivity and engagement in oncology care and research, diversifying the workforce, and improving inclusion in clinical trial participation. Taken together, these recommendations can lead to exemplary and equitable care for all patients.

Abstract PO-120: Differences in health-related quality of life outcomes for Latino versus non- Latino cancer survivors participating in 16-week holistic pilot intervention

Abstract Introduction: A cancer survivor’s health-related quality of life (HR-QOL) can be conceptualized as the state of the physical, mental, and spiritual aspects that define a human being. Interventions to improve health related quality of life need to address all three of these components. In addition, there may be differences in how interventions can best be applied for different groups that suffer cancer related health disparities such as Latinos, the fastest growing demographic in the U.S. The purpose of this secondary analysis is to understand differences in how a holistic intervention impacts HR-QOL in Latino cancer survivors as compared to non-Latino cancer survivors. The analysis assesses HR-QOL before, during, and at the conclusion of a holistic pilot intervention for 29 adult cancer survivors in San Antonio Texas. Methodology: Using a retrospective cohort design, we will analyze the association between Latino ethnicity and outcome among participants of a 16-week pilot holistic intervention. The parent study is a pilot feasibility study, consisting of a sample size of 29 adult cancer survivor participants, with any diagnosis of cancer at any stage of treatment. The intervention consists of group yoga-meditation, individualized exercise, diet guidance, and motivational text messages. Participants complete comprehensive assessments of HR-QOL outcomes (body, mind and spirit) using validated instruments and semi-structured interviews at the beginning, mid-way and at the end of 16 weeks. In this analysis we report only the quantitative results and not the interviews. We will report on the differences between Latinos and non- Latinos groups at baseline (week 0), mid-way (week 8) and at post (week 16) on HR- QOL in 2 × 3 analysis of variance (ANOVA). Results: This pilot study is nearly reaching completion of the 16-week active phase of the pilot. Baseline and mid analyses have been completed and currently under analyses. Data was collected on 11 Latino and 18 non-Latino adult survivors. The ‘post’ 16-week assessments are scheduled to be complete by 09/01/2020. We will analyze all the data collected at these three-time assessments reporting on the differences between both groups. Conclusions: Future research must critically review how interventions affect the individuals who participate and how to better meet their needs to improve their health outcomes in an overly strained public health system. With the presence of nearly 17 million cancer survivors in the U.S. today, and with Latino being the largest minority and 18% of the US population, it is increasingly important for survivorship research focused on maximizing HR-QOL for all cancer survivors. In this analysis we report on differences between Latinos/non-Latinos that participated in a 16-week holistic pilot. This data will inform future interventions targeting vulnerable disparate populations, such as Latino cancer survivors; ultimately eliminating unnecessary costs while reducing health disparities gap that continue in this country. Citation Format: Corina Zamora, Alexis Ortiz, Amelie G. Ramirez, Julissa Marin, Darpan Patel, Monica Serra, Tim Calderon, Bianca Gutierrez, Kelseia Hertzog, Nydia Darby, Angelika Lapetoda, Daniel C. Hughes. Differences in health-related quality of life outcomes for Latino versus non- Latino cancer survivors participating in 16-week holistic pilot intervention [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-120.

Abstract D102: Lower acculturation is associated with lower aerobic physical activity among recent Latino immigrant cancer survivors

