Promising Directions: A Systematic Review of Psychosocial and Behavioral Interventions with Cultural Incorporation for Advanced and Metastatic Cancer.

BACKGROUND: Improving quality of life (QOL) in advanced and metastatic cancer is a priority with increasing survivorship. This systematic review synthesizes psychosocial and behavioral interventions incorporating culture with the goal of examining their benefit for understudied and medically underserved populations with advanced and metastatic cancer. METHOD: Reports were systematically screened for (1) a focus on advanced and metastatic cancer survivors, (2) psychosocial or behavioral intervention intended to improve QOL, (3) evidence of incorporating the culture(s) of understudied/underserved populations, and (4) availability in English. Bias was evaluated using the JBI Critical Appraisal Checklist and the Methodological index for non-randomized studies. Qualitative synthesis and quantitative meta-analyses were completed. RESULTS: Eighty-six reports containing 5981 participants' data were examined. Qualitative synthesis of 23 studies identified four overarching themes relevant for incorporating culture in interventions. Meta-analysis of 19 RCTs and 4 quasi-experimental studies containing considerable heterogeneity indicated greater improvements in QOL (g = 0.84), eudaimonic well-being (g = 0.53), distress (g = -0.49), and anxiety (g = -0.37) for main intervention conditions compared to controls. Meta-analysis of 10 single-arm trials containing minimal to moderate heterogeneity found benefit for anxiety (g = -0.54), physical symptoms (g = -0.39), and depression (g = -0.38). CONCLUSION: Psychosocial and behavioral interventions with cultural incorporation appear beneficial for improving QOL-related outcomes in advanced and metastatic cancer. Studies incorporating culture in psychosocial or behavioral interventions offer noteworthy insight and suggestions for future efforts such as attending to deep cultural structure.

Culturally adapting relational savoring: A therapeutic approach to improve relationship quality.

Relational savoring (RS) is a brief, strengths-based approach to heightening attentional focus to moments of positive connectedness within relationships. RS can be administered preventatively or within an intervention context when a therapist aspires to foster more optimal relational functioning. Typically administered within a one-on-one therapy setting, RS has demonstrated efficacy in enhancing intra- and interpersonal outcomes. To increase access to mental health services, the developers of RS are committed to engaging in an iterative approach of enhancing the cultural congruence and accessibility of this intervention within various cultural contexts, beginning with Latine groups in Southern California. In this article, we describe relational savoring and its theoretical and empirical support, including the process of culturally adapting the intervention within the context of three major studies, each with a distinct focus on Latine groups, a community that is underserved in mental health care settings. We then provide a vision for future research to improve upon the intervention's compatibility for Latine families and other populations.

Maternal blood pressure and birth weight associations in U.S.-born and foreign-born Latinas.

OBJECTIVES: Research suggests that acculturating to the United States is detrimental for immigrants' health. Consistent with this pattern, higher levels of U.S. acculturation among Latina-American women have been associated with giving birth to lower birth weight babies. The mechanisms that shape this shift in pregnancy health are not clear, but researchers have begun to consider the role of physiological systems that are sensitive to social experience. The present study examined the association of cultural orientation with blood pressure (BP) trajectories over the course of pregnancy. METHOD: In a study of 1,011 U.S.- and foreign-born Latina-American women, cultural orientation was assessed and multiple BP measures were collected throughout pregnancy. Postpregnancy data, including gestational age-adjusted birth weight, were extracted from medical records. Bayesian structural equation models examined average BP and slopes of BP change during pregnancy while accounting for psychosocial stress, support, and pregnancy health-related factors (e.g., maternal age, smoking). RESULTS: We found evidence that greater U.S. orientation was associated with higher diastolic blood pressure (DBP) and steeper increases in DBP, which was associated with less fetal growth. CONCLUSIONS: This is the first evidence that BP may mediate the association between cultural orientation and pregnancy outcomes in Latina-American women. These findings advance our understanding of the biopsychosocial pathways through which acculturation to the U.S. links with health. As scholars seek to better understand the influence of U.S. acculturation on health, focusing on the cardiovascular system and other physiological systems that are sensitive to social experience is warranted and likely to prove valuable. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perceived neighborhood disorder and type 2 diabetes disparities in Hispanic, Black, and White Americans.

