A Peer-Led Decision Support Intervention Improves Decision Outcomes in Black Women with Breast Cancer

Sheppard, Vanessa B.; Wallington, Sherrie Flynt; Willey, Shawna C.; Hampton, Regina; Lucas, Wanda; Jennings, Yvonne; Horton, Sara; Muzeck, N.; Cocilovo, Costanza; Isaacs, Claudine

doi:10.1007/s13187-013-0459-z

Cited by 21 publications

(44 citation statements)

References 17 publications

(24 reference statements)

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“…Rather than having a direct effect on outcomes, contextual factors such as collectivism (which was significant in bivariate analysis) may serve as mediators or moderators of anxiety or depression. Contextual factors such as spirituality and collectivism have been successfully integrated into interventions to improve self-efficacy regarding treatment decisions and communication with providers in newly diagnosed Black patients [29,30,53]. A strong patient-provider relationship after diagnosis may help reduce distress in Black patients with higher levels of medical mistrust.…”

Section: Discussionmentioning

confidence: 99%

The importance of contextual factors and age in association with anxiety and depression in Black breast cancer patients

et al. 2013

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Objectives Limited research exists on correlates of psychosocial distress in Black breast cancer patients. The goals of the study were to describe the prevalence of distress (anxiety and depression) in Black women with breast cancer and to examine the influence of demographic, clinical, contextual (e.g. self-efficacy, medical mistrust), and process of care factors (e.g., patient satisfaction) on women’s level of anxiety and depression. Methods Eighty-two Black women diagnosed with invasive non- metastatic breast cancer were interviewed by phone. Collected data included demographics, clinical, contextual, and process of care factors. Bivariate correlations were used to examine relationships between those variables. Multiple linear regressions were used to examine predictors of anxiety and depression. Results About one-third of the women (32%) met cut-off thresholds for distress. Medical mistrust and positive attitude had significant influences on anxiety levels while age and positive attitude were determinants of levels of depression. Participants with higher medical mistrust reported more anxiety (r=.379; p<.001) and depression (r=.337 p=.002) while women with higher self-efficacy reported less anxiety (r=−.401; p<.001) and depression (r=−.427; p < .001). Age was inversely related to both anxiety and depression (r=−.224, r=−.296, respectively; p<.05). Conclusions Findings support national recommendations for routine distress screening in the delivery of cancer care particularly in younger Black patients. Interventions targeted to boost self-efficacy or reduce medical mistrust through enhanced patient-provider interactions may decrease psychological distress. Psychosocial needs of younger patients warrant particular attention.

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Section: Discussionmentioning

confidence: 99%

The importance of contextual factors and age in association with anxiety and depression in Black breast cancer patients

et al. 2013

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“…In the context of cancer care, a 2008 systematic review indicated that patients exposed to DAs were more likely to participate in decision making and to achieve higher quality decisions . Additional studies indicated that DAs increased cancer patients' knowledge, participation in decision making, self‐efficacy in communicating with the provider and in making treatment decisions, and decisional satisfaction . DAs can also reduce cancer patients' stress or anxiety and decisional conflict .…”

Section: Methodsmentioning

confidence: 99%

Implementing and evaluating shared decision making in oncology practice

Kane

Halpern

Squiers

et al. 2014

CA A Cancer J Clinicians

239

161

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Engaging individuals with cancer in decision making about their treatments has received increased attention; shared decision making (SDM) has become a hallmark of patient-centered care. Although physicians indicate substantial interest in SDM, implementing SDM in cancer care is often complex; high levels of uncertainty may exist, and health care providers must help patients understand the potential risks versus benefits of different treatment options. However, patients who are more engaged in their health care decision making are more likely to experience confidence in and satisfaction with treatment decisions and increased trust in their providers. To implement SDM in oncology practice, physicians and other health care providers need to understand the components of SDM and the approaches to supporting and facilitating this process as part of cancer care. This review summarizes recent information regarding patient and physician factors that influence SDM for cancer care, outcomes resulting from successful SDM, and strategies for implementing SDM in oncology practice. We present a conceptual model illustrating the components of SDM in cancer care and provide recommendations for facilitating SDM in oncology practice.

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“…Satisfaction with the nutritionist, exercise physiologist, and survivor coach was assessed with Likert-formatted items respectively that captured participants' ratings of their performance, interpersonal, and technical skills [36]. Higher scores represented higher levels of satisfaction.…”

Section: Study Design and Intervention Armsmentioning

confidence: 99%

The feasibility and acceptability of a diet and exercise trial in overweight and obese black breast cancer survivors: The Stepping STONE study

Sheppard

Hicks

Makambi

et al. 2016

Contemporary Clinical Trials

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104

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Purpose Black breast cancer survivors have high rates of obesity and low physical activity levels. Little is known about the acceptability and feasibility of interventions in this population. Objective A two-arm RCT was launched to assess the efficacy of a culturally targeted 12-week multimodal lifestyle intervention in overweight and obese black survivors. Methods Intervention components included nutrition education, exercise groups, and survivor-led motivational interviewing phone sessions. The analytic sample included women who completed the trial (intervention n = 10; control n = 12). Anthropometric measures, physical activity, and VO2max were assessed at baseline and follow-up. Change scores (intervention vs. control) were assessed with Wilcoxon rank-sum tests. A process evaluation assessed intervention acceptability. Results Overall adherence was 70% and overall satisfaction was high (86%). Despite the 5% weight loss target, the intervention group lost 0.8% but BMI improved. Total physical activity levels increased in the intervention vs. control arm (+3501 MET min/week vs. +965 MET min/week, respectively). VO2max improved in the intervention group (+0.10 ± 1.03 kg/L/min). Intervention participants reduced energy intake (−207.3 ± 31.5 kcals) and showed improvements in fat intake (−15.5 ± 3.8 g), fiber (+3.2 ± 1.2 g) and % energy from fat (−4.8 ± 3.1%). Survivors suggested providing diet/exercise information within a cancer context. Conclusions Group and individualized intervention strategies are acceptable to black survivors. Observed differences between self-report and objective outcomes may suggest reporting bias or changes in body composition. Increasing supervised intervention components and assessment of body composition will be important for future trials.

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A Peer-Led Decision Support Intervention Improves Decision Outcomes in Black Women with Breast Cancer

Cited by 21 publications

References 17 publications

The importance of contextual factors and age in association with anxiety and depression in Black breast cancer patients

The importance of contextual factors and age in association with anxiety and depression in Black breast cancer patients

Implementing and evaluating shared decision making in oncology practice

The feasibility and acceptability of a diet and exercise trial in overweight and obese black breast cancer survivors: The Stepping STONE study

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