African American women with breast cancer (AAWBC) have decreased quality of life (QOL) and mood when compared to European American (EA). Research has not examined the effectiveness of therapeutic group (TG) for AAWBC even though positive effects are well established for Caucasians.
The aims of the randomized clinical trial (RCT) are to determine the effectiveness of TG by teleconference for AAWBC and identify mediator and moderator effects of the intervention. The primary hypothesis is that participants in the intervention group will have significantly greater cancer knowledge, less fear, less isolation, better social connection, better mood, and better QOL when compared to a control group receiving usual psychosocial care. A pilot study documented the feasibility and utility of the TG by teleconference, especially the increased participation of AAWBC. The TG by teleconference circumvents many of the barriers, e.g. fatigue, transportation that prevent AAWBC participation. Yalom's Group Theory and Miller's Relationship Theory guide the intervention which is derived from Fawzy's TG model. A 2-group repeated measures design will be used. 240 Stage II AAWBC will be recruited. Intervention participants attend eight weekly 90 minute sessions by teleconference and 2 follow-up boosters. Each culturally appropriate session contains the story, information and group processes of connection, commonality and catharsis. Information focuses on increasing self care and stress management knowledge while countering myths and taboos. Story capitalizes on African American oral traditions by discussing coping parables. Group processes provide an alternative source of social support and opportunities to express feelings. Measurements of social connection, mood and QOL will occur at baseline, after 10 group sessions and 16 weeks post baseline. Mediators (cancer knowledge, fear and isolation) and moderators (spirituality, stigma, fatalism) will be similarly measured. The study findings are expected to inform about the effectiveness of TGs in AAWBC and lay the groundwork for exploring if reducing disparities in psychosocial care have a health benefit.
