Refinement of a meaning-centered counseling program for Chinese patients with advanced cancer: Integrating cultural adaptation and implementation science approaches Journal Article

   

Authors:	Lui, F.; Zhang, Q.; Bao, G. C.; Narang, B.; Chen, R. Y.; Niu, Y.; Leng, J.; Breitbart, W.
Article Title:	Refinement of a meaning-centered counseling program for Chinese patients with advanced cancer: Integrating cultural adaptation and implementation science approaches
Abstract:	BACKGROUND: This mixed methods study identified needed refinements to a telehealth-delivered cultural and linguistic adaptation of Meaning-Centered Psychotherapy for Chinese patients with advanced cancer (MCP-Ch) to enhance acceptability, comprehensibility, and implementation of the intervention in usual care settings, guided by the Ecological Validity Model (EVM) and the Practical, Robust Implementation and Sustainability Model (PRISM). METHODS: Fifteen purposively sampled mental health professionals who work with Chinese cancer patients completed surveys providing Likert-scale ratings on acceptability and comprehensibility of MCP-Ch content (guided by the EVM) and pre-implementation factors (guided by PRISM), followed by semi-structured interviews. Survey data were descriptively summarized and linked to qualitative interview data. Three analysts independently coded the transcripts according to EVM and PRISM domains; discrepancies were resolved through discussion and consensus. RESULTS: Quantitative findings showed high appropriateness and relevance of MCP-Ch across five EVM domains of Language, Metaphors/Stories, Goals, Content, and Concepts. Qualitative analysis yielded 23 inductive codes under the seven EVM domains: (1) Language (3 subcodes), (2) Persons (2 subcodes), (3) Metaphors/Stories (2 subcodes), (4) Methods (8 subcodes), (5) Content (2 subcodes), (6) Goals (4 subcodes), and (7) Concepts (2 subcodes). Themes based on PRISM included (1) Intervention characteristics (organizational perspective, 7 subcodes; and patient perspective, 6 subcodes) (2) External environment (2 subcodes), (3) Implementation and sustainability infrastructure (4 subcodes), and (4) Recipients (organizational characteristics, 5 subcodes; and patient characteristics, 4 subcodes). CONCLUSION: Recommendations for next steps include increasing the MCP-Ch protocol's flexibility and adaptability to allow interventionists to flexibly tailor MCP-Ch material to meet patients' individual needs, simplifying content to improve comprehension and acceptability, providing additional training to Chinese-serving providers to increase adoption and sustainability, and considering interpreter-assisted delivery to increase access. Findings yielded important information to maximize cultural relevance as well as the implementation and sustainability potential of MCP-Ch in real-world settings. © 2025. The Author(s).
Keywords:	adult; middle aged; counseling; neoplasm; neoplasms; questionnaire; interviews as topic; interview; qualitative research; therapy; psychotherapy; china; telemedicine; mixed methods; procedures; asian americans; transcultural care; east asian; humans; human; male; female; surveys and questionnaires; implementation science; cultural adaptation; culturally competent care; east asian people
Journal Title:	BMC Health Services Research
Volume:	25
ISSN:	1472-6963
Publisher:	BioMed Central Ltd.
Date Published:	2025-01-15
Start Page:	85
Language:	English
DOI:	10.1186/s12913-024-12124-3
PUBMED:	39815347
PROVIDER:	scopus
PMCID:	PMC11736934
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85215982591&doi=10.1186%2fs12913-024-12124-3&partnerID=40&md5=5a113d5fa0945011382bf2e12fe47e69
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Florence Lui -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/222132