Navigating norms and expectations: the influence of culture on Latino couples and their interpersonal communication and coping post-breast cancer diagnosis.

OBJECTIVES: Cultural norms shape expectations, care, and communication. Effective interpersonal communication is a prominent predictor of patient-partner cancer management, improving the overall quality of life for the dyad by increasing their ability to cope with cancer. However, couples-based cancer interventions often do not consider cultural factors. Additionally, although Latinas have a high incidence of breast cancer, few studies focus on Latino couples and the influence of culture in cancer care interventions. This study focuses on understanding how Latino culture's norms and expectations influence how couples communicate and cope post-breast cancer diagnosis. DESIGN: This study conducted interviews and focus groups with a purposive sample of Spanish-speaking Latina breast cancer survivors (N = 21) and intimate partners (N = 5). In the focus group and interviews, participants were asked about the influence cancer had on their relationship, with specific questions focusing on communication within the dyad. The study team used CARV: Community-Engaged Adaptation with Rapid Analysis and Visualization framework to identify cultural considerations and recurring themes. RESULTS: The cross-cutting cultural considerations and themes found were: the negative influence of gendered and social norms on managing emotions and coping; the silent struggle with physical intimacy; and the inability to discuss the topic - or even say the word 'cancer.' CONCLUSION: Understanding the role of Latino culture in how couples cope with and communicate about cancer post-diagnosis is essential. This understanding will help strengthen the dyad by assisting with positive interpersonal support, which contributes to a better quality of life. These findings will also help providers assist dyads in navigating the cancer diagnosis and journey, helping to lessen the interpersonal stress and tensions that can occur after diagnosis.

Examining intervention hours attended for couples randomly assigned to receive relationship education.

Relationship education (RE) has shown promise as an effective intervention for couples. Yet, challenges exist with retaining low-income couples and federal funding required that grantees provide at least 12 h of core content. We conducted a follow-up analysis to a randomized trial of RE with low-income couples. We focused on couples randomly assigned to the treatment (N = 579) and examined the influence of intervention hours on emotion regulation, dyadic coping, and individual distress at 1 and 6-month follow-up. Results of longitudinal actor-partner interdependence models indicated that women who completed the program reported fewer difficulties in emotion regulation at 6-month follow-up than women who attended fewer intervention hours. Additionally, men who completed reported more individual distress at 1-month follow-up than men who attended fewer hours. Given that most couples were Hispanic, we conducted an exploratory analysis to examine language as a covariate with mixed results.

Examining the stability of emotional regulation and psychological distress for low-income individuals: A latent transition analysis.

Previous relationship education research has focused on investigating healthy relationships at the couple level, with limited research conducted on individual-oriented relationship education programs for economically disadvantaged individuals. More specifically, there is a lack of research on how individual-oriented relationship education programs contribute to changes in unique attributes of individuals who enroll in these programs and who would benefit most from relationship education programs. The primary aim of this study is to understand the stability of economically disadvantaged individuals' psychological distress and emotion regulation over two time points, comparing individuals randomly assigned to the relationship intervention using Prevention and Relationship Education's (PREP) Within My Reach (WMR) versus those assigned to a wait-list control. Using a sample of 1129 economically disadvantaged individuals enrolled in the study, results indicated that the three-class model for psychological distress and emotion regulation was the most appropriate for the latent transition analysis. Treatment group participants were more likely to transition to more adaptive models than their wait-list control counterparts, although a small percentage of participants did transition to a less adaptive model. Implications, future directions, and limitations are discussed.

A randomized trial of relationship education using Within Our Reach for economically vulnerable couples.

Couples relationship education is grounded in teaching couples' skills and strategies to form and sustain healthy relationships. The purpose of this investigation was to examine the impact of a relationship education intervention on emotion regulation, individual distress, dyadic coping, and relationship adjustment utilizing a randomized control trial for economically vulnerable couples. The analysis sample included 1418 couples (2836 individuals) who were randomly assigned to receive the 12-h Within Our Reach curriculum immediately, or to a wait-list control group. We estimated multilevel growth curve models over time among outcomes between treatment and wait-list control conditions. Treatment group couples demonstrated statistically significant improvements over the 6-month study period on emotional regulation and dyadic coping when compared to their wait-list group counterparts. Although models showed improvements in individual distress and relationship adjustments, these improvements did not amount to statistically significant group differences. Implications and limitations are also noted.

