Drs. Elyse Park, Sheila Cannon & Lara Traeger

Elyse R. Park, PhD, Assistant Professor of Psychiatry at MGH, and MIHP core faculty member, has received funding through a National Cancer Institute U54 grant to compare depression severity, cancer care experiences, and mental health care utilization between African American and non-Hispanic White lung cancer patients. The overall goal of the U54 is to facilitate collaborative research between the Dana-Farber Harvard Cancer Center and the University of Massachusetts Boston in reducing racial disparities in cancer prevention and treatment and to support the success of minority researchers.
Dr. Park’s study builds from findings of a 2007 Institute of Medicine report, “Cancer Care for the Whole Patient: Meeting Psychosocial Health Care Needs,” that found that psychosocial problems associated with cancer often go unaddressed. This neglected aspect of care is especially pressing for lung cancer patients who are often at greater risk for psychological distress relative to other cancers. Detecting and addressing psychosocial problems is important to decrease suffering and improve adherence to prescribed treatments Depressive symptoms are of particular concern given their associations with poorer quality of life, riskier health behaviors, and increased lung cancer mortality independent of clinical factors. Nonetheless, mental health care referral rates for depression among cancer patients remain very low.
This study is a collaborative effort with Dr. Sheila Cannon, a Clinical Assistant Professor from the UMASS Boston College of Nursing and Health Sciences. Dr. Lara Traeger, a postdoctoral fellow in the Department of Psychiatry at MGH, will lead these analyses. Drs. Park, Cannon and Traeger will consider these issues within the larger context of wide-recognized racial and ethnic disparities in health and health care. African American (AA) lung cancer patients may be particularly vulnerable to psychosocial problems associated with cancer care since they have poorer lung cancer outcomes relative to Non-Hispanic Whites (NHWs). Despite this disparity, it remains unknown whether AA patients have an elevated risk for depression symptoms. Data from non-cancer samples suggest that AAs may be less likely to report depression relative to NHWs. However, research also suggests that when AAs do experience depression, they are more likely than NHWs to experience it as chronic, severe, and disabling; furthermore, they face greater mental health care barriers than NHWs. Poor access to general mental health care services among AAs may compound low rates of mental health care referrals in oncology settings.
Using a nationally representative dataset, the proposed pilot project will address the shortage of information about depression and mental health care needs of AA and NHW lung cancer patients by focusing on patient-level factors. They will compare AAs and NHWs by a) prevalence of depression symptoms; b) factors underlying depression symptoms; c) rates of unmet mental health care needs; and d) beliefs and attitudes about depression and mental health care seeking. This work is guided by two complementary theories (the Self-Regulatory Model and the Explanatory Model) which focus on perceptions of illness within a sociocultural context.