Although cognitive-behavioral interventions [CBI] have been previously studied, little research has examined the effectiveness of various strategies during the early post-treatment phase [EOT]. The African American [AA] breast cancer [BCA] population has been underserved and generally experienced poorer outcomes than other ethnic populations. In addition, most CBIs use a face-to-face format, limiting their use to those who are able to 'get to' the intervention site. Our community partners have identified significant gaps in programs for AA BCA survivors in our own community, particularly in the EOT phase. We propose to work with our community partners; using community based participatory research methods [CBPR] to adapt an existing CBI for use with AA BCA survivors during the first 6 months after completing treatment.
The specific aims for the proposed study are to: (1) Determine how an existing CBI should be modified for use during the first 6 months following treatment with AA patients completing treatment for BCA and their supportive other, with specific attention to cultural content, number of sessions, and mode of delivery; (2) Evaluate the modified CBI in terms of feasibility, acceptability and satisfaction; (3) Determine the impact of the modified CBI on personal coping resources, perceived social support and quality of life. In the first stage, the focus will be on creating research capacity within the community and information gathering. The collaborative research team will engage in capacity-building activities. AA BCA survivors and supportive others will be asked to critique the existing CBI or to participate in focus groups to gather information to identify needs/issues and suggest elements for the intervention in order to ensure its acceptability and cultural sensitivity. In Stage 2, a pilot study of the modified CBI will be conducted to evaluate its acceptability, feasibility and determine the effects on quality of life and other related outcomes. The proposed study addresses the previously identified gaps and limitations by: incorporating both the patient's and supportive other's perspectives; targeting AA women; delivering the intervention during the first 6 months post-treatment; and using a multi-modal format that makes the intervention widely accessible and culturally tailored for AA breast cancer survivors and their loved ones. This pilot study will provide the foundation for an R01 application to conduct a large scale RCT of the intervention for AA BCA survivors and supportive others. ? ? ?