Introduction: Approximately 32 million Americans have type 2 diabetes, and that number continues to grow. Higher prevalence rates are observed among certain subgroups, including members of marginalized racial/ethnic groups as well as residents of disordered neighborhoods (i.e., those with more trash and vandalism). Institutionalized discriminatory practices have resulted in disproportionate representation of marginalized racial/ethnic groups in disordered neighborhoods compared to non-Hispanic Whites. These neighborhood disparities may partially contribute to health disparities, given that signs of neighborhood disorder often relate to a general withdrawal from the neighborhood, minimizing opportunities for both physical and social engagement. Yet, research suggests variability across racial/ethnic groups both in reporting rates of neighborhood disorder and in the extent to which neighborhood disorder is interpreted as posing a threat to health and well-being. Methods: Using 2016-2018 Health and Retirement Study data (n = 10,419, mean age = 67 years), a representative sample of older US adults, this study examined the possibility of racial/ethnic differences in associations between perceived neighborhood disorder and type 2 diabetes risk. Participants reported their perceptions of neighborhood disorder and type 2 diabetes status. Weighted logistic regression models predicted type 2 diabetes risk by perceived neighborhood disorder, race/ethnicity, and their interaction. Results: Non-Hispanic Blacks and Hispanics had higher type 2 diabetes risk; these two groups also reported more disorder in their neighborhoods compared to non-Hispanic Whites. Perceiving more neighborhood disorder was associated with increased type 2 diabetes risk, but the interaction between race/ethnicity and disorder was not significant. Discussion: Findings from the current study suggest that the negative effects of perceiving neighborhood disorder, a neighborhood-level stressor, extend to increased type 2 diabetes risk.

Attachment insecurity, heart rate variability, and perceived social support in a diverse sample of young adults.

Psychological and physical factors are robustly associated with perceived social support. Drawing from the literature on attachment style in adults and psychophysiology, we examined the possibility that the interaction of attachment insecurity and resting heart rate variability (HRV) was associated with perceived social support in a diverse sample of young adults living in the U.S (N = 145, Mage = 20.45) that was majority Latino (n = 77). Analyses revealed three key findings. First, in the overall sample, attachment avoidance and attachment anxiety were negatively associated with perceived social support, but in the Latino sample, only attachment avoidance was negatively associated with perceived social support. Second, HRV was not associated with perceived social support in the overall sample nor in the Latino sample. Third, attachment insecurity and HRV interacted to predict perceived social support only in the Latino sample such that, for those with lower levels of HRV, attachment anxiety was positively associated with perceived social support. This study underscores the importance of examining both psychological and physiological processes with careful consideration of ethnicity/culture in order to better understand perceived social support.

What predicts interdependence with family? The relative contributions of ethnicity/race and social class.

OBJECTIVE: Interdependence with family is considered a core element of collectivistic cultures, and it is routinely endorsed by people of ethnic/racial minority backgrounds in the United States. In contrast, a preference for independence from family is characteristic of individualistic cultures, and of European Americans, who are considered prototypical of cultural individualism. Scholars have also theorized that socioeconomic factors play a role in shaping these patterns. We hypothesized and tested the possibility of a more nuanced and interactive pattern. Drawing from long-standing research on U.S. ethnic-minority cultures and recent research on social class, we expected that lower income would be least associated with family interdependence in foreign-born Latino/a Americans and most strongly associated with higher family interdependence in European Americans. METHOD AND RESULTS: In a prospective community study of a diverse sample of U.S. adults (N = 2,466), income interacted with ethnic/racial group to predict interdependence with family. In line with our predictions, income was not associated with family interdependence for foreign-born Latino/a Americans or African Americans, but lower income was significantly associated with higher interdependence with family in European Americans and, to a lesser extent, in U.S.-born Latino/a Americans. CONCLUSIONS: These findings provide novel evidence for the relevance of both ethnicity/race and social class-two aspects of culture-for family interdependence. They highlight the centrality of interdependence with family among foreign-born Latino/a Americans while showing that European Americans, a group considered most representative of cultural individualism, can also highly value interdependence with family. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Displaying pride: Variation by social context, ethnic heritage, and gender?

