Researching Expressive Helping for Chinese American Cancer Survivors

Conversation with Dr. William Tsai, NYU Steinhardt School of Culture, Education, and Human Development

NIMHD’s Conversations with Researchers Engaging With Communities

May is Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Heritage Month. As we celebrate the significant contributions to America—from its history through present day and beyond—by people who represent AANHPI communities, we’re recognizing researchers who are promoting health equity through their community-engaged research.

Dr. William Tsai

Meet William Tsai, Ph.D., principal investigator in minority health and health disparities research.

Dr. William Tsai is an assistant professor in the Department of Applied Psychology and on the Counseling Psychology doctoral program faculty at the NYU Steinhardt School of Culture, Education, and Human Development. His scholarship focuses on improving the well-being of racial and ethnic minority communities, with a particular focus on the health and well-being of Asian and Asian American people.

Dr. Tsai serves as principal investigator for the NIMHD-funded project, “Helping Oneself by Helping Others: A Writing Intervention for Chinese American Cancer Survivors” (5K01MD014750-04). The aims of this project are to:

  1. Conduct a qualitative study to culturally adapt for Chinese American cancer survivors the intervention known as Expressive Helping, which asks participants to write about their experiences, disclosing their emotions and providing encouragement and guidance, with the knowledge that their narratives will be shared with and used as a resource for others facing similar challenges.
  2. Conduct a mixed methods randomized controlled trial of the Expressive Helping intervention to test its feasibility and preliminary efficacy on the psychological well-being of Chinese American cancer survivors.

Dr. Tsai earned a bachelor’s in psychology from the University of Michigan - Ann Arbor, and a master’s and doctorate in clinical psychology from the University of California-Los Angeles.

Q&A with Dr. William Tsai

What is your project’s goal, purpose, and aim?
My research aims to test the feasibility of a culturally adapted writing intervention, Expressive Helping, and its efficacy in improving Chinese American cancer survivors’ psychological well-being and quality of life. In Expressive Helping, survivors write about their cancer experiences, disclosing their emotions and providing encouragement and guidance, with the knowledge that their narratives will be shared with and used as a resource for other cancer survivors.

How is your work advancing the science of minority health and the health of populations that experience health disparities? Are you seeing specific changes in particular communities or groups?
My work focuses on the cultural shaping of emotion regulation and its health implications. I’m working to expand the existing paradigms of emotion regulation and health psychology by incorporating cultural and ethnic diversity into existing models. By demonstrating that cultural norms around emotion suppression and expression have significant implications for mental and physical health outcomes, my research has provided insights into how health interventions can be tailored more effectively to diverse populations.

This work has important implications for advancing the science of health disparities, as it underscores the need for a more nuanced understanding of the cultural dimensions of health behaviors and outcomes.

A significant portion of my research has focused on the development and implementation of culturally tailored writing interventions aimed at improving psychological well-being among Asian American populations, particularly Chinese American cancer survivors. By involving community members in the research process, prioritizing their voices and experiences, and respecting and leveraging these communities’ cultural strengths, we aim to develop interventions that are not only scientifically sound but also relevant and impactful for the communities we serve.

Beyond individual interventions, my work also seeks to raise awareness about the unique health challenges faced by specific Asian subgroups to challenge the view that Asian American communities are a monolith and advocate for more targeted research and health care strategies. By highlighting the diversity within the Asian American community, we're contributing to a broader understanding and appreciation of varied health needs and experiences within these communities.

What has surprised you about the discoveries from your work and your experiences engaging with communities?
While implementing the Expressive Helping intervention with Chinese American cancer survivors, I was inspired by the participants’ eagerness to be a source of strength and their motivation to transform their personal struggles into a resource for the community. For instance, some participants, interested in serving as peer support for others, offered to list their phone numbers on our study website. Additionally, some participants asked that we donate their research participation incentives to those in greater need.

These experiences highlight the potential of culturally tailored interventions to foster support and resilience, showcasing the power of collective healing and the communal aspect of individual experiences, especially in cultures that value collective well-being.

I have been fortunate to be invited by many community organizations to give talks on mental health, caregiving, and ways to manage cancer-related distress. It has been meaningful to talk about the importance of mental health in the Chinese community, where there are still elevated levels of stigma. I have heard from community members that sharing de-identified narratives from the writing intervention has been appreciated and well-received.

What inspired you to become a researcher in minority health and health disparities?
My inspiration to become a researcher in minority health and health disparities stems from personal experiences and academic curiosity. Growing up in a multicultural environment (Taiwan and the United States), I was struck by the varied ways in which different cultures approached mental health and coping with stress.

For instance, there is an emphasis in many Asian cultures on engaging in negative self-reflection to learn from difficult situations and improve oneself for the future. Conversely, there is a stronger focus on avoiding rumination and an emphasis on “letting go” to maintain well-being in the United States. These early observations made me curious about how cultural contexts and values influence health, health behaviors, and their outcomes.

This curiosity deepened during my academic journey, where I encountered disparities in access to care among racial and ethnic minority populations, particularly within Asian and Asian American communities. Through the research experiences and training opportunities supported by the K01 Career Development Award, my eyes were opened to the exciting real-world impact of culturally-tailored interventions.

Ultimately, my inspiration is driven by my upbringing and the opportunity to advance the understanding of and solutions for health disparities in minority populations.

How do we encourage the next generation to advance community engaged research?
Integrating community-engaged research approaches and principles into the education curriculum is crucial. When I teach the research methods course to undergraduate students at NYU, I cover the importance of cultural humility, historical ethical failures, such as the Tuskegee Study, ethical considerations in working with diverse communities, and the role of community engagement in addressing health disparities and advancing health equity. I also integrate case studies, service-learning projects, and guest lectures from community leaders and community-engaged researchers.

More broadly speaking, mentorship plays a pivotal role in guiding and inspiring the next generation of researchers. In my own journey, my mentors not only guided me through the complexities of academia, but also shaped my research approach, emphasizing the importance of understanding the communities we work with. They also served as role models and inspiration for continuing my research. Mentoring my students is a great privilege and responsibility.

What do you envision as the future of minority health and health disparities research?
I hope that research will increasingly focus on the complex interplay of culture, psychology, and social determinants of health, allowing more effectively tailored interventions to meet the unique needs of racial and ethnic minority populations.

The future of minority health and health disparities research must also include stronger global perspectives. Collaborations between researchers and organizations across countries offer valuable insights into universal and culture-specific factors contributing to health disparities.

Page published May 9, 2024