Susan G. Komen has been deeply invested in supporting researchers at Texas cancer institutions since its founding in 1982. Over the last forty years, Komen has awarded 319 grants to Texas-based researchers, totaling nearly $117 million.
Amelie Ramirez, Dr.P.H., M.P.H., of the University of Texas Health Science Center at San Antonio (known as UT Health San Antonio), is the Director of the Institute for Health Promotion Research. She is also a Susan G. Komen grantee and serves as a Komen Scholar, where she is part of an advisory group of distinguished leaders in breast cancer research, clinical practice, public health, advocacy and other relevant fields.
She recently spoke with Komen about a research project she’s leading to improve long-term outcomes for Hispanic and Latina breast cancer survivors through a holistic program that provides therapeutic yoga with meditation, optional tailored exercise and diet counseling, and real-time psycho-social support based on survivors’ motivational status.
Komen: Breast cancer affects everyone differently. What are some of the trends you’ve noticed in Hispanic and Latina women that might be different from other ethnic groups?
Ramirez: I’ve become even more passionate about working with the Hispanic population because breast cancer has become the leading cause of death in Hispanic women and Latinas. We don’t understand why the incidence rate of breast cancer is lower, compared to Black and white women. But when you look at mortality rate within Hispanic women, breast cancer is the leading cause of cancer death for them. And what we’re finding is that our population is really impacted by a number of the social determinants of health that make it difficult for our women to access care.
For many women, we put off our care; we put our families first and it’s hard for us to come in to see a doctor. When you don’t have health insurance, or you tend to be of lower socioeconomic status or lower education, and you’ve never been told about breast cancer, your likelihood of coming in and being diagnosed with breast cancer at a later stage is higher. This is what we have seen in Hispanic women – late-stage diagnosis.
Komen: Can you tell us more about your Komen-funded research project?
Ramirez: With this new project, we’re taking a holistic approach to helping Hispanic and Latina breast cancer survivors. We’re trying to take what we’ve learned over the years about physical exercise, mental health and spiritual wellbeing and study them together. Usually, we study each one of these things individually, but we would like to see what kind of synergistic effect these three components will have in terms of totally looking at mind, body and spirit, and how we can optimize this to really improve the health-related quality of life for breast cancer survivors.
So, with this new study, we’re integrating a yoga-based exercise program with meditation. We’ll also provide participants with some tailored exercise and diet counseling to increase their endurance and help them maintain their weight, because we know weight gain after diagnosis can increase one’s risk of recurrence. The whole idea is that we’re really providing them with the information that they need to keep their recurrence at a lower rate over a long period of time. All of these are lifetime skills that people can take with them and also share with other family members.
Komen: The idea of involving family members seems important, especially since family is an important part of Latino culture and Latinas often prioritize caring for family members over themselves. Do you envision participants in your study becoming “health ambassadors” and talking to family members about breast health?
Ramirez: Definitely. As they become more informed about their own health and about things like genetic risk that may have predisposed them to breast cancer, they’re now becoming more knowledgeable. And then just recognizing that external factors such as stress can be a precursor to health issues as well and how to better manage that stress over a long period of time will not only be beneficial for them, but it’s also a tool they can share with others and talk about health in different ways.
Komen: Are you only recruiting people in the San Antonio area to participate in your study?
Ramirez: We are hoping to have a telehealth component to the study. We feel obviously that in-person would be the optimal situation, so we will be recruiting locally. And then we also plan to take the study to Laredo as well. Laredo is a border setting, so we hope to compare the barriers to actual physical participation in that external setting. We’ll have some telehealth elements to the study in Laredo that we can incorporate into the program.
Komen: How important is it to have Latino representation in the study, in terms of the team members who are leading it?
Ramirez: It’s extremely important. We base a lot of our work on the social cultural, social cognitive theory by Albert Bandura and where he showed that if you can show an individual that represents or is similar to the person you’re trying to reach, you’re more likely to increase their efficacy to try it. So, this is why it’s really important to show the individual that the researchers understand where they’re coming from, we understand some of the issues they are dealing with, and that we are here to truly help bridge that cultural gap they may have experienced.
Komen: Going through treatment can be a lot for a person, so how do you get them interested and excited about participating in your research?
Ramirez: In addition to including the exercise, the meditation, the spirituality, we also do some tailored messaging to increase the motivation of the individual and really reinforce their self-efficacy. We want people to know that they can do all of this. The first thing we’re going to hear is, “I don’t have time to do all of this.” But it’s amazing – there’s always time to just say a positive message before you go to bed at night, in terms of incorporating your spirituality. You know, there’s always 30 minutes, 30 seconds, a minute where you can take the time and just really breathe and breathe deeply and kind of bring that stress level down. We’re going to provide them with these motivational messages as well, to reinforce what they’re learning.