Pride is universal; however, the complexities linked to its social status functions and implications for social relationships suggest the possibility of variation in its display. Drawing from empirical evidence, this study examined whether displayed pride would vary by social context (i.e., whether the target was a competitor or a loved one), ethnic heritage (i.e., membership in individualistic or collectivistic cultural groups) and by gender. Young adults (N = 145) verbally described a pride experience to an imagined competitor, loved one, stranger or in a no-context control condition. Results showed similarity in displayed pride across the four contexts. However, some ethnic group and gender variations were observed. Latino/a/x Americans displayed less pride verbally than European Americans while women displayed more than men. These findings contribute to a better understanding of how people manage the display of pride and suggest that ethnic and gendered motivations for managing pride displays are relevant to a comprehensive understanding of interpersonal emotion regulation.

Well-being: Strengthening and Broadening a Key Psychological Construct.

Park et al.'s (2022) goal of bringing conceptual clarity to the study of psychological aspects of well-being is a good one. We consider their work in terms of its implications for moving towards an understanding of well-being that reflects the full spectrum of human experience, especially the experience of people who remain underrepresented, and poorly accounted for, in psychological science. In our view, there is reason to think that strengthening existing frameworks and broadening in terms of methodologies will be most productive for developing a comprehensive and inclusive understanding of well-being. We describe the distinct strength of the subjective well-being (SWB) construct for this purpose and offer two empirical examples that highlight the value of multiple measures and methods for understanding well-being. We suggest that continued use of the SWB measure, combined with state-of-the-art emotion measurement, and a mix of qualitative and quantitative methodologies be recommended as the way forward.

Relational savoring intervention: Positive impacts for mothers and evidence of cultural compatibility for Latinas.

Parenting young children poses numerous emotion regulation challenges, and prevention programs that promote emotion regulation skills can help with this important task of parenthood. Relational savoring (RS), which entails savoring a positive experience of interpersonal connectedness, is a brief manualized intervention program, 4 weeks in length, grounded in positive psychology and attachment theory. In the current longitudinal, randomized, controlled trial, we examined the impacts of RS compared with an active control (personal savoring [PS], defined as savoring a positive individual experience) in a sample of N = 164 mothers of toddlers (Mage = 20.93 months) on outcomes that were assessed immediately postintervention (positive emotion, closeness to child) and at a 3-month follow-up visit (parenting sensitivity, reflective functioning [RF], savoring uptake, and parenting wellness). Compared with mothers assigned to the PS condition, mothers in the RS condition had greater immediate response to the intervention (greater increases in positive emotions [gratitude, pride], closeness to their child) as well as greater increase in sensitivity to toddlers' cues at the three-month follow-up. Neither RS nor PS increased overall parenting wellness at the three-month follow-up. Latina mothers (but not non-Latina mothers) in the RS condition had higher RF and greater savoring uptake than Latina mothers in the PS condition at follow-up. Findings provide preliminary evidence of the efficacy of RS in modifying therapeutic targets and suggest evidence of the cultural congruence of RS for Latina mothers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Within- and between-group heterogeneity in cultural models of emotion among people of European, Asian, and Latino heritage in the United States.

