Over half of women treated for breast cancer report concerns related to sexual health. If unaddressed, such concerns can cause substantial distress and compromise patients' health and well-being. Yet, although clinical guidelines uniformly call for breast cancer clinicians to discuss sexual health with their patients, evidence suggests that sexual health is overwhelmingly neglected in breast cancer patients' routine cancer care. Breast cancer clinicians' lack of knowledge and basic communication skills are key barriers that impede their communication about sexual health. The absence of sexual health communication in the face of considerable patient distress thus constitutes a critical gap in the care of women with breast cancer. Previously, we demonstrated that a novel, brief intervention combining a workbook for self-study (approximately 15 minutes) followed by an in-person 1-hour small group called iSHARE (improving patients' Sexual Health and Augmenting Relationships through Education) was acceptable to breast cancer clinicians and had promising effects on cancer clinicians' knowledge, beliefs, and communication with respect to sexual health. Yet by requiring in- person attendance and small group participation, the format presented challenges for recruitment and implementation and would require significant resources to be disseminated. To address these limitations and enhance the potential reach of the iSHARE intervention, we propose to adapt iSHARE to a novel technology- based (mLearning) format consisting of a mobile web-based platform showcasing a two-part podcast (1: Education; 2: Skills). After using feedback from cognitive interviews with 8 breast cancer clinicians to adapt the iSHARE intervention to the new format, the main objective will be to pilot test iSHARE in its new format for feasibility, acceptability, and preliminary outcome data in 30 breast cancer clinicians. There are two primary study aims. Primary Aim 1 is to assess the feasibility and acceptability of iSHARE in the new mLearning format. We expect that iSHARE will be judged as feasible, determined through measures of rates of participant enrollment, retention, and study completion, and acceptable, determined through post-intervention evaluations of intervention satisfaction, helpfulness, and relevance, and ease of participation. Primary Aim 2 is to assess the preliminary effects of iSHARE. We expect that iSHARE will show positive effects on clinicians' knowledge, beliefs (self-efficacy, outcome expectancies), and communication with respect to sexual health from pre- to post- intervention and 3-month follow-up. The proposed study will be the first to develop and test an intervention targeting breast cancer clinicians communication' about sexual health. This study represents the next step in an ongoing body of research centering on the development of evidence-based interventions to improve patient- clinician communication about sexual health in cancer. The overarching goal of this research is to improve the health and quality of life for patients with cancer through integrating sexual health into their routine cancer care.
Although clinical guidelines recommend that sexual health be routinely discussed clinically for breast cancer patients, a lack of training for breast cancer clinicians serves a major impediment to their communication about this topic. The objectives of the proposed study are to assess the feasibility, acceptability, and preliminary effects of a novel mobile technology-based (mLearning) intervention designed to enhance breast cancer clinicians' in communication about sexual health (iSHARE; improving patients' Sexual Health and Augmenting Relationships through Education). This study has public health relevance because enhancing breast cancer clinicians' communication about sexual health could improve patients' sexual health and overall quality of life as well as benefit the patient-clinician relationship.
