Abstract

African Americans continue to suffer disproportionately from cancer. The cancer mortality rate for this population remains 33% higher than for Caucasians and twice as high as the rates for all other U.S. minority populations. The occurrence of cancer increases with age, with the majority of cancer cases occurring in persons 55 years and older, compounding the cancer burden experienced by the individual who is older and African American. In this study, we propose to evaluate a questionnaire designed to measure coping strategies used by older African American cancer survivors. The Ways of Helping Questionnaire (WHQ) was developed from in-depth interviews with older African American cancer survivors and captures unique coping strategies used by this population to manage their cancer experience. Content validity has been determined by cancer survivors, researchers, and clinicians with expertise in coping, oncology, and caregiving. Pilot testing of the WHQ with a sample of 88 older African American cancer survivors has provided adequate reliability and construct validity evaluations. Thus, in this study, we propose a more extensive analysis of the psychometric properties of the WHQ. In addition, we propose to test the theoretical validity of the WHQ within the Stress and Coping Theoretical Framework. Three hundred and fifty older African American cancer survivors will be recruited from outpatient oncology clinics to conduct tests of reliability (test-retest, internal consistency) and validity (factor analysis, hypothesized associations). Data from our preliminary studies and that of others suggest that older African American cancer survivors cope primarily through religiosity and spirituality, and use other coping strategies characterized by giving and receiving help, coping strategies not emphasized in existing coping measures. The long-term goal of this study is to develop a culturally sensitive measure of coping that drives intervention studies; addressing the need for interventions that promote optimal coping and positive health outcomes among this medically underserved population.