Research on cultural variation in emotion values and beliefs has usually explained this variation in terms of individualism and collectivism, typically comparing European American against East Asian cultural contexts. This study examined emotion model variability across as well as within cultural contexts in a large sample of young adults of Latino heritage along with people of European and East Asian heritage. Using latent class analysis, we characterized and predicted endorsement of emotion models, distinguishing emotion ideals (the emotions one desires) from beliefs about injunctive norms for emotion (the emotions one believes are appropriate). Students from three universities in different regions of the United States (N = 1,618; 490 of European heritage, 463 of Asian heritage, 665 of Latino heritage) provided data on the desirability and appropriateness of experiencing 19 specific emotions in daily life, as well as their U.S. cultural orientation and sociodemographic characteristics. Four distinct classes/models of emotion desirability and four classes/models of emotion appropriateness emerged. Latent class regression demonstrated that endorsement of emotion models was systematically related to heritage group membership and mainstream cultural orientation. Findings suggest meaningful within-group heterogeneity in emotion models and highlight the ways in which emotion models among people of Latino heritage are both similar to and distinct from models among people of European and Asian heritage. By developing a more nuanced understanding of between- and within-group variation in emotion models and highlighting the Latin American form of collectivism as in need of further research, this study advances cultural psychology, affective science, and their integration. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Salivary uric acid reactivity and baseline associations with physiological stress response.

Uric acid, an end product of the purinergic system, plays a role in several physiological systems that are responsive to stress. However, few studies have examined whether (1) uric acid concentrations change in response to acute stress, and (2) there are cross-system associations where uric acid might influence other physiological system responses to acute physical stress. The present study measured indices of the purinergic, hypothalamic-pituitary-adrenal axis, sympathetic, and parasympathetic systems (uric acid, cortisol, pre-ejection period, and root mean square of successive differences, respectively) in response to a standardized acute physical pain stressor, the cold pressor task. A diverse sample of participants (n = 67; mean age = 20.5 years, 52% female; 48% male) from a larger study completed anthropometric measurements and took part in a room temperature water task followed by the cold pressor task and sociodemographic questionnaires. Throughout the study, electrocardiography and impedance cardiography were measured continuously, and five saliva samples were collected that were later assayed for cortisol and uric acid. Descriptively, uric acid increased about 32 min following completion of the cold pressor. Resting uric acid concentrations were not associated with the autonomic nervous system response, but higher resting uric acid concentrations were associated with increased cortisol concentrations. Future research should examine the extent to which the purinergic system influences, and is influenced by, other types of stress and other physiological systems. The current findings highlight the potential role of an understudied biomarker and physiological system in the stress literature and have implications for basic and mechanistic researchers who study psychoneuroendocrinology, stress, and health.

Prevalence of Primary Liver Cancer is Affected by Place of Birth in Hispanic People Residing in the United States: All of Us Research Program Report.

BACKGROUND: Hispanic individuals have a disproportionately higher incidence and mortality for stomach, cervix, and liver cancers compared to Non-Hispanic White people. Since disparities in cancer incidence are influenced by multiple factors including immigration, elucidating the effect of birthplace and exposure to risk factors on the prevalence of these cancers is crucial for identifying high-risk populations and target risk reduction interventions. METHODS: The National Institutes of Health All of Us Research Program is a prospective, multidimensional biomedical data resource of underrepresented, minoritized people. The Registered Tier Dataset v5 was utilized to evaluate the prevalence and risk of stomach, cervix, and liver cancers among United States (US) born and non-US born Hispanic participants. RESULTS: Of over 434 000 current participants, 60 540 are Hispanic; 30 803 (50.9%) reported being US born and 29 294 (48.4%) non-US born. Non-US born Hispanic participants had significantly higher prevalence (.39% vs .21%, P < .001) and associated risk (OR 1.84, 95% CI 1.29-2.64, P < .001) of liver cancer, and trend towards higher prevalence of stomach (.14% vs .09%, P = .076) and cervix cancers (.27% vs .20%, P = .083) compared to US born counterparts. US born Hispanic patients with these 3 cancers were significantly younger than non-US born cohort (mean age 56.8 vs 61.7 years, P < .001). DISCUSSION: This is the first report using All of Us data to show that non-US born Hispanic participants have a higher risk of liver cancer compared to US born participants. Further analyses, including genomic studies, are necessary to understand these differences and identify targets for risk reduction interventions.

Pregnancy Anxiety and Beliefs Surrounding Motherhood in Latinas: A Qualitative Study.

