Helping Yourself by Offering Help: Mediators of Expressive Helping in Survivors of Hematopoietic Stem Cell Transplant

Hematopoietic Stem-Cell Transplantation: Exploring the Latest Advances and Gaps in Disparities, Psychosocial and Symptom Management Interventions, and Chronic Graft-Versus-Host Disease Care

Although allogeneic hematopoietic cell transplantation (HCT) offers a potential for cure for many patients with advanced hematologic malignancies and bone marrow failure or immunodeficiency syndromes, it is an intensive treatment and accompanied by short- and long-term physical and psychological symptoms requiring specialized care. With substantial advances in therapeutic approaches for HCT and supportive care, HCT survivors experience less morbidity and mortality. However, disparities in both HCT access and outcomes persist, and HCT survivors and their caregivers often lack access to much-needed psychosocial care. Additionally, more medical and psychosocial resources are needed to holistically care for HCT survivors with chronic graft-versus-host disease (GVHD). Hence, this chapter focuses on three areas pertaining to advances and gaps in HCT care: disparities in access to and outcomes of HCT, psychosocial and physical symptom management with supportive care interventions, and GVHD prevention and management.

Prosocial Interventions and Health Outcomes: A Systematic Review and Meta-Analysis

Importance

Prosocial interventions encourage voluntary actions that benefit others. Community solidarity in response to the COVID-19 pandemic, expanding mutual aid programs, and health workforce issues have accelerated prosocial health interventions.

Objective

To investigate the association of prosocial interventions with health outcomes in clinical trials and observational studies.

Data Sources

In this systematic review and meta-analysis informed by the Cochrane Handbook for Systematic Reviews of Interventions, 5 databases (MEDLINE [via PubMed], Embase, CINAHL, PsycInfo, and Scopus) were searched from database inception through February 23, 2023. The search included terms for altruism and prosocial behaviors, health outcomes, and study type.

Study Selection

Included studies, determined by multiple reviewers, compared health outcomes in a prosocial intervention group with a nonintervention group.

Data Extraction and Synthesis

Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline, data extraction and synthesis captured quantitative and qualitative data. To pool data from quantitative studies, random-effects meta-analyses were used to estimate the impact of prosocial interventions. To combine data from quantitative and qualitive studies, data were transformed into qualitative narratives using meta-aggregation.

Main Outcomes and Measures

The main outcome was whether prosocial interventions were associated with improved health outcomes. Barriers to and facilitators of implementation of these interventions were assessed.

Results

The search identified 5229 citations; 30 studies were included in the synthesis. Studies indicated that prosocial interventions were associated with positive health outcomes for givers (17 studies [56.7]) and recipients (8 [26.7%]). Prosocial interventions included acts of kindness (12 studies [40.0%]), cash gifts (7 [23.3%]), pay-it-forward approaches (6 [20.0%]), and expressions of kindness (5 [16.7%]). Improvements were reported in depression, testing for sexually transmitted diseases, vaccine uptake, physical activity, and individual biomarkers. Data from 6 studies (20.0%) demonstrated that pay-it-forward approaches were associated with increased uptake of diagnostic tests or vaccines among vulnerable groups (moderate certainty of evidence). Data from 14 studies (46.7%) suggested that community connectedness facilitated prosocial interventions. Shared vulnerabilities among groups (eg, sexual minority individuals, older adults) may provide a context for collective mobilization to improve health in local communities.

Conclusions and Relevance

This systematic review and meta-analysis found that prosocial interventions were associated with improved health outcomes among vulnerable groups and have been useful for addressing health disparities. Further research is needed to develop and evaluate prosocial interventions.

Providing Support Differentially Affects Asian American and Latinx Psychosocial and Physiological Well-Being: A Pilot Study

Although substantial evidence suggests receiving social support has positive implications for well-being, less is known about how providing support can confer benefits, particularly for Asian American and Latinx individuals who are more likely to come from interdependent cultures that emphasize family obligation. Asian American and Latinx college students (N = 48; M_age = 21.44, SD = 2.61; 68.75% female) reported on anxiety before taking part in a modified laboratory task that elicited a physiological stress response as measured by total cortisol output. They were randomly assigned to write (a) a supportive note to a family member, (b) a supportive note to a close friend, or (c) about their day in a control condition after the mild lab stressor and reported on psychosocial well-being (i.e., post-task anxiety and self-esteem). Those who provided support to a family member experienced higher self-esteem compared to those in the control condition. However, there was variation in Asian American and Latinx participants’ physiological stress response (i.e., total cortisol output). The findings suggest that providing support to close others, particularly family members, can be differentially meaningful for individuals from diverse backgrounds.