Using Intent-to-Attend to Predict Attendance in Community-Based Relationship Education.

Government-supported relationship education has provided resources for inclusion of economically vulnerable and ethnically diverse participants; however, many grantees and programs struggled to retain couples in longitudinal studies, which has likely influenced study effects and threatened internal validity. In the present study, we assessed 1,056 couples' baseline relationship satisfaction and intent-to-attend their next scheduled visit while participating in a randomized controlled trial of relationship education and evaluated the predictive ability of their responses to remain in the six-month study. We conducted actor-partner interdependence models for couples, using a probit cross-lagged regression with a structural equation modeling framework, to test the dyadic influence of intent-to-attend on future couple attendance. We also examined the influence of higher or lower baseline relationship satisfaction between partners and group assignment (treatment or wait-list control) on attendance. Intent-to-attend scores were associated with attendance for couples at the one-month follow-up, and early attendance was the biggest predictor of later attendance. Additionally, baseline intent-to-attend scores predicted later intent-to-attend scores for all follow-up time points. However, we found no partner effects, and no effects for the influence of baseline relationship satisfaction or group assignment. We discuss practical suggestions for including intent-to-attend in future studies, relationship education programming, and general therapy practice.

La capacitación en relaciones financiada por el gobierno ha facilitado recursos para la inclusión de participantes económicamente vulnerables y de distintas etnias; sin embargo, a muchos beneficiarios y programas les costó mantener a las parejas en los estudios longitudinales, lo cual probablemente haya influido en los efectos de los estudios y amenazado su validez interna. En el presente estudio, evaluamos la satisfacción con la relación en el momento basal de 1056 parejas y la intención de asistir a su próxima visita programada mientras participaban en un ensayo controlado aleatorizado de capacitación en relaciones, y evaluamos la capacidad predictiva de sus respuestas para permanecer en el estudio de seis meses. Implementamos modelos de interdependencia actor-pareja para las parejas usando un modelo Probit de regresión y retardo cruzado con un marco de modelos de ecuaciones estructurales con el fin de evaluar la influencia diádica de la intención de asistir en la asistencia futura de la pareja. También analizamos la influencia del nivel más bajo o más alto de satisfacción con la relación en el momento basal entre los integrantes de la pareja y la distribución a un grupo (de tratamiento o de control en lista de espera) en la asistencia. Los puntajes de la intención de asistir estuvieron asociados con la asistencia de las parejas en el seguimiento de un mes, y la asistencia inicial fue la mayor predictora de la asistencia posterior. Además, los puntajes de la intención de asistir en el momento basal predijeron los puntajes posteriores de la intención de asistir de todos los momentos de seguimiento. Sin embargo, no hallamos efectos de la pareja ni efectos de la influencia de la satisfacción con la relación o la distribución a un grupo en el momento basal. Comentamos sugerencias prácticas para incluir la intención de asistir en estudios futuros, en programas de capacitación en relaciones y en la práctica de la terapia general.

Examining quality time as a mediator of dyadic change in a randomized controlled trial of relationship education for low-income couples.

Research identifying specific mechanisms of positive change for couples participating in relationship education is scant. Recent studies have identified the potential of communication skills as a likely mechanism, yet more information is needed about the contribution of process factors. Thus, we examined the influence that quality time spent together had on positive post-intervention outcomes based on couples' reports of dyadic coping and dyadic adjustment for 1,367 low-income couples randomly assigned to receive relationship education. Results indicated that treatment couples reported significant gains in quality time spent together, and that those gains fully mediated positive changes in dyadic coping and adjustment. Additionally, actor and partner effects existed such that men's and women's reports of improved quality time influenced their own and their partners dyadic coping and dyadic adjustment. We discuss study implications for practice and future research.

Effects of individual-oriented relationship education for parents: A randomized controlled trial.