Objectives: Prior research indicates that Latinas are at risk for experiencing high levels of anxiety during pregnancy. Pregnancy anxiety is a specific affective experience involving fears and worries about one's current pregnancy and it has been linked to heightened risk for preterm birth and developmental effects. Despite this concerning pattern, research has rarely examined Latina beliefs about the transition to motherhood and little is known about specific sources of pregnancy anxiety in Latinas, including whether fears are rooted in cultural concerns. The present study investigates the experiences of pregnancy anxiety among Latinas and explores their broader cultural beliefs surrounding pregnancy. Methods: Fourteen pregnant Latinas articulated their experience of pregnancy anxiety, how they coped with their anxiety, and the beliefs they held surrounding pregnancy in 11 individual interviews and one focus group of three participants, all conducted in Spanish. Results: Thematic analysis revealed that overall, Latinas felt that anxiety during pregnancy was normal, and that they worried about labor and delivery, losing their baby, their baby being born with a birth defect, and felt affected by the broader sociopolitical climate. Latinas felt lucky to be pregnant, believed that pregnancy was a blessing from God, and stressed the importance of maintaining a healthy pregnancy. Themes about family involvement and culturally-driven privileged status also emerged. Conclusions: The present study highlights specific themes that may be important to consider in the context of Latina perinatal health. Such findings set the stage for future investigations examining the experience of anxiety specific to pregnancy in Latinas.

Objetivos: Investigaciones anteriores indican que las latinas corren el riesgo de experimentar altos niveles de ansiedad durante el embarazo. La ansiedad relacionada con el embarazo es una experiencia afectiva específica que involucra temores y preocupaciones y se ha relacionado con un mayor riesgo de parto prematuro y consecuencias en el desarrollo. A pesar de este patrón preocupante, rara vez se han examinado las creencias de gestantes latinas sobre la transición a la maternidad y se sabe poco sobre las fuentes específicas de ansiedad relacionada con el embarazo entre las latinas, incluso si los temores tienen sus raíces en inquietudes culturales. El presente estudio investiga las experiencias de ansiedad relacionada con el embarazo en gestantes latinas y explora sus creencias culturales más amplias en torno al embarazo. Métodos: Catorce latinas embarazadas expresaron su experiencia de ansiedad relacionada con el embarazo, las formas en que lidiaron con dicha ansiedad y las creencias que tenían sobre el embarazo en 11 entrevistas individuales y un grupo de enfoque de tres participantes, todas realizadas en español. Resultados: El análisis temático reveló que, en general, las gestantes latinas sentían que la ansiedad relacionada con el embarazo era normal y que estaban preocupadas por el parto, la pérdida de su bebé, que su bebé naciera con un defecto de nacimiento y se sentían afectadas por el ambiente sociopolítico más amplio. Las latinas se sintieron afortunadas de estar embarazadas, creían que el embarazo era una bendición de Dios y enfatizaron la importancia de mantener un embarazo saludable. También surgieron temas sobre la participación familiar y el estatus privilegiado impulsado por la cultura. Conclusiones: El presente estudio destaca temas específicos que pueden ser importantes a considerar en el contexto de la salud perinatal de las latinas. Dichos hallazgos sientan las bases para futuras investigaciones que examinen la experiencia de ansiedad específica relacionada con el embarazo entre las latinas.

Who emphasizes positivity? An exploration of emotion values in people of Latino, Asian, and European heritage living in the United States.

