Does a community-based stress management intervention affect psychological adaptation among underserved black breast cancer survivors?

Suzanne C Lechner; Nicole E Whitehead; Sara Vargas; Debra W Annane; Belinda R Robertson; Charles S Carver; Erin Kobetz; Michael H Antoni

doi:10.1093/jncimonographs/lgu032

Back

Does a community-based stress management intervention affect psychological adaptation among underserved black breast cancer survivors?

Journal article

Open access

Does a community-based stress management intervention affect psychological adaptation among underserved black breast cancer survivors?

Suzanne C Lechner, Nicole E Whitehead, Sara Vargas, Debra W Annane, Belinda R Robertson, Charles S Carver, Erin Kobetz and Michael H Antoni

Journal of the National Cancer Institute. Monographs, Vol.2014(50), pp.315-322

2014-11

DOI: https://doi.org/10.1093/jncimonographs/lgu032

PMCID: PMC4411537

PMID: 25749598

Abstract

Stress, Psychological - therapy

Vulnerable Populations - psychology

Humans

Middle Aged

Community Mental Health Services

Complementary Therapies

Psychiatric Status Rating Scales

Breast Neoplasms - psychology

Depression - psychology

Quality of Life

Adult

Cognitive Therapy

Female

Psychotherapy, Group

Survivors - psychology

Adaptation, Psychological

African Americans - psychology

Patient Education as Topic

In this randomized trial, Project CARE, we examined whether participation in a cognitive-behavioral stress management and breast cancer wellness and education program improved psychological outcomes among a sample of underserved black breast cancer survivors. Both complementary medicine interventions were 10-sessions, manualized, group-based, and were culturally adapted for black women in the community from evidence-based interventions. Participants were 114 black women (mean age = 51.1, 27-77 years) who had completed breast cancer treatment 0-12 months before enrollment (stages 0-IV, mean time since cancer diagnosis = 14.1 months). Women were enrolled upon completion of curative treatment (ie, surgical, chemotherapy, radiation oncology) and randomized to receive cognitive-behavioral stress management or cancer wellness and education program. There was a remarkable 95% retention rate from baseline to 6-month follow-up. Participants in both conditions showed statistically significant improvement on indices of psychological well-being, including overall quality of life (Functional Assessment of Cancer Therapy-Breast), intrusive thoughts (Impact of Event Scale-Revised), depressive symptoms (Center for Epidemiologic Studies-Depression), and stress levels (Perceived Stress Scale) over the 6-month postintervention follow-up (all repeated measures analysis of variance within-subjects time effects: P < .05, except for overall mood; Profile of Mood States-Short Version). Contrary to hypotheses, however, condition × time effects were not statistically significant. Findings suggest that improvements in multiple measures over time may have been due to intensive training in stress management, extensive provision of breast cancer information, or participation in an ongoing supportive group of individuals from a similar racial background. Implications bear on decisions about appropriate control groups, the timing of intervention delivery during the treatment trajectory, and perceived support from the research team.

Files and links (1)

url

https://doi.org/10.1093/jncimonographs/lgu032View

Published (Version of record) Open

Metrics

15 Record Views

See more details

Details

Title: Does a community-based stress management intervention affect psychological adaptation among underserved black breast cancer survivors?
Creators: Suzanne C Lechner - Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC). SLechner@med.miami.edu
Nicole E Whitehead - Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
Sara Vargas - Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
Debra W Annane - Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
Belinda R Robertson - Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
Charles S Carver - Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
Erin Kobetz - Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
Michael H Antoni - Department of Psychiatry and Behavioral Sciences (SCL, BRR, MHA), Sylvester Comprehensive Cancer Center (SCL, DWA, CSC, EK, MHA), and Department of Public Health Sciences (EK), University of Miami Miller School of Medicine, Miami, FL; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL (NEW); The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI (SV); Department of Psychology, University of Miami, Coral Gables, FL (MHA, CSC)
Publication Details: Journal of the National Cancer Institute. Monographs, Vol.2014(50), pp.315-322
Publisher: United States
Grant note: R01CA131451 / NCI NIH HHS UL1 TR000460 / NCATS NIH HHS
Academic Unit: Miller School of Medicine; College of A&S; Jay Weiss Institute for Health Equity at Sylvester; A&S - Psychology
Language: English
Resource Type: Journal article
PMID: 25749598
PMCID: PMC4411537
Record Identifier: 991031559356402976