A Descriptive Internet Survey on Menopausal Symptoms: Five Ethnic Groups of Asian American University Faculty and Staff

Five Dimensions of Needs for Help: The Efficacy of a Technology-Based Intervention Among Asian American Breast Cancer Survivors

Cancer survivors including Asian American breast cancer survivors have reported their high needs for help during their survivorship process. With the COVID-19 pandemic, the necessity of technology-based programs to address their needs for help without face-to-face interactions has been highlighted. The purpose of this randomized intervention study was to determine the efficacy of a technology-based program in reducing various types of needs for help among this specific population. This was a randomized clinical trial with repeated measures. A total of 199 participants were included in the data analysis. The recruitment settings included both online and offline communities/groups for Asian Americans. The needs for help were assessed using the Support Care Needs Survey-34 Short Form (SCNS) subscales measuring psychological, information, physical, support, and communication needs. Data analysis was conducted through an intent-to-treat approach. In the mixed effect models, psychological needs, information needs, physical needs, and communication needs decreased over time (P < .001). However, there were no significant group * time effects. Social support significantly mediated the effects of a technology-based intervention on psychological, information, and support needs at the pre-test and the post-1 month. This study supported significant decreases in the needs for help of Asian American breast cancer survivors by a technology-based intervention. Further studies are needed with other racial/ethnic groups of cancer survivors to confirm the efficacy of a technology-based intervention in reducing cancer survivors' needs for help during their survivorship process.

A randomized controlled trial testing a virtual program for Asian American women breast cancer survivors

A culturally tailored virtual program could meet the survivorship needs of Asian American women breast cancer survivors (AABC). This study aims to determine the efficacy of a culturally tailored virtual information and coaching/support program (TICAA) in improving AABC's survivorship experience. A randomized clinical trial (NCT02803593) was conducted from January 2017 to June 2020 among 199 AABC. The intervention group utilized TICAA and the American Cancer Society [ACS] website while the control group used only ACS website for 12 weeks. The outcomes were measured using the SCNS-34SF (needs; primary), the MSAS-SF (symptoms; secondary), and the FACT-B (quality of life; secondary). The data were analyzed using an intent-to-treat approach. The intervention group showed significant reductions in their needs from the baseline (T0) to post 4 weeks (T1) and to post 12 weeks (T2). Although the changes were not statistically significant, the intervention group had decreased symptoms from T0 to T2 while the control group had an increase in their symptoms. The intervention group had a significant increase in their quality of life from T0 to T2. A culturally tailored virtual program could therefore improve quality of life in AABC patients. Trial Registration: To Enhance Breast Cancer Survivorship of Asian Americans (TICAA), NCT02803593, https://clinicaltrials.gov/ct2/show/NCT02803593?titles=TICAA&draw=2&rank=1.

What to Consider in a Culturally Tailored Technology-Based Intervention?

The purpose of this article is to identify practical issues in implementing a culturally tailored technology-based intervention among Asian American survivors of breast cancer. In a large-scale technology-based breast cancer intervention study, research team members wrote memos on issues in implementing a culturally tailored technology-based intervention and plausible reasons for the issues. Then, the content of the research diaries was analyzed, along with written records of the research team. The practical issues found in the research process included those related to (1) technology literacy and preferences; (2) language issues; (3) cultural attitudes, beliefs, and values; (4) intervention staff competence; (5) security and confidentiality issues; and (6) time and geographical constraints. Based on the issues, several recommendations are proposed for future research using culturally tailored technology-based interventions among racial and ethnic minorities.

The relationships of multiple factors to menopausal symptoms in different racial/ethnic groups of midlife women: The structural equation modeling

The purpose of the present study was to examine the relationships of multiple factors to menopausal symptoms in different racial/ethnic groups of midlife women. This secondary analysis was conducted with the data from 980 midlife women that were collected from 2005 to 2013 using the Midlife Women's Symptom Index. Structural equation modeling was used to analyze the data. The model had the highest fit indices for non-Hispanic (NH) White midlife women, and prominent racial/ethnic differences were observed in the relationships of multiple factors to menopausal symptoms. In all racial/ethnic groups (except in Hispanic women), perceived health status was significantly positively associated with menopausal symptoms (β = -0.149 for NH African-American; β = -0.207 for NH Asians; β = -0.162 for NH Whites). Body mass index was significantly positively associated with menopausal symptoms only in NH Asians (β = 0.118) and Hispanics (β = 0.210). The racial/ethnic differences in the relationships of multiple factors to menopausal symptoms could have resulted from the different cultural contexts in which women undergo during their menopausal transitions. Further cultural studies on the associations of racial/ethnic-specific factors with menopausal symptoms would help in understanding possible causes for racial/ethnic differences in the factors significantly associated with menopausal symptoms.

