Lessons Learned From Implementing a Culturally Tailored Virtual Support Program for Asian American Breast Cancer Survivors With Pain and Depression

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Abstract
Breast cancer is the most diagnosed cancer among women in the United States, with a greater increase in incidence among Asian American women than among others. Despite having resided in the United States for decades, Asian American breast cancer survivors face unique cultural challenges, including stigma and reluctance to disclose their illness. We present a Viewpoint to discuss practical issues encountered in implementing a culturally tailored, technology-based program aimed at reducing pain and depressive symptoms in Asian American breast cancer survivors. This Viewpoint is a simple ancillary content analysis of meeting minutes and research diaries from a parent study of cancer pain management; here, we identify themes related to practical issues in conducting a culturally tailored, technology-based intervention among Asian American breast cancer survivors with pain and depressive symptoms. Key issues identified include (1) reluctance to disclose, (2) variability in engagement based on disease status, (3) the need for personalized support, and (4) intraethnic differences related to various factors. Suggestions for future research include (1) tailoring communication to participants’ preferences while building trust over time, (2) applying flexible care strategies, (3) assessing individual needs early and adapting materials based on feedback, (4) matching participants with interventionists according to language and level of acculturation, and (5) respecting differences in cultural identities between ethnic subgroups. Addressing these challenges can improve the effectiveness of technology-based interventions for racial or ethnic minority groups.

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