Objective. Treatment adherence, with minimal numbers of missed appointments, is an important determinant of survival among cancer patients. This study aims to determine if unmet financial, logistic, and supportive care needs predict self-reported adherence to cancer treatment appointments of chemotherapy and/or radiation among low-income ethnic minority patients. Design. The sample included 1098 underserved Latino and Black patients recruited from cancer clinics in New York City through the Cancer Portal Project. Participants completed a survey which included sociodemographic, health-related questions and a needs assessment, in their preferred language. Patients’ adherence to chemotherapy and/or radiation treatment appointments was assessed using a self-report. Results. A sample of 1098 patients (581 Latino and 517 Black cancer patients) was recruited. Forty-two Latino cancer patients (7.4%) and 78 Black cancer patients (15.5%) reported missing treatment appointments. Patients, who experienced four or more unmet needs (odds ratios [OR] = 2.02–3.36), and those with unmet housing needs (OR = 3.10–3.31), were more likely to report missing cancer treatment appointments, regardless of their ethnicity/race. Black patients with unmet supportive care (OR = 2.27) and health insurance needs (OR = 3.80) were more likely to miss appointments. Amongst Latinos, legal health-related issues (OR = 2.51) was a significant predictor of missed appointments. Conclusions. Among ethnic minority cancer patients, unmet socioeconomic and supportive care needs, housing needs in particular, predicted patient-reported missed radiation, and/or chemotherapy appointments. Future research should focus on exploring the impact of practical and supportive unmet needs on adherence and development of interventions aiming to improve cancer treatment adherence.

Underserved racial/ethnic minority patients diagnosed with cancer are a vulnerable patient population, and at significant risk for inadequate food.

Background: This study examined the use of psychosocial services (i.e., social work, psychiatric, psychological, and spiritual/pastoral services) among Latina and Non-Latina white breast cancer survivors. Methods: Survivors who received treatment in a Comprehensive Cancer Center in New York completed a mailed questionnaire about interest in help for distress, and psychosocial service use. Descriptive and non-parametric statistics were used to explore ethnic differences in use of, and interest in, psychosocial services. Results: Thirty-three percent of breast cancer survivors reported needing mental health or psychosocial services after their cancer diagnosis (33% Latinas, 34% whites); 34% of survivors discussed with their oncologist or cancer care provider their emotional problems or needs after the diagnosis (30% Latinas, 36% whites). Only 40% of the survivors who reported needing services received a referral for psychosocial services (42% Latinas, 39% whites). Sixty-six percent of survivors who reported needing services had contact with a counselor or mental health professional (psychiatrist, psychologist, or social worker) after their diagnosis (57% Latinas, 71% whites), and 61% of those needing services reported receiving psychosocial services (53% Latinas, 67% whites). Whites were significantly more likely than Latinas to have contact with a social worker (33% vs. 17%, respectively) and to receive psychotropic medication (15% vs. 0%, respectively). However, Latinas were significantly more likely to receive spiritual counseling than whites (11% vs. 3%, respectively). Conclusion: Our study revealed gaps for both groups; however, the gaps differed by group. It is crucial to study and address potential differences in the psychosocial services availability, acceptability, and help-seeking behaviors of ethnically diverse cancer patients and survivors.

Background: Latino patients with advanced cancer need culturally responsive, effective psychotherapeutic interventions that can assist them in coping with their diagnosis and improve spiritual and existential well-being and psychological adjustment. Objective: This study describes the cultural and linguistic adaptation of individual meaning-centered psychotherapy for Latinos with advanced cancer. Design: A mixed-methods, concurrent integrative approach was used for this study, using the ecological validity and cultural adaptation process models as frameworks for cultural adaptation. Setting/Subjects and Measurements: Quantitative and qualitative data were collected through (1) a survey of mental health professionals (n = 70) who offer services to Latino cancer patients; (2) a questionnaire for Latino patients with advanced cancer (n = 54), measuring relevant intervention concepts; and (3) in-depth interviews with 24 Latino patients. Results: Quantitative findings showed that most of the goals and concepts were highly acceptable for patients and providers. The qualitative findings supported adaptations to include using more simple definitions; changing phrases that are challenging to translate and comprehend; using words that are common to all Latino cultures, providing more than one option if needed; simplifying the questions/reflections, as needed; changing the metaphors to be culturally congruent; and modifying content to make it responsive to Latino cultural values and norms. Conclusions: Findings demonstrate the need for adaptation to achieve the aims of the intervention, accounting for both linguistic and cultural considerations, emphasizing issues related to literacy, cultural and linguistic diversity, cultural values, and culturally congruent content. The mixed-methods approach is described to provide recommendations for clinicians, researchers, and program developers.