Attitudes towards dementia and caregiving differ by family caregivers’ racial/ethnic backgrounds. However, there is a gap in the literature on midlife women family caregivers’ attitudes toward Alzheimer’s Disease (AD) and family caregiving. The study purposes were to (1) explore racial/ethnic variations in midlife women family caregivers’ attitudes toward AD and family caregiving and (2) examine the relationships among their attitudes towards dementia and caregiving, quality of life, and physical and psychological symptoms. This cross-sectional study was conducted through an online survey among 36 Whites, 41 African Americans, 40 Hispanics, and 55 Asians. The structured measures consisted of two types of attitudes (Attitude toward AD and Related Dementias Scale and Questions on Attitudes toward AD Caregiving), health-related quality of life (EQ-5D-5L), and multidimensional symptoms (Midlife Women’s Symptom Index). The data were analyzed using one-way ANOVA and multiple linear regression analyses with SPSS 26. Asian caregivers perceived the care recipients’ symptoms as more bothersome than White caregivers (p = .039). Asian caregivers reported lower levels of behavioral skills and shared responsibility compared with other racial/ethnic groups of caregivers (p < .01). African Americans showed more positive attitudes toward family caregiving compared with Hispanics and Asians (p = .001). The regression analyses indicated that more positive attitudes toward family caregiving were significantly related to a better quality of life and fewer symptoms (both physical and psychological symptoms; p < .05). Culturally tailored interventions that incorporate caregivers’ attitudes are needed to improve midlife women family caregivers’ quality of life and symptoms.
Background: Despite an increasing number of studies among breast cancer survivors, little is known about how socio-behavioral factors influence the symptom experience of racial/ethnic minority breast cancer survivors, especially Asian American breast cancer survivors. The identified socio-behavioral factors could give directions for development of unique intervention components that are tailored to a specific population in needs. Purpose: This study examined the relationship of multiple socio-behavioral factors including attitudes, perceived barriers, social influences, and self-efficacy to the symptom experiences of Asian American breast cancer survivors. Methods: This secondary analysis was conducted using data collected from 195 Asian American female breast cancer survivors. Subjects were recruited from January 2017 to June 2020 through online and offline communities and groups. The study variables were measured using validated instruments such as the Questions on Attitudes, Self-Efficacy, Perceived Barriers, and Social Influences (QASPS); the Cancer Behavior Inventory (CBI); and the Memorial Symptom Assessment Scale-Short Form (MSAS-SF). The hypothetical model was built based on Bandura’s self-efficacy theory. Mediation analysis was conducted using structural equation modeling with SPSS version 26.0 and Amos 28. Results: The overall fitness of the hypothetical model to the data was acceptable (χ2=51.36, p<.001, the goodness of fit index [GFI] = .95, adjusted GFI [AGFI] = .89, comparative fit index [CFI] = .96, Tucker-Lewis index [TLI] = .94, normed fit index [NFI] = .94, and root mean square error of approximation [RMSEA] = .08 Attitude and perceived barrier and social influence had a significant direct effect on self-efficacy (direct effect, β = 0.247, p =.003; β = -0.552, p =.003; β = 0.241, p =.002, respectively). Attitudes indirectly influenced symptom distress scores through self-efficacy (β =-0.054, p = .019). Perceived barriers had a significant direct effect (β = 0.605, p=.003), indirect effect (indirect effect, β = 0.121, p =.024), and a total effect on symptom distress scores (total effect, β = 0.726, p =.004). In addition, social influence had an indirect effect on symptom distress scores through self-efficacy (β = -0.053, p = .017) Conclusions: The findings supported that the self-efficacy for coping had a mediating effect on their symptom experience among Asian American breast cancer survivors as well as identified meaningful associations with attitudes, perceived barriers and social influences and symptom experience. Future research and practice should consider socio-behavioral factors, especially self-efficacy, in symptom management of Asian American breast cancer survivors. Acknowledgments: The parent study was funded by the National Institutes of Health (NCI/NINR; 1R01CA203719). Citation Format: Seo Yun Kim, Heejung KIM, Wonshik Chee, Eun-ok Im. The relationship of socio-behavioral factors to the symptom experience of Asian American breast cancer survivors: a structural equation model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB145.
Background: Breast cancer survivors often report their high needs for help during the transition to cancer survivorship. During the COVID-19 pandemic, technology-based programs are increasingly popular because of their high flexibility and accessibility in delivering information and coaching/support to address the current needs for help among cancer survivors. Yet, little is known about how socio-behavioral factors influence the effects of a technology-based intervention on the needs for help of racial/ethnic minority breast cancer survivors, especially Asian American breast cancer survivors. Purpose: The purpose of this secondary analysis was to examine the multiple socio-behavioral factors (including attitudes, self-efficacy, perceived barriers, and social influences related to breast cancer survivorship) mediated the effects of a technology-based intervention on the needs for help among Asian American breast cancer survivors. Methods: This analysis was conducted with the data from 199 Asian American breast cancer survivor women who were recruited from January 2017 to June 2020 through online and offline communities/groups. The needs for help were measured using the Support Care Needs Survey-34 Short Form (SCNS) with five domains on psychological, information, physical, support, and communication needs. Mediation analysis was conducted using the PROCESS macro within SPSS. The analysis determined the mediating effects of four socio-behavioral mediators on the needs for help at pre-test [T0], post 1-month [T1], and post 3-months [T2] of a technology-based intervention. Results: Overall, all the mediators had statistically significant mediation effects on all types of needs for help (p < .05) at different points. Attitudes and social influence presented statistically significant mediation effects on the total needs for help score over 3 months (T0, T1, and T2). Perceived Barriers had mediation effects on all types of needs for help over 1 month (T0, T1). Self-efficacy mediated the effects on all types of needs for help only at post 1 month (T1). Conclusions: The findings supported that all the socio-behavioral factors (attitudes, self-efficacy, perceived barriers, and social influences) mediated the effects of a technology-based intervention on the needs for help of Asian American breast cancer survivors. Future research and practice should consider socio-behavioral factors to reduce their needs for help during their survivorship process Acknowledgments: The parent study was funded by the National Institutes of Health (NCI/NINR; 1R01CA203719). Citation Format: Seo Yun Kim, Eun-ok Im, Wonshik Chee, TICAA Research Team. The mediating effects of socio-behavioral factors on the needs for help among Asian American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB147.
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