Use of cultural appropriateness strategies and behavioral frameworks in behavioral interventions for black and hispanic cancer survivors: a systematic review

• Published in: BMC cancer Vol. 25; no. 1; pp. 835 - 14
• Main Authors: Arana-Chicas, Evelyn, Zhang, Yingting, Chávez-Iñiguez, Arlette, Lin, Po-Ju, Mattick, Lindsey J., Kamen, Charles, Clark, Viktor, Cartujano-Barrera, Francisco, Mustian, Karen M.
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 06.05.2025; BioMed Central; BMC
• Subjects: Analysis; Behavior modification; Behavior Therapy - methods; Behavioral framework; Black or African American - psychology; Cancer; Cancer survivors; Cancer Survivors - psychology; Clinical trials; Clinical Trials as Topic; Cultural appropriateness; Cultural Competency; Cultural values; Culturally Competent Care; Demographic aspects; Economic aspects; Ethnicity; Evidence-based medicine; Exercise; Female; Health aspects; Health care disparities; Health disparities; Hispanic Americans; Hispanic or Latino - psychology; Hispanic or Latino - statistics & numerical data; Humans; Inclusion; Language; Medical colleges; Methods; Neoplasms - psychology; Neoplasms - therapy; Oncology; Quality of Life; Racial and ethnic minorities; Social aspects; Subject heading schemes; Systematic Review; United States; Cancer survivors; Cultural appropriateness; Behavioral framework; Racial and ethnic minorities; Health disparities
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-025-14182-0

Black and Hispanic cancer survivors experience significant inequities in supportive cancer care. Incorporating cultural appropriateness strategies and behavioral frameworks into supportive care interventions can improve cancer outcomes of Black and Hispanic survivors. This review evaluated behavioral oncology trials for Black and Hispanic cancer survivors to assess their use of cultural appropriateness strategies and behavioral frameworks. A systematic search was conducted across seven databases with a cutoff date of November 15, 2023: 1) PubMed, 2) Cochrane Central Register of Controlled Trials, 3) Embase, 4) Cumulative Index of Nursing and Allied Health Literature, 5) APA PsycInfo, 6) Scopus, and 7) Web of Science. Studies with Black or Hispanic cancer survivors, with or without a comparator, were included. Thirty-seven trials met the inclusion criteria. Most focused on Black survivors (n = 19, 51.4%) and breast cancer survivors (n = 32, 86.5%). Most were psychosocial interventions addressing quality of life or distress (n = 20, 54.1%). Culturally appropriate strategies were reported in 86.5% (n = 32) of trials, with the most common being sociocultural (n = 30, 81.1%;), constituent-involving (n = 27, 73.0%;), and linguistic (n = 20, 54.1%;). Behavioral frameworks were reported in 56.8% (n = 21) of trials, with Social Cognitive Theory (n = 10, 52.6%) and Stress and Coping Theory (n = 3, 15.8%) being the most frequent. Less than half combined cultural adaptation strategies and a behavioral framework (n = 18, 48.6%). While most trials incorporated cultural appropriateness strategies, fewer utilized behavioral frameworks, and even fewer used both. Future research should integrate these approaches to improve cancer outcomes and address disparities.