scholarly journals Telehealth intervention for Latina breast cancer survivors: A pilot

2018 ◽  
Vol 14 ◽  
pp. 174550651877872 ◽  
Author(s):  
Karen Meneses ◽  
Silvia Gisiger-Camata ◽  
Rachel Benz ◽  
Dheeraj Raju ◽  
Jennifer R Bail ◽  
...  

Aim: This study was a pilot test of the Latina Breast Cancer Survivorship Intervention, a survivorship self-management intervention delivered via telephone. Materials and methods: This study used a wait-list control design with random assignment to either (1) support and early education or (2) support and delayed education. Latina breast cancer survivors were recruited through the Florida Cancer Data System Registry. Latinas with stage I–III breast cancer who completed primary cancer treatment 3 years prior to study enrollment were eligible. The Latina Breast Cancer Survivorship Intervention consisted of three education sessions delivered weekly via telephone and six telephone support calls, both delivered by a native Spanish speaker. Primary outcome variables included physical well-being, emotional well-being, fatigue, pain, and depressive symptoms. Data collection occurred at baseline, 3 months, and 6 months. Results: In total, 40 Latina breast cancer survivors who were middle-aged to older, married, with health insurance, and Spanish as preferred language enrolled in the Latina Breast Cancer Survivorship Intervention. Data were analyzed using mean change scores. Overall, physical and emotional well-being remained similar over time with well-being scores poorer compared with the general population. Pain levels improved over 6 months and showed a high effect size. Fatigue scores improved at 3 months and showed a moderate effect size. Depressive symptoms remained elevated but were not clinically significant. Conclusion: Telephone-based Latina Breast Cancer Survivorship Intervention reached Latina breast cancer survivors for survivorship education and support. Self-management of pain and fatigue showed improvement over time.

10.2196/23414 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e23414
Author(s):  
Akshat Kapoor ◽  
Priya Nambisan

Background Breast cancer is the most common form of cancer among American women, accounting for 23% of all cancer survivors nationally. Yet, the availability of adequate resources and tools for supporting breast cancer survivors has not kept up with the rapid advancement in treatment options, resulting in unmet supportive care needs, particularly among low-income and minority populations. This study explores an alternative means of delivering breast cancer survivorship care plans (SCPs), with the aim of improving survivor morbidity, patient knowledge, and self-management of treatment-related symptoms, as well as addressing inconsistencies in follow-up care visits. Objective The overall goal of this study is to improve the uptake of SCP recommendations via an educational intervention for breast cancer survivors, to improve treatment-related morbidity, patient knowledge, self-management, and adherence to follow-up visits. The specific aims of the study are to (1) evaluate the feasibility of the online SCP, and (2) assess the impact of the online SCP on survivorship outcomes. Methods We will enroll 50 breast cancer survivors who have completed initial breast cancer treatment into a 2-armed, randomized, waitlist-controlled pilot trial, and collect data at baseline and 6 months. For the first aim, we will use mixed methods, including surveys and personal interviews among the intervention group, to determine the feasibility of providing an online, interactive SCP (called ACESO) based on the survivors’ online user experience and their short-term adoption. For the secondary aim, we will compare the 2 groups to assess the primary outcomes of survivor knowledge, self-efficacy for self-management, perceived peer support, and adherence to SCP-recommended posttreatment follow-up visits to oncology and primary care; and the secondary outcomes of treatment-related morbidity (body weight, fatigue, depression, anxiety, sexual function, distress, and sleep quality). We assess these outcomes by using measurements from validated instruments with robust psychometric properties. Results We have developed and refined the online breast cancer survivorship plan, ACESO, with consultation from breast cancer oncologists, nurses, and survivors. Approval for the study protocol has been obtained from the Institutional Review Board. An advisory board has also been established to provide oversight and recommendations on the conduct of the study. The study will be completed over a period of 2 years. Conclusions The results of this pilot study will inform the feasibility and design of a larger-scale pragmatic trial to evaluate the impact of an online breast cancer SCP on treatment-related morbidity and self-efficacy for self-management. International Registered Report Identifier (IRRID) PRR1-10.2196/23414


2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e19673-e19673
Author(s):  
K. C. Demel ◽  
B. N. Jahagirdar ◽  
D. M. Anderson ◽  
C. Anderson ◽  
D. J. Schneider ◽  
...  

