Conducting Photovoice With Binational Cancer Survivors to Identify Health Behavior Change Intervention Preferences.

BACKGROUND: Culturally adapted behavior interventions are needed to support lifestyle behavior change for survivors of cancer. OBJECTIVES: To identify programming preferences of Mexicanorigin female survivors of breast cancer living on the U.S./Mexico border. METHODS: We conducted a nine-week photovoice project with survivors of breast cancer in Nogales, Sonora/Arizona exploring viewpoints on food and dietary habits, wellness activities, and preferences for healthy lifestyle intervention programming. Photovoice, a participatory qualitative research technique, provided participants with research skills to document and share their lived experience through photographs. Weekly sessions began with photograph presentations and concluded with group discussion of common themes. Data were analyzed following a thematic content analysis using session notes and written narratives compiled during discussion sessions. RESULTS: Survivors (n = 6) worked collaboratively with facilitators to identify themes related to diet and physical activity behavior. Connection between food and culture and the importance of enjoying meals with others was emphasized. Primary activity interests included leisure-time recreation that relieved anxiety related to their cancer diagnosis rather than regimented exercise routines. Participants noted the importance of giving and receiving social support and emphasized altruism to support positive mood and self-efficacy during survivorship. Networking and knowledge sharing were considered valuable. CONCLUSIONS: Our findings highlight the importance of collaborative research such as photovoice to gain insights for adaptation of evidence-based lifestyle interventions for Mexican-origin survivors of cancer. Key adaptation considerations include culturally relevant dietary preferences and patterns, physical activities with a strong mind-body component, and opportunities for social engagement and experience sharing.

Health Promotion Among Mexican-Origin Survivors of Breast Cancer and Caregivers Living in the United States-Mexico Border Region: Qualitative Analysis From the Vida Plena Study.

BACKGROUND: Hispanic survivors of cancer experience increased cancer burden. Lifestyle behaviors, including diet and physical activity, may reduce the cancer burden. There is limited knowledge about the posttreatment lifestyle experiences of Hispanic survivors of cancer living on the United States-Mexico border. OBJECTIVE: This study aims to support the development of a stakeholder-informed, culturally relevant, evidence-based lifestyle intervention for Mexican-origin Hispanic survivors of cancer living in a border community to improve their dietary quality and physical activity. METHODS: Semistructured interviews with 12 Mexican-origin Hispanic survivors of breast cancer and 7 caregivers were conducted through internet-based teleconferencing. The interviews explored the impact of cancer on lifestyle and treatment-related symptoms, perception of lifestyle as an influence on health after cancer, and intervention content and delivery preferences. Interviews were analyzed using a deductive thematic approach grounded in the Quality of Cancer Survivorship Care Framework. RESULTS: Key survivor themes included perception of Mexican diet as unhealthy, need for reliable diet-related information, perceived benefits of physical activity after cancer treatment, family support for healthy lifestyles (physical and emotional), presence of cancer-related symptoms interfering with lifestyle, and financial barriers to living a healthy lifestyle. Among caregivers, key themes included effects of the cancer caregiving experience on caregivers' lifestyle and cancer-preventive behaviors and gratification in providing support to the survivors. CONCLUSIONS: The interviews revealed key considerations to the adaptation, development, and implementation of a theory-informed, evidence-based, culturally relevant lifestyle program to support lifestyle behavior change among Mexican-origin Hispanic survivors of cancer living in border communities. Our qualitative findings highlight specific strategies that can be implemented in health promotion programming aimed at encouraging cancer protective behaviors to reduce the burden of cancer and comorbidities in Mexican-origin survivors of cancer living in border communities.