The Contextual Model of HRQOL is informed by the traditional
HRQOL Model, the Biopsychosocial Model (Committee
on Population, 2004), more recent qualitative and quantitative
studies with survivors from diverse ethnic backgrounds,
the cancer and survivorship literature, and multicultural and
psychological literature. The model includes socioecologic,
cultural, demographic, and healthcare system contexts; general
health and comorbidity; cancer-related medical factors;
health effi cacy; and psychological well-being. The domains
may vary among and within ethnic groups and contain some
generalizations about group membership. However, great caution must be taken to avoid stereotyping. For example, ethnic
minorities are overrepresented among lower socioeconomic
standard (SES) groups in the United States. Although ethnic
status unfortunately has been used as a proxy for SES, both
dimensions should be disentangled and assessed. In this
model, self-identifi ed ethnic status and socioecologic and
cultural contexts are distinguished