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 171-171
Author(s):  
Stephanie B. Wheeler ◽  
Racquel Elizabeth Kohler ◽  
Ravi K. Goyal ◽  
Kristen Hassmiller Lich ◽  
Alexis Moore ◽  
...  

171 Background: Community Care of North Carolina (CCNC) initiated an innovative medical home (MH) program in the 1990s to improve primary care in Medicaid-insured populations. CCNC has been successful in improving asthma, diabetes, and cardiovascular outcomes, but has not been evaluated in the context of cancer care. We sought to determine whether MH enrollment was associated with guideline-concordant surveillance and follow-up care among breast cancer survivors. Methods: Using state cancer registry records matched to Medicaid claims, we identified women ages 18-64 diagnosed with stage 0, I, or II breast cancer from 2003-2007 and tracked their CCNC enrollment. Using published American Society for Clinical Oncology breast cancer survivorship guidelines to define our outcomes, we employed multivariate logistic regressions to examine correlates of receipt of surveillance mammogram and at least two physical exams within 15 months post-diagnosis. Results: In total, 840 women were included in our sample. Approximately half were enrolled in a CCNC MH during the study period, 38% were enrolled for more than 7 months post-diagnosis. Enrollment in a MH for at least 7 months post-diagnosis was strongly associated with receiving guideline-recommended surveillance mammogram (p<0.01) and at least 2 physical exams (p<0.01) within 15 months post-diagnosis. Conclusions: Results suggest that MH enrollment is associated with higher quality breast cancer survivorship care among women insured by Medicaid. Given the growing population of cancer survivors and increased emphasis on primary care MH, more research is needed to explore how medical homes can enhance and ensure the provision of guideline-recommended care during cancer survivorship.


2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 60-60
Author(s):  
Shakuntala Shrestha ◽  
Pam Khosla ◽  
Janos Molnar ◽  
Maria Eugenia Corona ◽  
Sofia M Garcia

60 Background: To provide comprehensive services and meet Commission on Cancer (CoC) accreditation requirements, we developed and evaluated a customized breast cancer SCP template and delivery model. Objective: To implement and pilot test survivorship care plan (SCP) delivery for breast cancer survivors. Methods: Clinicians at a safety net hospital partnered with investigators at an academic institution to start a breast cancer survivorship care program. We developed an SCP template that is CoC-complaint and responsive to input gathered in 2 focus groups with breast cancer survivors (n = 12) and interviews with staff (n = 8). Oncologists and nurses identified and referred English-speaking women who had completed breast cancer treatment. Participants completed baseline measures prior to receiving individualized SCPs in a survivorship consultation visit with a dedicated APN. In response to high no-show rates, we expanded clinic scheduling to harmonize with participants' other medical appointments. Interim feasibility results for our ongoing study are presented here. Results: A total of 154 patients were screened to reach target enrollment (n= 80) within 20 months. Participant median age was 60 ± 11; 71% were African American, 14% Hispanic; 11% Non-Hispanic White and 92% had household incomes < $20,000. Average times were: 30 ± 13.4 minutes for abstracting patient clinical information in preparation for the survivorship visit; 25 ± 16 minutes for completing individual SCPs; 22±7.65 minutes to review / deliver the SCPs with patients. The difference in no-show rate between first 3-month recruitment period (clinic limited to one day/week) and next 17 months (clinic appointment expanded to accommodate patients' schedule) was statistically significant, p = 0.028. Conclusions: Tailoring SCP templates and delivery models to the needs of a safety net hospital aided the sustainability of a new survivorship clinic. Patient non-adherence to scheduled visits was significantly improved by expanding clinic hours. Significant clinician time was spent preparing SCPs and a level 4 visit (25 minutes) does not adequately reflect this effort. This study is funded by the American Cancer Society, Illinois Division (Grant# 254698).