Individual-oriented relationship education aims to support healthy relationship development for singles, and provides flexibility for couples when only one member is available or willing to attend. While quasi-experimental studies have shown some benefits for those who attended relationship education individually, no randomized controlled trials have been conducted for individual-oriented RE. Moreover, it is not clear how relationship education benefits the co-parenting relationship when only one parent attends. Thus, this paper presents the results of a randomized controlled trial, with a wait-list control group, for a sub-sample of parents (N = 322) who participated in a 6-month trial of individual-oriented relationship education utilizing Prevention and Relationship Education Program's (PREP) Within My Reach (WMR) curriculum. Results indicated statistically significant, small, positive intervention effects on parent-child relationships 3 months after random assignment. However, no other treatment effects were detected for parents. We also found no statistically significant differences in the rate of change over the 6-month study period between treatment and wait-list control parents. There was a statistically significant effect for time, indicating that all enrolled parents in the study reported significant positive growth on emotion regulation, positive encouragement, parent-child relationships, and parental adjustment. We discuss implications for relationship education programming, as well as evaluating outcomes in future studies. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mediation of Childhood Adversity and Health by Relationship Quality in Diverse Couples.

Individuals with economic disadvantage experience greater (a) adverse childhood experiences (ACE), (b) risk for low relationship quality and relationship dissolution, and (c) disparity in physical and mental health. Thus, a critical need exists to understand the connections between areas of disparity in family and relational health on physical and mental health for those most vulnerable to the deleterious effects. The researchers therefore tested a dyadic model for the mediation of ACE and health by relationship quality with data from 503 couples with economic disadvantage and a racial or ethnic minority background (76.9%). The data fit the proposed model and explained a majority of the variance in health, 82.3% of the variance in men's health and 56.5% in women's health-both large effects. Moreover, the significant indirect pathway between ACE and health through relationship quality contributed 98.05% and 57.40% of the total effects for men and women, respectively. Overall, a significant relationship existed between ACE, relationship quality, and health for men and women at the actor-level and the dyadic influence between members of a couple contributed to the overall model fit. Results add to support for the role of relationship quality as a dyadic social determinant of health disparities with implications for prevention and intervention.

Las personas desfavorecidas económicamente sufren más (a) experiencias adversas en la infancia (EAI), (b) riesgo de una baja calidad de las relaciones y de disolución de las relaciones, y (c) disparidad en la salud física y mental. En consecuencia, existe una necesidad imperiosa de comprender las conexiones entre las áreas de disparidad en la salud familiar y relacional, y la salud física y mental para aquellos más vulnerables a los efectos perjudiciales. Por lo tanto, los investigadores evaluaron un modelo diádico para la mediación de las EAI y la salud según la calidad de la relación con datos de 503 parejas desfavorecidas económicamente y un origen de minoría étnica o racial (76.9%). Los datos se adaptaron al modelo propuesto y explicaron una mayoría de la varianza en la salud, un 82.3% de la varianza en la salud de los hombres y un 56.5% en la salud de las mujeres, ambos grandes efectos. Además, la vía indirecta significativa entre las EAI y la salud mediante la calidad de la relación aportó un 98.05% y un 57.40% de los efectos totales para los hombres y las mujeres respectivamente. En general, existió una relación significativa entre las EAI, la calidad de la relación y la salud para los hombres y las mujeres a nivel del actor, y la influencia diádica entre los integrantes de una pareja contribuyó a la adaptación al modelo en general. Los resultados respaldan aún mas el rol de la calidad de la relación como determinante social diádico de disparidades en la salud con implicancias para la prevención y la intervención.

Relationship Distress as a Mediator of Adverse Childhood Experiences and Health: Implications for Clinical Practice with Economically Vulnerable Racial and Ethnic Minorities.

Adverse childhood experiences (ACE) are interpersonal sources of distress negatively correlated with physical and mental health, as well as maladaptive intimate partner conflict strategies in adulthood. Economically vulnerable racial and ethnic minorities report the greatest disparities in exposure to ACE, as well as relationship distress and health. Yet, little is known about the connections between ACE, relationship distress, and health. We therefore tested a theoretical model for the mediating role of relationship distress to explain the ACE-health connection with a sample (N = 96) predominantly racial/ethnic minorities (87%) with low income. We applied partial least squares structural equation modeling with bootstrapping (N = 500). Relationship distress strengthened the predictive relationship between ACE and health, and accounted for 42% of the variance in health. The results provide preliminary support for relationship distress as a social determinant of health disparities with implications for interdisciplinary health intervention.

