Can a brief multimedia intervention facilitate breast cancer patients’ communication about sexual health? Findings from a randomized controlled trial.

Abstract

e24179 Background: Many women with breast cancer (BC) lack the confidence to discuss sexual health with their clinicians. We evaluated, in a randomized controlled trial, a brief multimedia intervention designed to facilitate BC patients’ communication about sexual health. Methods: We randomly assigned BC patients to either a multimedia sexual/menopausal health communication skills intervention [ Starting the Conversation (STC), including a video, workbook, and pamphlet with local and web-based resources] or a control [resource guide only]. About 1-2 weeks after patients received materials, we audio recorded a clinic encounter with their BC provider, and subsequently coded the dialogue for patients raising the topic of sexual health or asking > 1 sexual health question. Self-report surveys administered at baseline, post-intervention, and 2-month follow-up assessed patients’ self-efficacy for discussing sexual health with their BC providers, sexual function, anxiety and depression, and quality of life. T-tests or mixed-effects logistic regression compared study arms; analyses of communication outcomes (patient raising the topic or asking a question during clinic encounter) were clustered by providers. Results: Study participants were 144 BC outpatients (82% acceptance rate; mean age = 56; 67% white; 15% metastatic; 31% active treatment). Women in the STC arm versus the control arm were more likely to raise the topic of sexual health [OR = 2.48 (1.11, 5.55), p= .03] and more likely to ask a sexual health question [OR = 2.93 (1.04, 8.26), p= .04]. Specifically, 51% of women in the STC arm raised the topic of sexual health versus 30% in the control arm and 40% of women in the STC arm asked a sexual health question versus 19% in the control arm. At 2-month follow-up, women in the STC arm showed greater improvements in self-efficacy ( p= .03) and anxiety, t(139) = 2.0, p= .04) compared to the control arm. Conclusions: STC, a brief multimedia intervention, was effective in facilitating BC patients’ communication about sexual health during routine clinic encounters and significantly reduced patients’ anxiety, possibly due to greater patient confidence in expressing their medical needs. Future studies should use longer-term follow-up and examine how sexual health communication can translate to improved patient sexual outcomes. Clinical trial information: NCT03624972 .