Cultural Health Beliefs and Health Behaviors in Asian American Breast Cancer Survivors: A Mixed-Methods Approach

Purpose/Objectives: To explore the relationships between cultural health beliefs, acculturation, treatment-related decisions, the doctor-patient relationship, and health behaviors among Asian American breast cancer survivors (AABCS), and the contextual meaning of those relationships among Korean American breast cancer survivors (KABCS) and AABCS. Design: A mixed-methods triangulation design. Setting: Community- and hospital-based support groups and hospital cancer registries in California. Sample: 206 AABCS were included in the quantitative phase, and two focus groups were conducted with KABCS (N = 11) during the qualitative phase. Methods: The quantitative phase used secondary data for AABCS. Standardized (i.e., cultural health beliefs, doctor-patient relationship, and acculturation) and newly developed instruments (i.e., health behaviors and treatment-related decisions) were used in the quantitative phase. An exploratory, descriptive, qualitative study of KABCS then was undertaken. Main Research Variables: Cultural health beliefs, acculturation, treatment-related decisions, the doctor-patient relationship, and health behaviors. Findings: Inter-intrapersonal health beliefs, doctor-patient relationship, and shared decision making were positively associated with adopting healthy lifestyle practices. Findings from the quantitative phase were explained further by the diverse themes that emerged in the KABCS focus groups. Conclusions: This study provides new knowledge about cultural health beliefs and health behaviors among KABCS using a mixed-methods approach. Implications for Nursing: The results highlight the need for greater attention to the cultural contexts of AABCS to promote healthy behaviors and recognition of the significant relationship between health professionals and breast cancer survivors.