Abstract Introduction: Latino cancer survivors engage in less physical activity than non-Latino cancer survivors. Previous research has shown that higher acculturation is associated with higher leisure-time physical activity among foreign-born Latinos. However, there is limited research on the association of acculturation with leisure-time aerobic and muscle-strengthening activity among foreign-born Latino cancer survivors, for whom the acculturation and physical activity association may be influenced by lifestyle changes related to cancer survivorship. Therefore, we examined whether acculturation was associated with aerobic and muscle-strengthening physical activity among Latino cancer survivors. Methods: We used cross-sectional data from the 2008-2015 National Health Interview Survey (n=1,293). Participants were individuals that self-identified as Latino, ≥20 years old, and not pregnant. Cancer diagnosis was assessed by the survey variable, “Ever told by a doctor you have cancer?” Nativity (US-born, foreign-born) and years living in the US (<10 years living in US, ≥10 years living in US) were used as proxies of acculturation. Aerobic physical activity was measured based on self-reported minutes of moderate-to-vigorous aerobic physical activity engaged in per week, then categorized into none, some activity, and meeting the aerobic activity guideline. Muscle-strengthening activity was measured based on self-reported frequency of muscle-strengthening activity per week, then categorized into meeting and not meeting the muscle-strengthening guideline. Cutoffs for meeting the aerobic and muscle-strengthening guidelines were based on the 2018 Physical Activity Guidelines for Americans. Logistic regression models were used to examine the association of acculturation with aerobic and muscle-strengthening activity among Latino cancer survivors. Models were adjusted for age, sex, education, and Hispanic subgroup. Results: Approximately 33% of the sample reported meeting the aerobic activity guideline, and 15% reported meeting the muscle-strengthening guideline. Foreign-born cancer survivors living in the US <10 years were significantly less likely to meet the aerobic physical activity guideline (Odds Ratio [OR]: 0.26, 95% Confidence Interval: 0.10-0.67) and to engage in some aerobic activity (OR: 0.38, 95% CI: 0.16-0.89), compared with US-born Latino cancer survivors. There was no significant association between acculturation and muscle-strengthening activity. Conclusion: Recent Latino immigrants with a history of cancer are less likely to engage in aerobic physical activity compared with their US-born counterparts. Research is warranted on the barriers to aerobic physical activity among recent Latino immigrant cancer survivors. Citation Format: Shreya Desai, Mariana Vazquez, Daphne C Hernandez, Lorraine R Reitzel, Rosenda Murillo. Lower acculturation is associated with lower aerobic physical activity among recent Latino immigrant cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D102.

Assessing the effect of patient navigator assistance for psychosocial support services on health-related quality of life in a randomized clinical trial in Latino breast, prostate, and colorectal cancer survivors.

BackgroundAfter a diagnosis of prostate, breast, or colorectal cancer, Latinos experience higher mortality rates and lower health‐related quality of life (HRQOL) in comparison with other ethnic/racial groups. Patient navigation (PN) and lay community health workers or promotores are effective in increasing cancer screening and early‐stage diagnosis among Latinos. However, little is known about the effect of PN on HRQOL among Latino cancer survivors.MethodsLatinos previously diagnosed with breast, prostate, or colorectal cancer (n = 288) were randomized to 1 of 2 conditions: 1) the Patient Navigator LIVESTRONG Cancer Navigation Services (PN‐LCNS) survivor care program or 2) PN only. HRQOL was measured with the Functional Assessment of Cancer Therapy–General, and cancer‐specific HRQOL was measured with the Functional Assessment of Cancer Therapy–Breast, the Functional Assessment of Cancer Therapy–Prostate, and the Functional Assessment of Cancer Therapy–Colorectal for breast, prostate, and colorectal cancer survivors, respectively, at the baseline and at 3 follow‐up time points. Generalized estimating equation analyses were conducted to estimate the effect of condition on HRQOL with adjustments for covariates and baseline HRQOL.ResultsPN‐LCNS demonstrated a significant improvement in HRQOL in comparison with PN only for colorectal cancer survivors but not for breast and prostate cancer survivors.ConclusionsEnhanced PN improves HRQOL among Latino colorectal cancer survivors. Future research should identify the best strategies for engaging Latino survivors in PN programs. PN programs should also be adapted to address HRQOL concerns among Latina breast cancer survivors.

EHealth Diet and Physical Activity Program for the Improvement of Health in Rural Latino Cancer Survivors

eHealth Diet and Physical Activity Program for the Improvement of Health in Rural Latino Cancer Survivors

Improving quality of life among latino cancer survivors: Design of a randomized trial of patient navigation

Latino cancer survivors have lower survival rates for most cancers relative to non-Latino whites, including, colorectal, prostate, and breast. In addition, Latinos experience health disparities in both access to care and quality of care. Experts recommend providing psychosocial services as an integral part of quality cancer care; however, there continues to be a paucity of information on the efficacy of Patient Navigators (PNs) in linking Latino cancer survivors to appropriate psychosocial services. Redes En Acción: The National Latino Cancer Research Network partnered with LIVESTRONG Cancer Navigation Services Patient Navigation program (PN-LCNS) to provide an intervention to improve wellness and increase access to psychosocial services among non-metastatic Latino cancer survivors from Texas and Chicago using trained bilingual, bicultural PNs. The study design involved a mixed-methods approach in two phases. Phase I used a Community-Based Participatory Research (CBPR) approach wherein PNs engaged community partners who provide services to breast, colorectal and prostate Latino cancer survivors. Phase II was a randomized controlled trial (RCT) that evaluated the efficacy of combining PN-facilitated interventions with the culturally tailored and CBPR-informed PN-LCNS in 300 breast, prostate and colorectal Latino cancer survivors. Outcomes investigated were improvements in: 1) quality of life (QOL), both general and disease-specific, and; 2) treatment follow-up compliance. While limited work has addressed the psychosocial needs of Latino cancer survivors, culturally-competent interventions using PNs have potential to address these needs and significantly improve Latino cancer survivorship.

