Translating a Stress Management Program for Latinas
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Latinas are at higher risk of psychosocial problems due to breast cancer (e.g., anxiety, depression, fear of recurrence, fatigue, and pain) than White women. Two major reasons for these disparities are limited English proficiency and limited literacy because they reduce access to cancer support resources. A set of psychological techniques or skills one can learn, called cognitive-behavioral stress management, have improved quality of life and reduced stress, distress, and anxiety among White women with breast cancer. However, these programs have not been tailored to meet the special needs of Latinas. Our extensive translational research over several years has resulted in a cognitive-behavioral stress management program called Nuevo Amanecer (A New Dawn). We developed it by blending scientific evidence and community best practices, through a process of working closely with Latinas with breast cancer and community organizations providing them with supportive services. The program is delivered in Spanish by trained breast cancer survivors (peers). In a randomized controlled trial of urban-dwelling Latinas with breast cancer, our program improved several aspects of quality of life and reduced distress. Because the broader population of Latinas in California includes many living in rural settings and with limited literacy, the next step is to adapt Nuevo Amanecer for these groups to ensure it applies broadly to all vulnerable Latinas with breast cancer. To encourage dissemination of the program in a variety of settings across California, we need to develop a guide to its implementation for community-based organizations. 
 
 
 
 
 
 The question(s) or central hypotheses of the research: Our objectives are to: 1) to create a transportable Nuevo Amanecer program that is suitable for urban and rural Latinas of various literacy levels and test this revised program in a randomized controlled trial in new rural community settings; 2) develop a guide for community organizations serving Latinas with breast cancer that provides instructions on how to implement the program (e.g., how to train peers, how to use program manuals); and 3) better understand the factors that make it easier for these community organizations to adopt the program. We hypothesize that: 1) compared to a control group, Latinas randomized to receive the intervention will report better quality of life and less distress; and 2) Latina breast cancer survivors and advocates will indicate that the revised program addresses the unique needs of rural Spanish-speaking Latinas and that staff in the community-based organizations will find the guide helpful in implementing it.
 
 
 
 
 
 The general methodology: To adapt the 8-week long Nuevo Amanecer program, we will conduct interviews with Latina breast cancer survivors and cancer supportive services providers in 3 rural areas with large Latino populations (Imperial Valley, San Joaquin Valley, and Watsonville/Gilroy/Salinas). Using results of our interviews, through community consultations, our team and community advisors will adapt Nuevo Amanecer to create a revised program that is suitable for rural and low-literacy Latinas with breast cancer. Next, we will test the program’s effectiveness among 140 rural Latinas by randomizing half to receive the program and half to a usual care control group that waits 6 months to receive it. By providing women with cognitive-behavioral stress management tools (e.g., deep breathing, positive thought reframing) and comprehensible cancer information to manage stress, we hope to reduce distress and improve quality of life. Finally, we will identify key individual, organizational, and community factors and methods that facilitate implementation and support statewide dissemination through a process evaluation (conducting interviews with participants and organizational staff and tracking key implementation activities). Products will include interventionist and participant manuals for the revised program, a guide to implementation for organizations, and a dissemination plan. 
 
 
 
 
 
 Innovative elements of the project: Our research is innovative because we found that teaching vulnerable Latinas with breast cancer cognitive-behavioral stress management techniques, which had never been tested in this population, helps address their high levels of distress. Also, usually, such programs are delivered by cancer center professionals, whereas, we demonstrated that it is possible for peers (compañeras) to deliver them. Finally, our model for translating programs for vulnerable populations is innovative because it blends scientific evidence, community best practices and extensive community input to generate programs that are suitable for these communities and meet their unique needs (e.g., resource limitations, cultural relevance). This process is the reason our program is integrated into community organizations and peer-delivered. This model increases the likelihood of successful dissemination of the program throughout California to meet the psychosocial and self-care needs of vulnerable Latina breast cancer survivors.