Expressive writing intervention improves quality of life among Chinese-American breast cancer survivors: A randomized controlled trial

Background: Expressive writing interventions are shown to confer health benefits for Caucasian cancer survivors. However, few studies reported improved quality of life or studied ethnic minorities. Purpose: The study evaluated whether a culturally sensitive expressive writing intervention improved quality of life. Methods: Chinese-speaking breast cancer survivors (n = 136) in the USA were randomly assigned to one of three conditions to write three 30-min weekly essays: a cancer-fact condition to write about facts relevant to the cancer experience for three weeks; a self-regulation condition to write about deepest feelings at week 1, stress and coping at week 2, and finding benefits at week 3; or an enhanced self-regulation condition to write about stress and coping at week 1, deepest feelings at week 2, and finding benefits at week 3. Quality of life was assessed by Functional Assessment of Cancer Therapy at baseline, 1-, 3-, and 6-month follow-ups. Results: Growth curve models showed that quality of life was increased in the sample from baseline to the 6-month follow-up. The enhanced self-regulation condition had a large and statistically significant effect (d = 0.90, 95% CI [0.02, 1.687]), and the self-regulation condition had a small effect (d = 0.22, 95% CI [-0.79, 1.07]) on quality of life improvement compared with the cancer-fact group. Conclusion Expressive writing is shown to be an effective intervention to improve quality of life for Chinese-American cancer survivors. Future efforts are warranted to disseminate and implement this low-dose and brief intervention in community and clinical settings.