TY - JOUR
T1 - Randomized controlled trial of a breast cancer Survivor Stories intervention for African American women
AU - Thompson, Tess
AU - Pérez, Maria
AU - Yan, Yan
AU - Kreuter, Matthew W.
AU - Margenthaler, Julie A.
AU - Colditz, Graham A.
AU - Jeffe, Donna B.
N1 - Funding Information:
This research was funded by a grant from the National Cancer Institute (P50 CA095815, PI: M. Kreuter) and the National Cancer Institute Cancer Center Support Grant P30 CA0918142 to the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, Missouri (P30 CA091842; PI: T. Eberlein) to support services provided by the Health Behavior, Communication and Outreach Core. Dr. Thompson's timetim was supported in part by a Mentored Research Scholar Grant from the American Cancer Society (MRSG-19-086-01-CPPB, PI: Thompson). We thank our patient participants, the interviewers, and Ms. Lori Grove in Oncology Data Services at Washington University School of Medicine for assistance with medical record data collection. We greatly appreciate the physicians who helped recruit their patients for this study, including Drs. Timothy Eberlein, William Gillanders, Rebecca Aft, and Amy Cyr at Washington University School of Medicine, and Dr. Theresa Schwartz and Ms. Pam Hunborg, RN, at Saint Louis University School of Medicine. The study CONSORT diagram (Figure 1) was used with permission from the publisher, Oxford University Press.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/2
Y1 - 2021/2
N2 - Rationale: Video-based interventions hold promise for improving quality of life (QoL) among African American breast cancer patients. Objective: An interactive, cancer-communication intervention using African American breast cancer survivors' narratives was tested in a randomized controlled trial to determine whether viewing survivor stories improved newly diagnosed African American breast cancer patients' QoL. Method: Participants were 228 African American women with non-metastatic breast cancer interviewed five times over two years; 120 controls received standard medical care, and 108 intervention-arm participants also received a tablet-computer with survivor stories three times in 12 months. Growth curve models were used to analyze differences between arms in change in eight RAND 36-Item Health Survey subscales, depressive symptoms, and concerns about recurrence. Additional models explored the effects of intervention usage and other intervention-related variables on QoL among patients in the intervention arm. Results: Models showed no effect of study arm on QoL, depressive symptoms, or concerns about recurrence. Longer use of the intervention was associated with an increase in concerns about recurrence and decline in three QoL subscales: emotional wellbeing, energy/fatigue, and role limitations due to physical health. Conclusion: Although no significant impact of the intervention on QoL was observed when comparing the two study arms, in the intervention arm longer intervention use was associated with declines in three QoL subscales and increased concerns about recurrence. Women with improving QoL may have interacted with the tablet less because they felt less in need of information; it is also possible that encouraging patients to compare themselves to survivors who had already recovered from breast cancer led some patients to report lower QoL. Future work is warranted to examine whether adding different stories to this cancer-communication intervention or using stories in conjunction with additional health promotion strategies (e.g., patient navigation) might improve QoL for African American breast cancer patients.
AB - Rationale: Video-based interventions hold promise for improving quality of life (QoL) among African American breast cancer patients. Objective: An interactive, cancer-communication intervention using African American breast cancer survivors' narratives was tested in a randomized controlled trial to determine whether viewing survivor stories improved newly diagnosed African American breast cancer patients' QoL. Method: Participants were 228 African American women with non-metastatic breast cancer interviewed five times over two years; 120 controls received standard medical care, and 108 intervention-arm participants also received a tablet-computer with survivor stories three times in 12 months. Growth curve models were used to analyze differences between arms in change in eight RAND 36-Item Health Survey subscales, depressive symptoms, and concerns about recurrence. Additional models explored the effects of intervention usage and other intervention-related variables on QoL among patients in the intervention arm. Results: Models showed no effect of study arm on QoL, depressive symptoms, or concerns about recurrence. Longer use of the intervention was associated with an increase in concerns about recurrence and decline in three QoL subscales: emotional wellbeing, energy/fatigue, and role limitations due to physical health. Conclusion: Although no significant impact of the intervention on QoL was observed when comparing the two study arms, in the intervention arm longer intervention use was associated with declines in three QoL subscales and increased concerns about recurrence. Women with improving QoL may have interacted with the tablet less because they felt less in need of information; it is also possible that encouraging patients to compare themselves to survivors who had already recovered from breast cancer led some patients to report lower QoL. Future work is warranted to examine whether adding different stories to this cancer-communication intervention or using stories in conjunction with additional health promotion strategies (e.g., patient navigation) might improve QoL for African American breast cancer patients.
KW - African Americans
KW - Breast neoplasms
KW - Health communications
KW - Quality of life
KW - Randomized controlled trial
KW - United States
UR - http://www.scopus.com/inward/record.url?scp=85099463295&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2020.113663
DO - 10.1016/j.socscimed.2020.113663
M3 - Article
C2 - 33454539
AN - SCOPUS:85099463295
SN - 0277-9536
VL - 270
JO - Social Science and Medicine
JF - Social Science and Medicine
M1 - 113663
ER -