Emotion values vary within and between individualistic and collectivistic cultural contexts. The form of collectivism prevalent in Latin America emphasizes simpatía, a cultural model that stresses the relational benefits of positivity but also the costs of negativity. This model was predicted to engender a pattern of emotion values distinct from that of the more commonly studied collectivist group, people of Asian heritage (PAH), among whom an emphasis on moderating positive and negative emotions is typically observed, and from people of European heritage (PEH), among whom authenticity in emotions is typically valued. College students of Latino (n = 659), Asian (n = 446), and European (n = 456) heritage living in the United States completed a study examining positive and negative emotion values. Mixed-model analysis of variance that included interactions among culture, emotion valence (positive, negative), value type (desirability, appropriateness), and response type (experience, expression) suggested distinct patterns of emotion values across groups. People of Latino heritage (PLH) rated positive emotions as more desirable and appropriate to experience and express than PAH (ps < .001) but less desirable and appropriate to experience and express than PEH (ps ≤ .001). PLH also rated negative emotions as more undesirable (ps < .001) but similarly inappropriate to experience and express (ps > .05) compared with PAH and as similarly undesirable (ps > .05) but more inappropriate to experience (p < .001) compared with PEH. The emotion-value pattern that emerged was largely consistent with simpatía for PLH and provides new evidence of similarity and variation in emotion values in three distinct contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Future of Women in Psychological Science.

There has been extensive discussion about gender gaps in representation and career advancement in the sciences. However, psychological science itself has yet to be the focus of discussion or systematic review, despite our field's investment in questions of equity, status, well-being, gender bias, and gender disparities. In the present article, we consider 10 topics relevant for women's career advancement in psychological science. We focus on issues that have been the subject of empirical study, discuss relevant evidence within and outside of psychological science, and draw on established psychological theory and social-science research to begin to chart a path forward. We hope that better understanding of these issues within the field will shed light on areas of existing gender gaps in the discipline and areas where positive change has happened, and spark conversation within our field about how to create lasting change to mitigate remaining gender differences in psychological science.

Measurement of a Latino cultural value: The Simpatía scale.

OBJECTIVE: Simpatía, a term that captures the tendency to prefer and create social interactions characterized by warmth and emotional positivity while also avoiding conflict and/or overt negativity, is a cultural factor relevant to Latinos. The goal of this article was to develop a scale that measures this cultural value. METHOD: A self-report scale measure of simpatía was developed and administered to a combined sample of Latinos (N = 296) drawn from 3 larger studies. The scale's factor structure was explored, and its internal consistency and validity were tested. RESULTS: Exploratory factor analysis supported an 18-item scale and indicated 2 factors: simpatía-related positivity/warmth and simpatía-related negativity/conflict avoidance. Cronbach's alphas for the overall scale and subscales showed internal consistency. Validity analyses revealed that across subscales, simpatía was positively associated with positive emotion expressivity and dispositional positive emotion. The simpatía-related positivity/warmth subscale was also positively associated with an orientation toward Latino culture. CONCLUSIONS: The Simpatía Scale, which captures dual aspects of simpatía that emphasize the positive and avoid the negative, provides a new tool for advancing the study of Latino culture. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Is Receiving Social Support Costly for Those Higher in Subjective Socioeconomic Status?

BACKGROUND: Although social support is generally thought to have positive consequences, this is not always the case. Receiving social support may threaten independence, which research has shown is more highly valued among those higher in socioeconomic status. As a result, support may be less strongly associated with positive outcomes for those higher in socioeconomic status (SES). Conversely, those lower in SES are more interdependent (Kraus, Piff, Mendoza-Denton, Rheinschmidt, & Keltner, 2012; Stephens, Markus, & Phillips, 2014) and may, therefore, be less threatened when receiving social support. This study examined SES as a moderator of how daily received support (within and between persons) predicted both daily psychological stressor appraisals and diurnal cortisol. METHOD: Healthy undergraduate students (N = 128) participated in a 3-day study. Participants completed one or more evening diaries the first day of the study and additional questionnaires upon awakening, throughout the day, and at bedtime during the following 2 days. Support was measured each evening and stressor appraisals and cortisol were measured throughout the day. RESULTS: As expected, for those who reported higher subjective SES, receiving more support than usual (within-person support) was associated with a flatter pattern of diurnal cortisol the next day. Although SES did not moderate the association of either within- or between-person support with stressor appraisals, the receipt of more support on average (between-person support) was associated with higher reported resources to cope. CONCLUSION: The findings demonstrate that there may be physiological costs-but not psychological costs-associated with the receipt of support for those higher in socioeconomic status.