Assessing the utility of a telephonically delivered psychoeducational intervention to improve health-related quality of life in African American breast cancer survivors: a pilot trial

Abstract

Psycho-Oncology Psycho-Oncology 25: 236–238 (2016) Published online 15 April 2015 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.3823 Clinical Correspondence Assessing the utility of a telephonically delivered psychoeducational intervention to improve health-related quality of life in African American breast cancer survivors: a pilot trial Kimlin Tam Ashing* and Aria M. Miller Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope Medical Center, Duarte, CA, USA *Correspondence to: Director, Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope Medical Center, 1500 East Duarte Road, Duarte, CA 91010-3000, USA. E-mail: kashing@coh.org Received: 7 October 2014 Revised: 10 February 2015 Accepted: 18 March 2015 Background There is an urgent need for interventions to enhance the health-related quality of life (HRQOL) of African American breast cancer survivors (AABCS), who bear a disproportionate burden of cancer with some of the worst survival and survivorship outcomes [1,2]. The objective of this pilot trial was to determine the utility of telephonic-based psychoeducational intervention sessions, guided by a culturally informed breast cancer survivorship booklet, to improve HRQOL outcomes among AABCS. Methods Recruitment and participants Participants were recruited from hospital cancer regis- tries and breast cancer survivor support groups, via mailed letters and flyers providing general study details and staff contact information. Study staff then contacted potential participants by phone to assess study eligibility and obtain verbal consent. All partici- pants gave written informed consent. Participants were disease-free women aged ≥18 years who were within 1–6 years after a stage 0–III breast cancer diagnosis and self-identified as African American. A detailed description of study recruitment and enrollment is pre- sented elsewhere [3]. Procedure This pilot trial was grounded in the Contextual Model of HRQOL that emphasizes responsiveness to cultural and socio-ecological considerations [4] and the cognitive– Copyright © 2015 John Wiley & Sons, Ltd. behavioral framework [5], which focuses on goal- oriented, solution-focused adaptive skills. Institutional Review Board approval was obtained prior to study imple- mentation. Computer-generated randomization to the intervention or control condition used a 1:1 allocation scheme. Participants completed the study questionnaire at baseline and 4–6 months after randomization. Partici- pants eligible for randomization to the pilot study were those who endorsed burden, defined as two or more nega- tive responses (i.e., ‘quite a bit’ or ‘very much’ on nega- tively worded items and ‘not at all’ or ‘a little bit’ on positively worded items) within each subscale of the Functional Assessment of Cancer Therapy-General (FACT-G) [6] (i.e., physical, social/family, emotional, and functional well-being) at baseline. Participants were compensated with a US$20 and a US$25 gift card upon completion of each questionnaire, respectively. All participants received the 85-page survivorship booklet Embracing Hope, which was developed by Dr. Ashing and her team and informed by publications of the National Cancer Institute, American Cancer Soci- ety, Living Beyond Breast Cancer, Dr. Ashing’s previous work, and the multicultural and clinical psychology litera- ture. Embracing Hope contains clinically relevant details about breast cancer (e.g., staging and treatment), culturally relevant information on the psychosocial impact of cancer, and low-cost treatment, surveillance, and psychosocial re- sources. Intervention group participants received eight bi- weekly 40- to 50-minute telephonic sessions guided by the domains of Embracing Hope: (1) Basic Breast Cancer Information; (2) Managing Medical and Physical Issues, Follow-up Care, and Cancer Resources; (3) Coping, Problem Solving, and Medical Communication Skills;