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Identifying risk and protective factors related to depressive symptoms among Northern Plains American Indian women cancer survivors.

ABSTRACT: Cancer is the leading cause of death among American Indian and Alaska Native (AIAN) women, and depressive symptoms have been linked to higher mortality, but research on depressive symptoms among AIAN cancer patients has been scant. The purpose of this exploratory study was, using the Framework of Historical Oppression, Resilience, and Transcendence, to examine risk and protective factors related to depressive symptoms in American Indian (AI) women cancer survivors. We examined the relationships of adverse childhood experiences (ACE), perceived health status, resilience, and social support with depressive symptoms in Northern Plains AI women cancer survivors. We used a cross-sectional design with purposive sampling of 73 female cancer survivors (aged 18 years or older) between June 2014 and February 2015. Hierarchical multiple regression was used to test three sets of variables in relation to depressive symptoms: (1) sociodemographics, (2) risk factors (ACE and perceived health), and (3) protective factors (psychological resilience and social support). Approximately 47 percent of participants had probable depressive symptoms. Depressive symptoms were inversely associated with perceived health, psychological resilience, and social support. These results support bolstering existing social support among AI cancer patients and survivors as well as prevention and intervention efforts that strengthen resilience.

SUBMITTER: Roh S

PROVIDER: S-EPMC6591106 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Identifying risk and protective factors related to depressive symptoms among Northern Plains American Indian women cancer survivors.

Roh Soonhee S Burnette Catherine E CE Lee Yeon-Shim YS Giger Jarod T JT Goins R Turner RT Petereit Daniel G DG Lawler Michael J MJ Lee Kyoung Hag KH

Women & health 20181127 6

Cancer is the leading cause of death among American Indian and Alaska Native (AIAN) women, and depressive symptoms have been linked to higher mortality, but research on depressive symptoms among AIAN cancer patients has been scant. The purpose of this exploratory study was, using the Framework of Historical Oppression, Resilience, and Transcendence, to examine risk and protective factors related to depressive symptoms in American Indian (AI) women cancer survivors. We examined the relationships ...[more]

PMID: 30481139

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Project description:BackgroundBreast cancer is the most common cancer in the United States and the second leading cause of death for American Indian women. American Indian women have lower rates of breast cancer screening than other racial groups, and disparities in breast cancer mortality and survival rates persist among them. To address this critical need, a culturally appropriate, accessible, and personalized intervention is necessary to promote breast cancer screening among American Indian women. This study used mobile health principles to develop a mobile web app-based mammogram intervention (wMammogram) for American Indian women in a remote, rural community in the Northern Plains.ObjectiveThis study aimed to assess the feasibility and efficacy of the wMammogram intervention, which was designed to motivate American Indian women to undergo breast cancer screening, as compared with the control group, who received an educational brochure.MethodsUsing community-based participatory research (CBPR) principles and a multipronged recruitment strategy in a randomized controlled trial design, we developed the wMammogram intervention. This study involved 122 American Indian women aged between 40 and 70 years, who were randomly assigned to either the intervention group (n=62) or the control group (n=60). Those in the intervention group received personalized and culturally appropriate messages through a mobile web app, while those in the control group received an educational brochure. We measured outcomes such as mammogram receipt, intention to receive breast cancer screening after the intervention, and participants' satisfaction with and acceptance of the intervention.ResultsA significantly higher proportion of women who received the wMammogram intervention (26/62, 42%; P=.009) completed mammograms by the 6-month follow-up than the control group (12/60, 20%). The wMammogram intervention group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22; P<.001), increase in knowledge (t120=-4.75; P<.001), and satisfaction with the intervention (t120=-3.61; P<.001). Moreover, compared with the brochure group, the intervention group expressed greater intention to receive a mammogram in the future when it is due (62/62, 100% vs 51/60, 85%) and were more willing to recommend the intervention they received to their friends (61/62, 98.4% vs 54/60, 90%) with statistically significant differences.ConclusionsThis study shows the feasibility and efficacy of the wMammogram intervention to promote breast cancer screening for American Indian women in a remote, rural community-based setting. Findings suggest that, with advancements in technology and the ubiquity of mobile devices, mobile web apps could serve as a valuable health intervention tool that builds upon low-cost technology and enhances accessibility and sustainability of preventive care to help reduce breast health disparities experienced in hard-to-reach American Indian populations.Trial registrationClinicalTrials.gov NCT05530603; https://clinicaltrials.gov/ct2/show/NCT05530603.

Project description:ObjectivesThis paper aimed to review the experience of psychopathology symptoms (ie, depressive, anxiety and post-traumatic stress) and their social, cognitive and affective correlates among Asian American breast cancer survivors. Studies on psychosocial interventions for reducing psychopathology symptoms were also included in this review.DesignA systematic review was conducted.MethodsPubMed, PsycINFO and Web of Science were searched from database inception to November 2018. Empirical, peer-reviewed articles on adult women of Asian heritage residing in the USA with breast cancer diagnoses were included in this review. The methodological quality of the included articles was coded.ResultsThe search yielded 16 empirical articles, which were all deemed to be of high methodological quality. Eleven studies utilised a quantitative design, two studies utilised a qualitative design and three studies utilised a mixed-methods design. Thirteen were cross-sectional and three were longitudinal in design. Only two intervention studies were identified. Studies showed that Asian American breast cancer survivors endorsed moderate to high levels of depressive symptoms, anxiety and post-traumatic stress symptoms; those who are more acculturated demonstrated lower levels of depressive and anxiety symptoms. Asian American breast cancer survivors with social constraints were more likely to have intrusive thoughts and, in turn, have high levels of psychopathology symptoms. Intervention studies were limited, but the use of community-based participatory research approaches and cultural adaptations were noted strengths of the studies.DiscussionIn addition to discussing clinical implications, we highlight limitations of the literature, including a lack of longitudinal studies and the limited use of standardised diagnostic instruments for assessing psychopathology symptoms among this population. Clarifying the prospective relationships between psychopathology symptoms and their social, cognitive and affective correlates will help inform the development of culturally sensitive psychosocial interventions among Asian American breast cancer survivors.

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Identifying risk and protective factors related to depressive symptoms among Northern Plains American Indian women cancer survivors.

Publications

Identifying risk and protective factors related to depressive symptoms among Northern Plains American Indian women cancer survivors.

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