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Understanding the cultural health belief model influencing health behaviors and health-related quality of life between Latina and Asian-American breast cancer survivors

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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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Correspondence to Jung-won Lim.

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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

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