A systematic review and meta‐analysis of psychosocial interventions for immigrant and limited English proficient cancer patients

Abstract

Objective Immigrants, particularly those who are less acculturated and limited English proficient (LEP), often lack access to culturally and linguistically appropriate psychosocial care in cancer survivorship. We sought to determine what psychosocial interventions are available for immigrant and/or LEP cancer patients and to assess treatment and patient factors that may correlate with better psychosocial outcomes for this population. Methods We conducted a systematic review and meta‐analysis of studies published through August 2022 of interventions conducted with immigrant and/or LEP cancer patients aimed at improving psychosocial outcomes (i.e., quality of life, depression, cancer‐related distress, and anxiety). Using Covidence, a software program for systematic review management, four independent raters screened 16,123 records with a systematic process for reconciling disagreement, yielding 48 articles (45 studies) for systematic review and 21 studies for meta‐analysis. Results Most studies were conducted with Spanish‐speaking patients with breast cancer. Study participants (N = 5400) were primarily middle‐aged (mean = 53 years old), female (90.0%), and Hispanic (67.0%). The weighted average effect size (g) across studies was 0.14 (95% CI 0.03–0.26) for quality of life (18 studies), 0.04 (95% CI −0.08 to 0.17) for depression (8 studies), 0.14 (95% CI −0.03 to 0.31) for cancer‐related distress (6 studies), and 0.03 (95% CI −0.11 to 0.16) for anxiety (5 studies). Conclusion The interventions under review had small but beneficial effects on psychosocial outcomes for immigrant and LEP cancer patients. Notably, effect sizes were smaller than those found in previous meta‐analyses of psychosocial interventions conducted in majority U.S.‐born, non‐Hispanic White, English‐speaking cancer patient samples. More research is needed to identify key components and adaptations of interventions that benefit immigrant and LEP cancer patients to strengthen their effects for this growing yet underserved population.

Promoting Psychosocial Well-Being and Empowerment of Immigrant Women: A Systematic Review of Interventions

“…These effects were generally maintained when compared with the experimental and control groups, with a few exceptions. These findings are consistent with other SLRs that investigated interventions to improve the psychosocial well-being of immigrant people using psychosocial variables such as reduction of stress, depression, anxiety, suicidal ideation, and PTSD [47][48][49][50]. Furthermore, the therapies used in these studies were consistent with those that we found in our SLR, such as cognitive-behavioral techniques [47][48][49][50], counseling [49], psychoeducation [49,50], art therapy [49,50], mindfulness and relaxation [48,49], and group interpersonal theory [48,49].…”

Refinement of a Meaning-Centered Counseling Program for Chinese Patients with Advanced Cancer: Integrating Cultural Adaptation and Implementation Science Approaches

“…Yet empirically supported mental health interventions developed for Chinese immigrants with advanced cancer are scarce. Our team's systematic review and meta-analysis of psychosocial interventions for immigrant and LEP cancer survivors identi ed only ve interventions that have been empirically tested for Chinese-speaking cancer patients [16][17][18][19], none of which were psychotherapy/counseling interventions [20]. There is a critical need to develop high-quality, culturally and linguistically tailored, and accessible mental health interventions for this growing yet underserved population [21].…”