Engaging Older Chinese-Speaking Cancer Patients in Support Groups: Post-pandemic Lessons Learned

TL;DR

This study explores how to better engage older Chinese-speaking cancer patients in support groups by addressing cultural and linguistic barriers, especially through online formats post-pandemic.

Contribution

The paper introduces culturally responsive strategies for engaging Chinese-speaking older cancer patients in support groups using online formats and community-based approaches.

Findings

Building trust through shared language and cultural familiarity is crucial for engagement.

Online formats reduce transportation and stigma barriers for older Chinese-speaking cancer patients.

Culturally grounded health education and gradual emotional support improve participation.

Abstract

Older Chinese immigrants with cancer in the U.S. face linguistic, cultural, and psychosocial barriers, posing challenges for support group engagement. The COVID-19 pandemic accelerated the adoption of online group models, creating both challenges and opportunities for care delivery. This qualitative study explored strategies for engaging Chinese-speaking older adults with cancer support groups in the post-pandemic era. Using a community-engaged approach, we recruited Chinese-speaking cancer patients, caregivers, and social workers or community workers who have experience working with older Chinese-speaking cancer patients. Semi-structured interviews were conducted in English or Mandarin, online or in person, and analyzed inductively using thematic analysis. Nineteen participants were interviewed, including patients (n = 7), one caregiver (n = 1), and practitioners (n = 11). Strategies for engaging older patients included: (1) building trust through shared language and cultural familiarity, facilitated by bilingual practitioners who understood norms around emotional restraint and family duty; (2) embedding health education in accessible, culturally grounded language to address misinformation and reduce uncertainty; (3) introducing emotional support gradually, through activities or informational sessions rather than direct questioning about distress; (4) aligning group design with family-centered values, recognizing older adults’ prioritization of family needs; and (5) leveraging online formats to reduce barriers of transportation, stigma, and disclosure. In the post-pandemic era, online group-based care presents promising avenues to reduce barriers and foster engagement among Chinese-speaking older adults with cancer. Culturally responsive strategies that build trust, deliver accessible health information, and use flexible virtual formats can enhance equitable access to psychosocial support.