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24025-e24025
Author(s):  
Poorvi Kirit Desai ◽  
Diane Riccardi ◽  
Heewon L. Gray ◽  
Sonya Pflanzer ◽  
Zachary Thompson ◽  
...  

e24025 Background: The American Cancer Society (ACS) published Diet and Physical Activity Guidelines in 2020. Emerging evidence suggests that healthy dietary patterns are associated with reduced cancer risk, especially colon and breast. ACS estimates there are 3.5 million breast cancer survivors in the US. The transition from active treatment into survivorship is a critical period where they are uniquely positioned to adapt healthy behaviors, yet there is a lack of empirical research to best guide the transition. Methods: We developed an 8-week breast cancer survivorship program to educate and develop healthy habits. 40 participants were recruited through Moffitt breast and survivorship clinics, social media, and website. Weekly topics were: cancer survivorship, nutrition, emotional health and well-being, exercise, medical management after treatment, grocery store tour, meditation and mindful eating, and moving forward. To assess health-related quality of life (QoL), we used FACT-G Version 4, a validated patient-reported survey with 27 questions and 4 domains of wellbeing (physical, social/family, emotional, and functional) on a 5-point Likert scale (not at all to very much). Similarly, a nutrition questionnaire evaluated the understanding of healthy choices, confidence in making healthy changes, knowing how to purchase healthy foods and read nutrition labels, confidence in preparing healthy foods, and understanding of a plant-based diet. Surveys were administered pre- and post-intervention. Data analysis included those who completed both (n = 30). Pt characteristics and data trends were summarized using descriptive statistics. Paired Wilcoxon rank sum tests were used to assess the significance of the change in scores between surveys. Results: Participant ages ranged from 41 to 77. The majority (34.5%) completed treatment 13-24 months prior. Compared to baseline, greater proportions of participants had positive responses after intervention in all nutrition questions. The nutrition sum was significantly increased by 3.07 (p = 0.0001). There was no significant change in overall QoL (-1.77; p = 0.1178) or sub-domain wellbeing scores. Conclusions: Our 8-week intervention for breast cancer survivors showed significant improvement in nutrition domain. While a small sample size is limiting, it is evident that survivors can improve their confidence in making healthy changes and develop better understanding of a plant-based diet.[Table: see text]


2011 ◽  
Vol 29 (15_suppl) ◽  
pp. e19673-e19673
Author(s):  
N. K. Janz ◽  
C. R. Friese ◽  
S. J. Katz

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 107-107
Author(s):  
Jennifer R. Klemp ◽  
Lori Ranallo ◽  
Catie Knight ◽  
Carol J. Fabian ◽  
Christie A. Befort

107 Background: Breast cancer survivors have a 4x increased incidence of cardiovascular disease (CVD) compared to women never treated for breast cancer and cardiac events are the 2nd most common cause of death in long-term survivors. Attention to reducing the risk of CVD should be a priority for the long-term care of breast cancer survivors. This study was undertaken to describe cardiovascular risk factors in breast cancer survivors, and the cardio-oncology referral patterns and outcomes from cardio-oncology screening visits. Methods: 356 female breast cancer survivors seen at the University of Kansas Breast Cancer Survivorship Center between 2006 and 2012 who completed an initial intake visit were evaluated for cardiovascular risk factors and referrals to cardio-oncology. An expanded list of cardiovascular factors was used: BMI > 25, Diabetes, HTN, HLD, Current/Past Smoker, Family Hx of MI < 60 years, Exercise < 150 min/wk, Ejection Fraction < 50%, and exposure to cardio-toxic breast cancer treatment. Breast cancer survivors without evidence of metastatic disease were on average 57.8 +/-11.0 years old, underwent standard treatment regimens, and were approximately 7.5 years from their initial diagnosis. Results: 13% were already followed by a cardiologist, 21% were referred to cardio-oncology, and 66% were not referred at their initial survivorship visit. There were significant differences in the average number of risk factors between those not referred to cardio-oncology (4.36 +/-1.89), and those referred to cardio-oncology (5.68+/-1.8), and between those already followed by cardiologist (5.91+/-1.75), p < 0.001 and p < 0.0001, respectively. The most common risk factors were BMI >25, elevated HDL, exercise <150 min/wk, and exposure to an anthracycline. The most common outcomes following a cardio-oncology visit included further diagnostic tests, medication changes, or a return visit. Conclusions: These findings demonstrate the need to determine how to include treatment related risk factors along with traditional cardiovascular risk factors in assessing and managing cardiovascular risk in breast cancer survivors.


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