Pioneering Digital Approaches to Address Racial/Ethnic Cancer Survivorship Disparities With Eun-Ok Im, PhD, MPH, RN, CNS, FAAN

Eun-Ok Im, PhD, MPH, RN, CNS, FAAN, was recently named as the recipient of the 2023 Oncology Nursing Society (ONS) Distinguished Nurse Researcher Award. At this past ONS Congress, Dr. Im gave a presentation on her pioneering use of technology and Internet-based approaches to address racial and ethnic survivorship disparities in the cancer survivorship experience, which she has been among the first to research over the course of her career. In this interview, she provides the background behind this approach and how it has been used to improve survivorship experience for racial/ethnic minority cancer patients. 

Oncology Data Advisor: What are the gender, racial, and ethnic differences that exist in the cancer survivorship experience?

Eun-Ok Im, PhD, MPH, RN, CNS, FAAN: My research has indicated the following:

  • Across racial/ethnic groups, women participants indicated that their pain and symptom experience was a gendered experience. Their pain and symptoms tended to be underestimated by health care providers and inadequately managed
  • There certainly existed racial/ethnic differences in the cancer survivorship experience. For instance, while White patients tried to control their pain and symptoms as much as they could using diverse strategies, racial/ethnic minority patients tried to minimize their pain and symptoms because they did not want their family members worried. They tended to normalize their pain and symptoms, believing that pain and symptoms were natural because they had cancer
  • The quantitative findings from my research clearly supported statistically significant racial/ethnic differences in the cancer survivorship experience, but not gender differences. However, the qualitative findings certainly supported both racial/ethnic and gender differences in the cancer survivorship experience

Oncology Data Advisor: Why did you decide to investigate using a technology-based approach in improving the cancer survivorship experience?

Dr. Im: For two main reasons:

  • First, I thought using a technology-based approach via computers and mobile devices would allow me to adequately deal with diversities in the cancer survivorship experience. Even among Asian Americans, over 80 subgroups exist, so it would be difficult to deal with the diversities using the human brain
  • Second, because I initiated my research program in a local area where not many racial/ethnic minorities resided, I thought nationally accessing racial/ethnic minorities using computer-based and mobile technologies would allow me to reach out to an adequate number of racial/ethnic minorities to have a valid comparison among different racial/ethnic groups

Oncology Data Advisor: Did you encounter any barriers with this approach?

Dr. Im: Many unexpected methodological issues came up, because technology-based approaches using computers and mobile devices were hardly accepted as a legitimate research method in the late 1990s and early 2000s when I started to use the technology. My research team needed to go through multiple issues, including institutional review board (IRB) issues related to potential risks involved in technology-based approaches, unauthentic cases, and legal issues. Looking back on it, they were unnecessary hassles to go through; nowadays, nobody would raise a question on the legitimacy of technology-based approaches or risks involved in human subject protections. Being the first in a field means lots of headaches, but ultimately, it is worth it to try.

Oncology Data Advisor: What were the conclusions that you found regarding providing information, coaching, and support through technology-based approaches to improve cancer survivorship?

Dr. Im: My research strongly supported the efficacy of a technology-based information and coaching/support program in improving the cancer survivorship experience of Asian American breast cancer survivors. The approach was highly effective in reaching out to the groups with stigmatized conditions—including Asian American breast cancer survivors with the cultural stigma attached to breast cancer—by providing anonymous interactions to get information and coaching/support. However, more work is needed to provide culturally adequate and appropriate intervention components, such as deep cultural tailoring, to a specific population.

About Dr. Im

Eun-Ok Im, PhD, MPH, RN, CNS, FAAN, is a Professor of Nursing and the Edith Folsom Honeycutt Endowed Chair at Emory University. She is an internationally renowned methodologist and theorist in nursing science. Two of her most remarkable contributions include the development of a technology-based research program aimed at minimizing gender and ethnic disparities in cancer survivorship, and situation-specific theories providing theoretical basis for creating targeted interventions for cancer survivors of underrepresented racial/ethnic groups, both of which were among the first studies to incorporate internet-based approaches in this field. Over the past two decades, Dr. Im has received funding from the National Institutes of Health for six of her studies and has authored more than 400 publications on her research. She is the recipient of numerous awards, including the 2023 ONS Distinguished Nurse Researcher Award.

For More Information

Im EU & Pozza R (2023). ONS Distinguished Nurse Researcher Lectureship: to improve racial/ethnic minorities’ cancer survivorship using computer and mobile technology. Presented at: 48th Annual Oncology Nursing Society Congress: Available at: https://ons.confex.com/ons/2023/meetingapp.cgi/Session/5082

Transcript edited for clarity. Any views expressed above are the speaker’s own and do not necessarily reflect those of Oncology Data Advisor. 

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