Abstract
Purpose
The purpose of this study was to (1) describe health behaviors and health-related quality of life (HRQOL) of Latina and Asian-American breast cancer survivors (BCS), (2) estimate possible culturally driven predictors of health behaviors and HRQOL, and (3) compare pathways for predicting health behaviors and HRQOL between the two groups.
Materials and methods
Secondary data were used to investigate health behaviors and HRQOL among 183 Latina and 206 Asian Americans diagnosed with breast cancer. The study methodology was guided by the health belief model and the contextual model of HRQOL. Structural equation modeling was used to test cultural predictors on health behaviors of BCS.
Results
Asian Americans reported higher emotional and physical well-being scores than Latina-Americans. Confirmatory factor analyses demonstrated the adequacy of the two-factor model (“powerful others” and “sociocultural factors”) in the cultural health belief construct for Latina and Asian-American BCS. In the structural model, Latinas and Asian Americans showed different pathways in the predicted relationships among the variables. For Latina-Americans, doctor–patient relationship was positively related to exercise, and in turn, influenced physical and emotional well-being. For Asian Americans, treatment decisions and the “sociocultural factor” were significantly related to stress management.
Conclusion
This study adds to the existing literature in that no study has focused on cultural health beliefs and health behaviors between Latina and Asian-American BCS. Evidence that Latinas and Asian Americans varied in the patterns of cultural factors influencing health behaviors and HRQOL might lead to the development of culturally sensitive breast cancer interventions for promoting positive health behavior and ultimately increasing HRQOL.
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Abbreviations
- HRQOL:
-
health-related quality of life
- BCS:
-
breast cancer survivors
- SEM:
-
structural equation modeling
- FACT:
-
Functional Assessment of Cancer Therapy
- ADQ:
-
Adherence Determinants Questionnaire
- RMSEA:
-
root mean square error of approximation
- CFI:
-
comparative fit index
- AIC:
-
Akaike Information Criterion
- CFA:
-
confirmatory factor analysis
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Acknowledgements
Funding for this research was supported by grants from the Department of Defense 17-99-1-9106 and NIH P20 CA118755-02.
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Lim, Jw., Gonzalez, P., Wang-Letzkus, M.F. et al. Understanding the cultural health belief model influencing health behaviors and health-related quality of life between Latina and Asian-American breast cancer survivors. Support Care Cancer 17, 1137–1147 (2009). https://doi.org/10.1007/s00520-008-0547-5
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DOI: https://doi.org/10.1007/s00520-008-0547-5