Im and Chee Submits NIH R01 Application

Kudos to Eun-Ok Im and Wonshik Chee and their entire team for the submission of their NIH R01 application entitled "To Reduce Sleep-related Symptoms of Asian American Breast Cancer Survivors." This proposal requests funding for a five-year period with a start date of July 1, 2020.

Sleep-related symptoms are one of the most frequently reported health concerns by breast cancer survivors during their diagnosis and treatment process across racial/ethnic groups. Furthermore, racial/ethnic minorities are more likely to have sleep disturbances compared with Whites, and seep difficulties negatively impact their mood, physical symptoms, pain sensitivity, fatigue, and health-related quality of life. Although sleep-related symptoms could be managed using various modes of interventions, the choice of symptom management strategies mainly depends on women’s cultural attitudes related to their symptoms. With its well-known benefits for sleep-related symptoms and acceptance by racial/ethnic minorities, lifestyle physical activity promotion has high potential to improve racial/ethnic minority survivors’ sleep-related symptom experience. Furthermore, with advances in computer and mobile technologies, a technology-based program could provide a highly innovative and effective way to promote lifestyle physical activity, subsequently reducing sleep-related symptoms. Based on a former R01 study, the research team developed and pilot-tested the first theory-driven technology-based physical activity promotion program that is tailored to a racial/ethnic minority group of breast cancer survivors— Asian American breast cancer survivors (TPAPP-AB)—by incorporating their cultural attitudes related to breast cancer, sleep-related symptoms and physical activity. Asians were chosen as the first group to approach because they rarely complain about their symptoms, delay seeking help until symptoms become severe, and seldom ask or get support due to their cultural values, beliefs, and language barriers. The program uses computers, mobile devices (smart phones and tablets), and accelerometers, and has several innovative features in its design and delivery methods.

The purpose of this randomized intervention study is to examine the efficacy of TPAPP-AB in reducing sleep-related symptoms of Asian American breast cancer survivors. The specific aims are to: (a) determine whether the intervention group will show significantly greater improvements than the control group in sleep-related symptom experience from a pre-test to two follow-up time points (post 1-month and post 3-months); (b) determine whether the intervention group will show significantly greater improvements than the control group in physical activity experience from the pre-test to the two follow-up time points; (c) identify whether physical activity experience mediates the intervention effects from T0 to T1; and (d) determine whether the effects of the program on sleep-related symptoms are moderated by background characteristics and disease and menopausal status. The study is theoretically guided by the Bandura’s Theory of Behavioral Change. The study adopts a randomized repeated measures pretest/posttest control group design among 300 Asian American breast cancer survivors (150 for a control group and 150 for an intervention group). The long-term goals are to implement the program into various health care settings and fundamentally enhance the methodology/ paradigm of culturally tailored technology-based interventions for racial/ethnic minority cancer survivors.