Developing the Meaning-Centered Program for Chinese Americans with Advanced Cancer: Applying Cultural Adaptation Frameworks.

Abstract

Asian Americans have surpassed Hispanics as the fastest-growing racial/ethnic group in the United States and Chinese Americans are the largest Asian American subgroup. Cancer is the leading cause of death among Chinese Americans while heart disease remains the leading cause of death in the U.S. overall. Foreign-born immigrants are more likely to be diagnosed with advanced stage cancers than their native-born counterparts. Patients with advanced cancer have specific psychosocial needs, such as end-of-life concerns and existential distress. Meaning-Centered Psychotherapy (MCP), which enhances a sense of meaning in life to increase QOL, is among the most promising psychosocial treatments for advanced cancer patients, having demonstrated efficacy in several randomized controlled trials. Our preliminary qualitative work suggested a meaning-centered intervention was acceptable but required adaptation to ensure ecological validity among Chinese cancer patients. This paper presents the cultural and linguistic adaptation of Meaning-Centered Program for Chinese Americans with advanced cancer (MCP-Ch), which was informed by the Ecological Validity Model (EVM) and Psychotherapy Adaptation and Modification Framework (PAMF) for cultural adaptation of evidence-based interventions. Implementation considerations, which will be assessed in the next phase of the project, are also discussed. MCP-Ch is used as a case example to illustrate how to adapt culturally syntonic and sustainable evidence-based psychosocial interventions for racial/ethnic minority cancer populations.