Satisfaction with cancer care, self-efficacy, and health-related quality of life in Latino cancer survivors.

The objective of the current study was to examine how modifiable factors such as satisfaction with cancer care and self-efficacy impact health-related quality of life (HRQOL) among Latino cancer survivors. Latinos previously diagnosed with breast, prostate, or colorectal cancer (N = 288) completed questionnaires (Patient Satisfaction with Cancer Care Scale, Stanford Chronic Disease Self-Management Measures, Functional Assessment of Cancer Therapy-General, and Short Acculturation Scale for Hispanics) within 2 years after receiving primary cancer treatment. Path model analyses demonstrated that satisfaction with cancer care was associated with greater HRQOL and that this relationship was explained by several facets of self-efficacy (ie, confidence in managing psychological distress [z = 3.81; P<.001], social support from close others [z = 2.46; P = .014], social/recreational activities [z = 3.30; P = .001], and patient-provider communication [z = -3.72; P<.001]). Importantly, foreign-born, less acculturated, and monolingual Spanish-speaking survivors reported lower self-efficacy in patient-provider communication; however, adjusting for acculturation, language, nativity, and other covariates did not alter these results. Factors that contribute to disparities in HRQOL among Latino cancer survivors compared with non-Latino whites, such as low income, less education, and a lack of health insurance, can be difficult to address. The findings of the current study emphasize the importance of self-efficacy within the context of patient-centered cancer care practices (eg, patient inclusion in care decisions, sufficient time with provider, ready access to medical advice) and suggest that improving satisfaction with care may increase patients' confidence in managing important aspects of their cancer experience and, in turn, improve HRQOL among Latino cancer survivors. Cancer 2018. © 2018 American Cancer Society. Cancer 2018;124:1770-9. © 2018 American Cancer Society.

Interventions to Improve Quality of Life, Well-Being, and Care in Latino Cancer Survivors: A Systematic Literature Review.

Hispanic/Latino cancer survivors are at risk for increased psychosocial burden, in part, because of lower survival rates and lower quality of life (QOL) when compared with other populations. Despite this, very few interventional studies have been conducted in this population. This review synthesizes research on supportive care interventions to improve QOL, well-being, and cancer care in Hispanic/Latino cancer survivors. . Data sources included MEDLINE®, CINAHL®, and PsycINFO®. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was employed. . This review includes studies conducted with cancer survivors from diagnosis to survivorship and addresses any type of intervention for Hispanic/Latino survivors of all cancer types and sites. Studies were written in English and had a sample of at least 25% Hispanics/Latinos. Key study attributes were extracted and tabled. . Of the 15 studies reviewed, types of interventions included were psychosocial (n = 6), educational (n = 4), exercise/diet (n = 4), and navigational (n = 1). Most studies were pilot and feasibility studies, and nine were randomized, controlled trials (RCTs). . Interventional studies for Hispanic/Latino cancer survivors are at the very early stages of scientific development and are feasible and accepted by the Hispanic/Latino population. Culturally relevant psychosocial support and educational, exercise, and navigational interventions are beneficial for this population. . To advance the science, as the Hispanic/Latino population rapidly increases, a great need exists for additional research in this area. A theoretical basis for interventions is needed for development of additional research. Efficacy of culturally relevant supportive care interventions needs to be tested through RCTs, replication, and multisite studies. A need exists for these developing interventions to be translated into practice to improve QOL and well-being for Hispanic/Latino cancer survivors.

