Improving the validity and generalizability of studies with underserved USpopulations expanding the research paradigm

The gap in cancer incidence and mortality between ethnic minority groups an d European Americans in the U.S. is significant and growing. Compared with a drop in incidence and mortality rates in the U.S. since 1992, the rates f or ethnic minority groups have increased or stayed the same. A major transf ormation in the predominantly deductive social and behavioral research para digm in cancer is required to reduce these disparities in cancer outcomes a nd improve the quality of life fur ethnic minority populations with cancer. This article highlights the fundamental changes that are required to trans form the prevalent paradigm for social and behavioral research in cancer ca re from a monocultural, Eurocentric framework to a multicultural one. Use o f the expanded framework would enhance the scientific rigor, validity, gene ralizability, applicability, anal acceptability of multicultural behavioral research. The strategies developed from such research would have a greater likelihood of success in providing optimal cancer care for underserved pop ulations and reduce the disparities in cancer outcomes between U.S, ethnic minority populations and the white population Examples from the cancer lite rature are used to illustrate each of the seven steps of the expanded parad igm. (C) 2000 Elsevier Science Inc. All rights reserved.