Improving menopausal symptoms through promoting physical activity: a pilot Web-based intervention study among Asian Americans

OBJECTIVE

Based on previous studies, a Web-based physical activity promotion program with educational modules on menopausal symptoms and physical activity has been developed for Asian American midlife women to reduce their menopausal symptoms through increasing their physical activity. The purpose of this pilot randomized intervention study was to determine the efficacy of the Web-based program in improving menopausal symptom experience of Asian American midlife women.

METHODS

This was a randomized repeated measures pretest/posttest (pretest, post 1 month, and post 3 months) control group study among 29 Asian American midlife women. Multiple instruments were used, including the Midlife Women's Symptom Index and the Kaiser Physical Activity Survey. The data were analyzed using a mixed-model growth curve analysis.

RESULTS

Over time, total severity scores decreased for the control group (-0.53, P < 0.10), whereas they did not exhibit a meaningful change for the intervention group. Both study groups experienced improvement in active living habits over time, but such an improvement was greater for the intervention group (β = 0.29, P < 0.001) than for the control group (β = 0.08, P < 0.10). The time × group interactions for total severity scores were not statistically significant anymore after controlling for physical activity (-0.34 for the control group, P = 0.10).

CONCLUSIONS

The findings supported the feasibility of a 3-month Web-based intervention for menopausal symptom management among Asian American midlife women and the preliminary efficacy of the program in increasing their physical activity.

Immigration transition and sleep-related symptoms experienced during menopausal transition

The transition due to immigration from one country to another country (referred to as immigration transition henceforth) is inherently stressful, placing an additional dimension of stress to midlife women in the menopausal transition. However, few studies have examined the association of immigration to sleep-related symptoms experienced by midlife women in the menopausal transition. The authors' purpose for this study was to explore the associations of immigration to sleep-related symptoms among four major racial/ethnic groups of 1,054 midlife women in the United States. This was a secondary analysis of data from two national surveys that were collected from 2005 to 2013. The instruments included questions on background characteristics, health and menopausal status, immigration transition, and the Sleep Index for Midlife Women. The data were analyzed using t-tests, chi-square tests, correlation analyses, and hierarchical multiple regression analyses. Immigrants reported fewer total numbers of and lower total severity scores of sleep-related symptoms than non-immigrants (p < .01). Yet, when background characteristics and health and menopausal status were controlled, self-reported racial/ethnic identity was the only significant factor associated with sleep-related symptoms (ΔR² = 0.02, p < .01). Health-care providers need to consider self-reported racial/ethnic identity as a factor significantly related to sleep-related symptoms during the menopausal transition.

Physical activity and depressive symptoms in four ethnic groups of midlife women

The purpose of this study was to determine the associations between physical activity and depression and the multiple contextual factors influencing these associations in four major ethnic groups of midlife women in the United States. This was a secondary analysis of the data from 542 midlife women. The instruments included questions on background characteristics and health and menopausal status; the Depression Index for Midlife Women (DIMW); and the Kaiser Physical Activity Survey (KPAS). The data were analyzed using chi-square tests, the ANOVA, two-way ANOVA, correlation analyses, and hierarchical multiple regression analyses. The women's depressive symptoms were negatively correlated with active living and sports/exercise physical activities whereas they were positively correlated with occupational physical activities (p < .01). Family income was the strongest predictor of their depressive symptoms. Increasing physical activity may improve midlife women's depressive symptoms, but the types of physical activity and multiple contextual factors need to be considered in intervention development.

Immigration transition and depressive symptoms: four major ethnic groups of midlife women in the United States

The purpose of this study was to explore the relationships between immigration transition and depressive symptoms among 1,054 midlife women in the United States. This was a secondary analysis of the data from two national Internet survey studies. Questions on background characteristics and immigration transition and the Depression Index for Midlife Women were used to collect the data. The data were analyzed using inferential statistics including multiple regressions. Immigrants reported lower numbers of symptoms and less severe symptoms than nonimmigrants (p <.01). When controlling for background characteristics, self-reported racial/ethnic identity and immigration status were significant predictors of depressive symptoms (R(2) =.01, p <.05).

Ethnic differences in the clusters of menopausal symptoms

Our purpose for this study was to identify clusters of midlife women by menopausal symptoms in a multiethnic sample, and to determine ethnic differences in the clusters. This was a secondary analysis of data from 501 women in a larger Internet study on menopausal symptom experiences. The data were analyzed using factor analysis, hierarchical cluster analysis, and multinominal logistic analysis. A three cluster solution was adopted (F = 575.71, p <.01). The clusters differed significantly in the country of birth and ethnicity (p <.05). Only in the low symptomatic cluster were there significant ethnic differences in menopausal symptoms.

“Being Conditioned, yet Becoming Strong”

Purpose: This study aimed to explore the menopausal symptom experiences of Asian American midlife women within the contexts of their daily lives using a feminist approach. Design: This was a qualitative online forum study among 13 Asian American women recruited through the Internet. Seven discussion topics related to the menopausal symptom experience were used, and the data were analyzed using thematic analysis. Findings: Five themes emerged: (a) “being conditioned,” (b) “becoming strong,” (c) “appreciating,” (d) “without making a fuss,” and (e) “quiet support.” Discussion, Conclusion, and Implications for Practice: These themes represent the women’s marginalized but empowered experience during menopausal transition.