Abstract IA05: A GPS for cancer care: How patient navigation engages Latinos in preventing and reducing health disparities

Abstract Purpose: U.S. Latinos have higher rates of liver, cervical, and other cancers, have lower cancer screening rates, and are diagnosed at more advanced, less treatable cancer stages than non-Latinos. Community-based participatory research (CBPR) and patient navigation (PN) are emerging ways to tackle these grave disparities. Patient navigation is a means for providing access to recommended cancer screening services, follow-up, diagnosis, and treatment in medically underserved populations. Methods: Over several years, several CBPR-based PN programs and interventions have been implemented and evaluated among Latino cancer patients by the Institute for Health Promotion Research (IHPR) at the UT Health Science Center at San Antonio. Each of these IHPR projects starts with a community advisory group that identifies and assesses cancer health issues and needs. Based on that input, navigators from the community are selected and trained to help navigate underserved people through the complex care system and other barriers to care (finances, transit, child care, language, culture, etc.). The goal is to help reduce missed appointments, reduce delays in seeking care, increase follow-up care, and cover the entire ecological framework. The IHPR's main PN program is the Redes En Acción Six Cities Study, which was funded by the National Cancer Institute. The Six Cities Study formed a community advisory group, conducted a needs assessment, developed a PN program for minorities, and tested it in the Six Cities quasi-experimental study to evaluate the impact of patient navigation on Latinas' time from an abnormal mammogram to confirmatory breast cancer diagnosis and to initiation of treatment (within 30 and 60 days). The study recruited 425 women (208 navigated, 217 non-navigated controls). Results: The Redes En Acción Six Cities Study recruited 425 women (208 navigated; 217 non-navigated controls). Overall, navigated women achieved timely diagnosis significantly faster than non-navigated women. We also found that navigated women were much more likely (nearly 1.5x more likely) to initiate treatment tan non-navigated women. The PN activities most associated with treatment initiation were: accompaniment, transportation, telephone support, language, and system intervention. Conclusions: We suspect, based on evidence from other large studies of the rate of breast cancer growth and spread, that our CBPR-based PN intervention saved lives. Based on this success, the IHPR and Redes team has gone on to test PN in other studies: one hypothesizing that Latino breast, prostate, and colorectal cancer survivors who get an innovative navigation intervention (vs. usual care) will show greater compliance in following prescribed treatments and improved general and cancer-specific quality of life; one to teach breast cancer survivors how certain foods may reduce the risk of breast cancer recurrence as well as the risk of developing other cancers; and the creation of the Patient Navigator Manual: Developing and Implementing a Patient Navigator Program manual to outline the necessary steps and provides tools to incorporate navigation for Latinos at any organization. Citation Format: Amelie G. Ramirez. A GPS for cancer care: How patient navigation engages Latinos in preventing and reducing health disparities. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr IA05.

Abstract B07: Advocacy for an underserved minority: Patient navigation for Latino cancer survivors

Abstract Background: Latino cancer survivors experience an unequal burden of unmet needs following treatment. These include issues involving psychological issues, health care, wellness and ultimately, survival. Study Design: Redes En Acción: The National Latino Cancer Research Network and LIVESTRONG partnered to conduct a randomized control trial utilizing trained, bilingual, bicultural patient navigators to improve wellness and access to psychosocial services among non-metastatic Latino cancer survivors from Texas and Chicago. The trial tests the efficacy of patient navigation (PN) in improving general and disease-specific quality of life (QoL), treatment compliance, and identification of mechanisms that may promote quality of life. The study involves a 2 X 4 randomized repeated measures design with an experimental condition (combined PN over three months with access to the LIVESTRONG Cancer Navigation Center [LCNC] services [PN+LCNC]) versus a control condition (PN only) as the between-groups factor, and time-point (baseline/pre-randomization [T1]; post-PN [3-months post T1; T2], and 6 [T3] and 12 months [T4] follow up after T2) as the within groups factor. The unique combination of PN plus LCNC survivorship services is anticipated to show dramatic improvement in survivor-related measures. Results: LCNC provides free, bilingual support to U.S. cancer survivors throughout the cancer journey. It also refers survivors to services addressing their medical, economic and psychosocial needs, and monitors client contact and access outcomes. PN services are based on direct services provided by patient navigators, including but not limited to, securing transportation for clinic appointments, interpreting, completing complex medical forms, etc. Study implementation, needs assessment, community based participatory research, recruitment accrual to date, learned lessons, PN services offered, and referral to and effectiveness of the LCNC program and preliminary quality of life data analysis will be presented. Conclusions: Limited work has addressed the psychosocial needs of Latino cancer survivors. Culturally sensitive patient navigation (PN) could address these needs and significantly improve cancer survivorship. The results of the study will have immediate clinical relevance that could potentially highlight the importance of having patient navigators readily available to assist survivors within a clinic setting improving patients' overall health outcomes and screening compliance. Citation Format: Amelie Ramirez, Sandra L. San Miguel, Edgar Muñoz, Kip Gallion, Arely Perez, Leo Castillo, Sarah R. Arvey, Frank Penedo. Advocacy for an underserved minority: Patient navigation for Latino cancer survivors. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B07.