Las experiencias adversas de la infancia son fuentes interpersonales de distrés correlacionadas negativamente con la salud mental y física así como con estrategias desadaptativas de conflicto con la pareja íntima en la adultez. Las minorías étnicas y raciales económicamente vulnerables informan las mayores divergencias en la exposición a experiencias adversas de la infancia, así como en el distrés en la relación y en la salud. Sin embargo, se sabe poco acerca de las conexiones entre las experiencias adversas de la infancia, el distrés relacional y la salud. Por lo tanto, evaluamos un modelo teórico para el rol mediador del distrés relacional a fin de explicar la conexión entre la salud y las experiencias adversas de la infancia con una muestra (N = 96) de minorías raciales o étnicas (87%) predominantemente de bajos recursos. Aplicamos un modelo de ecuaciones estructurales utilizando regresión parcial por mínimos cuadrados con análisis de remuestreo (N = 500). El distrés relacional fortaleció la relación predictiva entre las experiencias adversas de la infancia y la salud, y justificó el 42% de la varianza en la salud. Los resultados ofrecen un respaldo preliminar del distrés de la relación como determinante social de divergencias en la salud con implicancias para una intervención interdisciplinaria en la salud.

Prostate cancer: the influence of stigma on quality of life and relationship satisfaction for survivors and their partners.

OBJECTIVES: Prostate cancer (PCa) stigma and its relationship to quality of life (QoL) is a relatively new finding. As the experiences of couples facing PCa are shared, the study examined the relationship between of PCa stigma, QoL, and relationship satisfaction of PCa survivors and their spouses. DESIGN: A correlational design with dyadic data was used. SAMPLE: Participants (N = 80 dyads) were PCa survivors and their spouses sampled from an oncology center and PCa support groups. METHODS: Structural equation modeling was used to assess how stigma related to the QoL and relationship satisfaction of participants. FINDINGS: Stigma had a negative association with QoL, but not relationship satisfaction. There were no significant demographic differences in regards to stigma. CONCLUSION: Overall, stigma has a relationship with the experience of couples, but not with every aspect of their experience. Implications for psychosocial providers: Implications for clinicians in regards to addressing PCa stigma with clients and areas for future research are discussed.

The influence of stigma on the quality of life for prostate cancer survivors.

The purpose of the present study was to investigate the influence of stigma on prostate cancer (PCa) survivors' quality of life. Stigma for lung cancer survivors has been the focus of considerable research (Else-Quest & Jackson, 2014); however, gaps remain in understanding the experience of PCa stigma. A cross-sectional correlational study was designed to assess the incidence of PCa stigma and its influence on the quality of life of survivors. Eighty-five PCa survivors were administered survey packets consisting of a stigma measure, a PCa-specific quality of life measure, and a demographic survey during treatment of their disease. A linear regression analysis was conducted with the data received from PCa survivors. Results indicated that PCa stigma has a significant, negative influence on the quality of life for survivors (R2 = 0.33, F(4, 80) = 11.53, p < 0.001). There were no statistically significant differences in PCa stigma based on demographic variables (e.g., race and age). Implications for physical and mental health practitioners and researchers are discussed.

Mindful caring: using mindfulness-based cognitive therapy with caregivers of cancer survivors.

Caregivers of cancer survivors face many burdens that often require treatment by mental health professionals. One intervention, mindfulness-based cognitive therapy, aims to help individuals change the ways in which they relate to their thoughts rather than changing their thoughts. In this manuscript, we discuss the use and adaption of mindfulness-based cognitive therapy with caregivers of cancer survivors as a way to decrease caregiver burden and increase caregiver quality of life. A session-by-session breakdown of how to tailor mindfulness-based cognitive therapy to caregivers of cancer survivors is provided.