Resilience in East Asian Immigrants

Study Overview
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Brief Summary
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The purpose of the study is to develop a culturally tailored digital resilience-building intervention to help East Asian immigrants engage in advance care planning discussions with their family caregivers.

Detailed Description
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Advance care planning (ACP) is a process to facilitate decision-making for future care and document values and preferences. However, the advance directive completion rates in East Asian Americans are low, which may extend to disparities in end-of-life care, including rates of hospice use and prevalence of unwanted aggressive treatments. To address this, this study uses information technology to develop a culturally tailored digital resilience-building intervention with and for East Asian immigrants to help them engage in ACP discussions. There are two aims of this study: (1) Conduct semi-structured interviews with a total of 30 religious leaders to identify the barriers and facilitators associated with discussing ACP and death-related topics with immigrants from China/Taiwan, Japan, and Korea and (2) Develop a culturally tailored digital resilience-building intervention using think-aloud interviews with 27 pairs of East Asian immigrants with cancer and their family caregivers (9 pairs each for immigrants from China/Taiwan, Japan, and Korea).

Official Title
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Development of a Culturally Tailored Digital Resilience-Building Intervention for East Asian Immigrants With Cancer to Facilitate Advance Care Planning Discussions

Conditions
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Neoplasms, Advance Care Planning

Intervention / Treatment
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* Behavioral: Culturally Tailored Digital Resilience-Building


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for Patients: Immigrants will be eligible for the study if they (1) are ≥ 18 years of age; (2) have a cancer diagnosis documented in the electronic medical record; (3) are able to read and respond to questions in English, Mandarin, Cantonese, Japanese, or Korean; (4) have a family caregiver willing to participate in the study; and (5) have adequate electronic health literacy with a score of > 30 on the electronic-Health Literacy Scale. Exclusion Criteria for Patients: Patients who (1) have cognitive impairment per a Short Portable Mental Status Questionnaire with more than three errors; (2) have completed an advance directive; or (3) were born in the US. Inclusion Criteria for Family Caregivers: Family caregivers will be eligible if they (1) are ≥ 18 years of age; (2) are able to read and respond to questions in English, Mandarin, Cantonese, Japanese, or Korean; (3) are identified by the patient as a family caregiver; and (4) have adequate electronic health literacy with a score of > 30 on the electronic-Health Literacy Scale.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Culturally Tailored Digital Resilience-Building<br>The Culturally Tailored Resilience-Building intervention will be provided to East Asian immigrants with cancer and their family caregivers. | Behavioral: Culturally Tailored Digital Resilience-Building<br>* The Culturally Tailored Digital Resilience-Building intervention consists of 6 modules, including an introduction of advance care planning and resilience skills that specifically address cultural beliefs and barriers.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Usability | Use the System Usability Scale to assess the usability of the intervention | Immediately at the end of the think-aloud interview | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptability | Use the Acceptability E-scale to assess the acceptability of the intervention | Immediately at the end of the think-aloud interview |