Abstract P1-09-22: Improving quality of life among Latino breast cancer survivors: A national randomized control trial of patient navigators using LIVESTRONG's Cancer Navigation Center

Abstract Purpose: Latina breast cancer survivors experience an unequal burden of unmet needs after treatment, which compromise their health care and wellness, experts recommend providing psychological services as an integral part of quality cancer care. Methods: Redes En Accion: The National Latino Cancer Research Network and LIVESTRONG partnered to conduct a randomized control trial utilizing trained, bilingual, bicultural patient navigators to improve wellness and access to psychosocial services among non-metastatic Latino breast cancer survivors from Texas and Chicago. The trial tests the efficacy of patient navigation (PN) in improving general and disease-specific quality of life (QoL), treatment compliance, and identification of mechanisms that may promote quality of life. The study involves a 2 X 4 randomized repeated measures design with an experimental condition (combined PN over three months with access to the LIVESTRONG Cancer Navigation Center [LCNC] services [PN+LCNC]) versus a control condition (PN only) as the between-groups factor, and time-point (baseline/pre-randomization [T1]; post-PN [3-months post T1; T2], and 6 [T3] and 12 months [T4] follow up after T2) as the within groups factor. LCNC provides free, bilingual support to U.S. cancer survivors throughout the cancer journey. LCNC also refers to survivors to services addressing their medical, economic and psychosocial needs, and monitors client contact and access outcomes. Preliminary Results: A total of 128 Latina women with early stage breast cancer have been randomized into either our control (Standard Patient Navigation; PN) or our experimental (Enhanced Patient Navigation; EPN) conditions. Complete data for multiple regression analysis on 76 randomized Latina women who completed baseline and first follow up assessment is available. At baseline, we identified major stated needs by our participants. These included fear of recurrence, more information regarding their disease, and assistance in communicating with the medical team. The top three physical functioning concerns stated by our participants included lack of energy/fatigue, interference with daily routines and poor physical well-being. Consistent with prior work with Hispanic cancer survivors, our sample reported significantly lower (over 1.5 standard deviation below) general health related quality of life, physical well-being and emotional well-being as measured by the FACT-G. Exploratory analyses have begun to reveal that there are several significant moderators of the effects of the intervention across several outcomes. At conference, we will present quality of life data on breast cancer participants, exploratory analysis, and lessons learned. Discussion: Limited work has addressed the psychosocial needs of Latina breast cancer survivors. Culturally sensitive patient navigation (PN) could address these needs and significantly improve breast cancer survivorship. Citation Format: Amelie G Ramirez, Edgar Muñoz, Sandra San Miguel, Kip Gallion, Arely Perez, Leo Castillo, Sarah R Arvey, Frank Penedo. Improving quality of life among Latino breast cancer survivors: A national randomized control trial of patient navigators using LIVESTRONG's Cancer Navigation Center [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-22.

Design, development, and feasibility of a spanish-language cancer survivor support group.

Latino cancer survivors experience lower psychosocial well-being compared to non-Latino Whites. This study describes the development of a culturally appropriate support group and reports on feasibility of implementation and preliminary outcomes. Promotores (lay health workers) conducted all aspects of data collection and program implementation. Participants were 29 Spanish-speaking Latino cancer survivors (n = 12 men, 17 women) who took part in one of three study phases. Phase 1 included one-on-one interviews and focus groups (n = 14) to investigate psychosocial needs of survivors. During phase 2, a 10-week program was developed that integrated data from phase 1 and culturally relevant concepts. Session topics included stress, nutrition, physical activity, body image, sexuality, medical advocacy, and social support. In phase 3, the program was implemented within gender-specific groups (n = 15). Within-group pre-post comparisons of distress (distress thermometer, salivary cortisol) and quality of life (FACIT) were conducted. Follow-up focus groups assessed participant experience Phase 1 activities identified survivor needs and interests (e.g., isolation, family and spirituality, supporting other Latinos with cancer). Evidence of program feasibility was demonstrated (e.g., 90-100% attendance, 100% data completion). While interpretation of significance is limited due to sample size, improvements in quality of life [functional (p = 0.05), social (p = 0.02), and meaning/purpose (p = 0.05)] were observed among women but not men. Qualitative follow-up revealed high satisfaction with group participation, but discomfort with the topic of sexuality in women. This project demonstrates development and feasibility outcomes for providing culturally appropriate psychosocial support to Latino cancer survivors. Limitations, including lack of control group, and future directions are discussed.