Psychometric evaluation of the Midlife Women's Symptom Index in multiethnic groups

The Midlife Women's Symptom Index (MSI) was designed to measure menopausal symptoms specifically in a multiethnic sample of midlife women. This study involved a psychometric property test to evaluate MSI among 512 multiethnic groups of midlife women (White, Hispanic, African American, and Asian American). Across the ethnic groups, the MSI had an adequate internal consistency in all subdomains except psychosomatic symptoms. The item-total correlation coefficients of lost weight and nosebleeds were lower than .20 among all ethnic groups. The discriminant validity was confirmed among all ethnic groups except Asian Americans. Overall, the MSI may work better for Whites compared with other ethnic groups. Additional studies with diverse groups of multiethnic midlife women are needed, however, to confirm the psychometric properties of the MSI because the samples tended to be a select group.

Menopausal symptoms among four major ethnic groups in the United States

The purpose of the study was to explore ethnic differences in symptoms experienced during the menopausal transition among four major ethnic groups in the United States. This study was done via a cross-sectional Internet survey among 512 midlife women recruited using a convenience sampling. The instruments included questions on background characteristics, ethnicity-related factors, health, and menopausal status and the Midlife Women's Symptom Index. The data were analyzed using descriptive and inferential statistics. Significant ethnic differences were found in the total number and severity of the symptoms. The most frequently reported symptoms and predictors of the total number and severity of the symptoms differed by ethnic identity. More in-depth cultural studies are needed to understand the reasons for the ethnic differences in menopausal symptom experience.

Cultural beliefs and attitudes toward health and health care among Asian-born women in the United States

OBJECTIVE

To describe Asian-born women's cultural beliefs and attitudes towards health, illness, and health care practices.

DATA SOURCES

Online databases PubMed and CINAHL.

STUDY SELECTION

Twenty-four studies published between January 2000 and May 2009 were retrieved based on the inclusion criteria.

DATA EXTRACTION

Data on publication year, authors, study sample, sample size (only Asian women in the United States were included), design, and related key findings were extracted.

DATA SYNTHESES

Data were organized under three categories: Asian cultural beliefs about health and illness, health promotion and illness prevention, and health care practices. Common beliefs across groups and unique beliefs within specific Asian ethnic groups were synthesized. The results indicated that different Asian ethnic groups share some health beliefs, but each group also has unique health beliefs. Existing literature on cultural health beliefs of Asian-born women is limited.

CONCLUSION

Health care providers can use the findings of this review to improve health care utilization among Asian-born women.

A national multiethnic online forum study on menopausal symptom experience

BACKGROUND

Little is known about how culture influences menopausal symptom experience, and few comparative qualitative studies have been conducted among multiethnic groups of midlife women in the United States.

OBJECTIVES

The purpose of this study was to explore commonalities and differences in menopausal symptom experience among four major ethnic groups in the United States (Whites, Hispanics, African Americans, and Asians).

METHODS

This was a secondary analysis of qualitative data from a larger national Internet-based study. The qualitative data from 90 middle-aged women in the United States who attended four ethnic-specific online forums of the larger study were examined using thematic analysis.

RESULTS

The themes reflecting commonalities across the ethnic groups were just a part of life, trying to be optimistic, getting support, and more information needed. The themes reflecting the differences among the ethnic groups were open and closed, universal and unique, and controlling and minimizing. Overall, the findings indicated positive changes in women's menopausal symptom experience and supported the existence of cultural influences on women's menopausal symptom experience across the ethnic groups.

DISCUSSION

Systematic efforts need to be made to empower midlife women in their management of menopausal symptoms.

Acculturation and the cancer pain experience

PURPOSE

Using a feminist perspective, the relationship between acculturation and cancer pain experience was explored.

DESIGN

This was a cross-sectional, correlational Internet study among 104 Hispanic and 114 Asian cancer patients. The instruments included both unidimensional and multidimensional cancer pain measures.

FINDINGS

There were significant differences in cancer pain scores by country of birth. Yet there was no significant association of acculturation to cancer pain scores.

DISCUSSION AND CONCLUSIONS

This study indicated inconsistent findings.

IMPLICATIONS FOR PRACTICE

To provide directions for adequate cancer pain management, further studies with a larger number of diverse groups of immigrant cancer patients are needed.

A qualitative study of menopause among women with disabilities

Few studies have examined the way women with disabilities understand and make decisions regarding menopause. This report is a qualitative descriptive study detailing how women with varying mobility impairments view the menopausal transition. Nineteen women aged 42 to 64 years were interviewed regarding their menopausal experiences. Results described their experiences as minority groups of women with disabilities using a women's ways of knowing framework. Overall, most women described menopause as a back burner issue, but maintained the need for accurate information from which to make informed decisions that might impact future health and functional outcomes.