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    Research Grants Awarded

    The ACT Intervention to Reduce Breast Cancer Treatment Disparity

    Study Section:
    Population Specific

    Scientific Abstract:
    The ACT intervention to reduce breast cancer (bc) treatment disparity in low income African American (LIAA) women: A pilot study A. Background : Increasingly, bc treatment disparity, not only late stage disease presentation is suggested as an important etiology for bc survival disparity. In addition, it appears that LIAA women suffer disproportionately from bc treatment related emotional and physical distress. Health care disparity is placed within a provider, institution and patient etiologic model. Unique beliefs attitudes and stressors among LIAA women, communication barriers with predominately white health care providers and a lack of understanding/belief of bc treatment in future bc risk reduction are etiologic factors for bc treatment and symptom management disparity that fit all disparity model components. B Purpose: We propose an "ACT" (adherence, communication treatment)intervention of first "bolus" and 3 "booster" education and coaching session for LIAA women receiving first systemic bc therapy. LIAA bc survivors will develop the ACT content and delivery method, bc professionals will review and media educational experts will produce. C. Specific Aims : 1) to develop through peer focus group methodology a 4 time (Bolus + 3 boosters) ACT educational intervention discussing a) unique beliefs, attitudes and stressors of LIAA women that may affect initial bc treatment, b) coaching communication of physical, emotional and social distress to health care providers and providing c) tailored treatment (pathology report/recommended treatment) information,2) to pilot test the effect of the ACT intervention on patient outcomes (bc knowledge, mastery, appointments, treatments, bc and supportive treatment dosages, symptom incidence/severity) on LIAA women receiving bc treatment as compared to usual care 3). to determine the feasibility (recruitment , attrition, and acceptability) of the ACT intervention. D. Design: Pilot testing of the intervention will use a randomized (10/group), repeated measure (X4) design in order to compare ACT outcomes with UC. E. Potential to Impact Care: . Addressing the patient component of the health disparity model does not diminish the responsibility of providers or institutions in decreasing disparity. Instead ACT reinforces the patient centeredness of care and empowers and coaches LIAA women to access equitable and needed care from providers and institutions.

    Lay Abstract:
    The ACT intervention to reduce breast cancer (bc) treatment disparity in low income African American (LIAA) women: A pilot study Background: Increasingly it has been noted that AA women do not receive the same dosages of breast cancer treatment as white women. The reason for this is not clear, but may be provider, institution or patient based. In addition, it appears that LIAA women suffer disproportionately from bc treatment related emotional and physical distress. Unique beliefs, attitudes and stressors among LIAA women, communication barriers with predominately white health care providers and a lack of understanding/belief of bc treatment in reducing the risk of bc recurrence or metastasis are believed to be etiologic factors for bc treatment and symptom management disparity. Aims: The intervention we propose is an "ACT" (adherence, communication treatment) intervention of first "bolus" and 3 "booster" education and coaching session for LIAA women receiving first breast cancer treatment . The ACT educational materials will be developed with LIAA bc survivors. Focus groups will explore the unique beliefs, attitudes and stressors of LIAA women that may affect initial bc treatment. They will also address communication problems with (predominantly white)doctors and nurses and strategies for enhanced communication. Lastly the survivor focus groups will guide how to present and teach a pathology report (staging), resultant implications and treatment information. Methods: Following focus group analysis, we will have the "ACT" materials developed for testing. The intervention will be given in a "bolus" dose (baseline) covering all the topics of beliefs, communication and treatment in depth and then 3 "booster" doses (Months 1,3 and 6) to reinforce the original teaching. The testing of the ACT intervention will be through a pilot study of 10 subjects/group, randomized (toss of a coin chances) to usual care (standard patient education) vs. ACT patients. Patient outcomes such as symptom distress, doses of treatment, and feelings of mastery will be measured in both groups and compared. Potential Impact: Addressing the patient component of the health disparity model does not diminish the responsibility of providers or institutions in decreasing disparity. Instead ACT reinforces the patient centeredness of care and empowers and coaches LIAA women to access equitable and needed care from providers and institutions.