The meaning of surviving cancer for Latino adolescents and emerging young adults.

Adolescent and young adult (AYA) survivors of cancer are an understudied population with unique developmental and medical needs that extend well beyond their active treatment. Survivors diagnosed as AYAs may experience both physical and emotional late effects. In particular, the experiences of Latino cancer survivors have not been explored. The purpose of this study was to conduct interviews with AYA Latino cancer survivors to inform professionals working with these survivors. A hermeneutic phenomenological approach was selected based on the focus on experiences and meanings of Latino adolescents' cancer survivorship. Phenomenology allows for understanding the subjective meaning and lived experience of populations that are understudied or marginalized. In-depth interviews were conducted with participants. Enrolled in the study were Latino AYAs between the ages of 14 and 21 years, after treatment. Interviews revealed 7 themes regarding the experience and meaning of survivorship for this population: gratitude, humor/positive attitude, empathy for younger children with cancer, God and faith, cancer happens for a reason/cancer changed my life, familial support, and staff relationships. Latino AYA cancer survivors develop meaning out of unique cancer experiences. Programs need to be developed specifically to address Latino adolescents and young adult survivors of cancer.

Barriers to cancer clinical trial enrollment in Latinos

e17519 Background: Cancer clinical trials (CCT) improve cancer outcomes. Nonmajority participants in CCT make up no more than 1% of all participants. Latinos would be included in this 1% or less. Specific barriers and facilitators to Latino accruement to CCT have not been well elucidated. The principal objective of this study was to identify barriers and facilitators to the enrollment of Latinos in CCT. Methods: Cancer patients were randomly invited to participate in a survey while they waited for their oncology appointment. The surveys had been developed, piloted and validated with a different population of Latino cancer survivors. All instruments were translated in standard fashion and recruiters were bilingual, bicultural Latino. Survey instruments addressed knowledge, attitudes and beliefs re: participation in CCT. Assessments were made by age, gender, education, ethnicity (Latino and non-Latino), language, place of residence, having been offered a CCT, and previous participation in a CCT. Answers were evaluated with bivariate analyses and multiple logistic regressions. In the bivariate analysis the chi-squared test was used to evaluate significant differences between groups. To determine the effect of each of the variables and the most significant predictors, multiple logistic regression models were constructed. Results: Sample characteristics: 64% male and 36% females; mean age 59.66; 18% Latinos and 82% non-Latinos; 67% urban and 31% rural. 83% of the participants spoke at least some English at home whereas 4% spoke only Spanish. From the total sample 22% had previously participated in a CCT and 30% had been offered a CCT. Significant differences were noted in knowledge of CCT by age (to age 70), ethnicity (non-Latino), language (English speakers), education (some college), and having been offered or participated in a CCT (p &lt; 0.05). There were no significant differences by sex and residence. Greatest predictors of CCT knowledge were ethnicity and education l:evel; however, no significant differences were noted by ethnicity or education level in interest in CCT participation. Conclusions: These data suggest that interventions to improve knowledge of CCT may ameliorate the disparity of CCT enrollment by Latinos. No significant financial relationships to disclose.

Development of a Linguistically and Culturally Appropriate Booklet for Latino Cancer Survivors: Lessons Learned

In response to the need for linguistically and culturally appropriate cancer survivorship materials for Latinos, the Office of Education and Special Initiatives and the Office of Cancer Survivorship at the National Cancer Institute (NCI) set out to test, adapt, and refine a Spanish translation of an English-language booklet for adult cancer survivors titled Facing Forward: Life After Cancer Treatment (Siga adelante: la vida después del tratamiento del cáncer). The authors used a process called "transcreation," which involves translating existing English-language materials into Spanish and then adapting them for Latino audiences. The Spanish version of the booklet was reviewed by nine Spanish-speaking reviewers who were cancer survivors. The multistage transcreation process reinforced the importance of conducting formative research as well as adjusting the methodology to address the needs of changing demographics.