Research Grants Awarded
Strategies for Health after Breast Cancer: A Survivorship Guide for African American Women
Breast Cancer Disparities
Background. Developing feasible plans of self-care after breast cancer can be a daunting task. This task is particularly important for African American (AA) breast cancer survivors, for whom disparities have been noted in early detection, recurrence, and mortality, compared to their Caucasian (Cau) counterparts. Objective/Hypothesis. The goal of this proposal is to produce and evaluate a video educational program (VEP), in collaboration with the Sisters Network Inc., a national AA breast cancer survivor?s network, which outlines the content and process of making informed decisions about survivorship care, while using evidence-based strategies for reducing the risk of recurrence. We hypothesize that after viewing the VEP, members of the SNI will demonstrate more complete knowledge about: disparities for AA survivors, concerns after breast cancer treatment, the components of plans for survivorship care, ways to prevent recurrence, patient communication with physicians about follow-up care, and ways to obtain social support. Specific Aims. 1) to develop and produce a theory-based VEP designed to promote informed decisions about survivorship care among AA breast cancer survivors which target the context of health status and lifestyle; 2) to evaluate the efficacy of the VEP in a national survivors? network for increasing knowledge about: disparities for AA survivors, concerns after breast cancer treatment, the components of plans for survivorship care, ways to prevent recurrence, patient communication with physicians about follow-up care, and ways to obtain social support; 3) to elicit feedback from breast cancer survivors, medical oncologists, and primary care practitioners regarding the efficacy of the VEP for developing feasible plans of survivorship care; and 4) revise and finalize the educational messages in the VEP based on survivor and physician feedback, in preparation for conducting a randomized trial. Study Design. A mixed methods qualitative and quantitative study design will be implemented to accomplish the study aims and test the study hypothesis. During Phase I, focus groups (2) will be conducted to film and produce the VEP, which will include group discussions, individual testimonials, and patient-physician vignettes. During Phase II, the VEP content will be evaluated with quantitative surveys by members in 20 chapters of SNI (n=200) for its effectiveness in increasing knowledge in the primary content areas, and by a team of physicians who deliver follow-up care to breast cancer survivors for its efficacy in delivering information about the Institute of Medicine guidelines and meeting the special needs of AA survivors. Potential Outcomes and Benefits of the Research. The proposed project will produce an evidence-based VEP which will deliver guidelines for developing plans of survivorship care. It will be evaluated for its efficacy as a training tool for improving the knowledge and skills of members of AA support networks to assist other survivors in developing plans of care.
Some cancer survivors are able to initiate changes in their lives that improve their health and cancer outcomes, but many are not. Even fewer are able to sustain these changes over time. Developing feasible plans of self-care, which target the health status and lifestyles of survivors, can be a daunting task. These issues are particularly important for African American (AA) women, who are significantly less likely to survive breast cancer for 5 years than their Caucasian (Cau) counterparts. Our earlier studies with AA and Cau breast cancer survivors found that many participants had no clear plan of follow-up care valued over others as a means for reducing their risk of cancer recurrence. AA survivors emphasized the importance of support from networks of other survivors in developing and maintaining their plans for self-care, particularly in the years following initial diagnosis and treatment. However, few guidelines are available for survivors that specify what to expect after breast cancer treatment, or how to obtain appropriate follow-up care afterwards. To address this need, our goal for the video educational program (VEP) will be to feature the experiences and perspectives of AA survivors about their medical care. These testimonials will be translated into a program that offers both education and distinct guidelines for self-care to other survivors after completing their primary breast cancer treatment. Members of the Sisters Network Inc, a national AA breast cancer survivors?network, will collaborate with us in producing this VEP, and will be featured in group discussions, individual testimonials, and patient-physician vignettes. This VEP will include modules on: a) understanding the disparities and special needs of African American women with breast cancer; b) dealing with concerns after treatment; c) creating a follow-up and survivorship plan of action d) ways to prevent recurrence; e) communicating with doctor(s) about follow-up care; and f) obtaining social support. It will be evaluated by survivors and physicians who deliver their follow-up care, as a tool for increasing the knowledge and skills of members of AA support networks in assisting other survivors to develop plans of follow-up care, which target the context of their health status and lifestyles. It will be based on a model we previously used to produce a VEP which delivered education about breast cancer screening, risk factors, prompt symptom care through AA church-based networks.