Abstract B50: Exploring correlates of lifestyle changes among Chinese- and Mexican-American breast cancer survivors

Purpose: Increasingly new data suggests that the adoption of healthy lifestyle behaviors after cancer diagnosis may influence survivorship outcomes for breast cancer survivors (BCS). Additionally, lifestyle behaviors may be changed according to individual and contextual factors among breast cancer survivors. There is, however, minimal research on exploring factors contributing to these changes among underserved BCS. Thus, this study explored and compared the individual and contextual factors relevant to lifestyle changes among Chinese- and Mexican-American BCS.

Methods: This study was conducted using an existing dataset of a study that examined health-related quality of life among a multiethnic cohort of BCS. A total of 123 Mexican- (64 English, 59 Spanish) and 85 Chinese- Americans (40 English, 45 Chinese) were included in this study. BCS were recruited from the California Cancer Surveillance Program, hospital registries, and community agencies in southern California. Health behaviors were measured using a self-report instrument that assessed lifestyle or health behavior changes (e.g., eating habits, exercise, complementary/alternative medicine, and stress management). Individual and contextual factors were assessed by language, SES factors (income, education, and occupation), and patient-doctor relationship.

Results: Approximately 71% of Chinese- and 59% of Mexican-Americans reported making a lifestyle change after their breast cancer diagnosis. Of those who reported making lifestyle changes, the most common change reported for the both groups was in their eating habits followed by exercise and stress reduction strategies. Yet, the two groups showed different patterns in their exercise, indicating that Chinese-Americans are more likely to exercise after cancer diagnosis compared to Mexican-Americans (p<0.005). In terms of language proficiency, findings demonstrated significant differences in lifestyle changes between the two groups. For example, English speaking Chinese were more likely to report the use of alternative medicine (p<0.05) compared to monolingual Chinese speaking BCS. English-speaking Mexican-Americans were more likely to use stress reduction strategies compared to Spanish-speaking survivors. Overall, age was the important factor relevant to lifestyle changes for the both groups, indicating that younger survivors were more likely to change their lifestyle (p<0.01). With regard to patient-doctor relationships, English-speaking Chinese experienced the best relationship with physicians, while Spanish-speaking Mexican-Americans showed the least score in the patient-doctor relationship (F=10.693; p<0.001). Only Chinese speaking BCS showed a positive correlation between patient-doctor relationship and taking steps to reduce stress (r=0.373; p<0.05); however, other participants did not demonstrate associations between patient-doctor relationship and lifestyle changes.

Conclusions: These findings provide us with a better understanding of lifestyle changes and their correlates of individual and contextual factors among Chinese and Mexican American BCS. This understanding can help develop evidence-based, culturally integrated breast cancer interventions to enhance positive health behaviors and ultimately increase quality of life.