TRADITIONAL AND NEW LIFESTYLE INTERVENTIONS TO PREVENT BREAST CANCER RECURRENCE (TANICA) FOCUS GROUP RECOMMENDED INTERVENTIONS COMPARED TO EVIDENCE-BASED FILIPINO AND NATIVE HAWAIIAN LIFESTYLE INTERVENTIONS IN HAWAIʻI
TRADITIONAL AND NEW LIFESTYLE INTERVENTIONS TO PREVENT BREAST CANCER RECURRENCE (TANICA) FOCUS GROUP RECOMMENDED INTERVENTIONS COMPARED TO EVIDENCE-BASED FILIPINO AND NATIVE HAWAIIAN LIFESTYLE INTERVENTIONS IN HAWAIʻI
Date
2023
Authors
Delos Reyes, Bernice Christine
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Esquivel, Monica
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Nutrition
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Abstract
Obesity is a modifiable risk factor for breast cancer recurrence. Breast cancer is the most common cancer among adult women in Hawaiʻi and the second leading cause of cancer-related mortalities in Hawaiʻi. Native Hawaiian and Filipino women are disproportionately affected by breast cancer. Studies have shown that breast cancer survivors benefit from healthy lifestyle behaviors after breast cancer treatment. Obesity is the result of a number of influential factors on varying levels of the Social-Ecological Model (SEM) of Health. Through community-based participatory research (CBPR), evidence-based lifestyle interventions involving physical activity and a healthy nutritional program have addressed chronic health conditions, such as cardiovascular disease and diabetes. Utilizing a CBPR approach to intervention development that addresses multiple levels of the SEM is an effective strategy for developing a culturally tailored program. However, evidence-based lifestyle interventions have not been created for Native Hawaiian and Filipino breast cancer survivors in Hawaiʻi. To bridge this gap in knowledge, the Traditional and New Lifestyle Interventions to Prevent Breast Cancer (TANICA) Project was initiated in 2021 to create a culturally relevant lifestyle intervention for Native Hawaiian and Filipino breast cancer survivors living in Hawaiʻi. Reducing obesity through an evidence-based lifestyle intervention may help prevent breast cancer recurrence among Native Hawaiian and Filipino women. Physical activity and nutrition education or activity components, intervention strategies, and themes were analyzed and developed through TANICA focus group discussions and surveys. The TANICA focus group discussion data was compared to evidence-based lifestyle interventions in Hawaiʻi from the TANICA systematic review. The evidence-based interventions were scored by the number of cultural adaptations and cultural sensitivities identified.
The TANICA systematic review identified 16 evidence-based journal articles representing 11 interventions unique to Hawaiʻi. Throughout the 11 interventions, all levels of the SEM were addressed. Five interventions employed all eight cultural adaptation strategies22,25,31,38,39,43. From these, the Ola Hou i ka Hula pilot22 and Kā-HOLO Project23,39,40 received the highest scores for physical activity and nutrition components utilized closest to recommendations with the TANICA breast cancer focus group participants. Focus group participants requested an eight-week intervention with in-person, outdoor, and group physical activity. The physical activity intervention should be in a convenient location, have childcare, and be family-centered. The focus group participants requested a nutrition intervention be either online or in-person and also in a group setting. The nutrition intervention should include affordable, healthier local alternatives, nutrition education, and pre-cooked meal options, as well as promoting an environment where the family could eat together and where breast cancer survivors could exchange stories with other survivors. They recommended the intervention be held twice a week, on a weekday, and for the duration of an hour in the mornings. The results will inform a culturally relevant lifestyle intervention for Native Hawaiian and Filipino breast cancer survivors living in Hawaiʻi.
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Nutrition,
Public health,
Health sciences
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61 pages
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