Anna María Nápoles1, Jasmine Santoyo-Olsson2, Anita L Stewart3,4, Carmen Ortiz5, Cathy Samayoa6, Alma Torres-Nguyen7, Helen Palomino8, LaVerne Coleman9, Aday Urias8, Nayeli Gonzalez8, Silvia Araceli Cervantes7, Vicken Y Totten7. 1. Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA. 2. Division of General Internal Medicine, Department of Medicine, University of California San Francisco (UCSF), San Francisco, California, USA. 3. Center for Aging in Diverse Communities, University of California San Francisco, San Francisco, California, USA. 4. Institute for Health & Aging, University of California San Francisco, San Francisco, California, USA. 5. Círculo de Vida Cancer Support and Resource Center, San Francisco, California, USA. 6. Health Equity Research Lab, Department of Biology, San Francisco State University, San Francisco, California, USA. 7. Kaweah Delta Health Care District, Visalia, California, USA. 8. Cancer Resource Center of the Desert, El Centro, California, USA. 9. WomenCARE/Entre Nosotras, Family Service Agency of the Central Coast, Park, California, USA.
Abstract
OBJECTIVE: We report results of a community-based multisite, randomized controlled trial of Nuevo Amanecer (NA-II), a 10-week stress management program for rural, low literacy Latina breast cancer survivors. METHODS:Trained peers delivered NA-II to Spanish-speaking Latinas with non-metastatic breast cancer in three rural communities. Women were randomized to receive the program immediately or wait 6 months. Assessments were conducted at baseline, 3 months, and 6 months. Primary outcomes were breast cancer-specific quality of life domains; secondary outcomes included general distress symptoms and stress management skills. Intention-to-treat analyses using repeated-measures linear regression models estimated changes in slope between groups. RESULTS: Of 153 participants (76 randomized to intervention, 77 to control group), 92% were retained at 6 months. Mean age was 54.8 years (SD = 10.5); 80% had less than high school education. There were no statistically significant treatment × time effects on quality of life. Compared to women in the control group, intervention group women reported greater improvements in anxiety at 6 months (-0.20 vs -0.02, P = .049; range 0-4) as well as three stress management skills: relaxation at 3 months (+0.98 vs -0.07, P < .0001; range 0-4) and 6 months (+0.82 vs +0.04, P < .001), awareness of tension at 3 months (+0.31 vs -0.19, P < .01; range 0-4) and 6 months (+0.29 vs -0.11, P < .05), and coping confidence at 3 months (+0.12 vs -0.23, P < .01; range 0-4). CONCLUSIONS: Stress management programs delivered by trained peers in rural community settings can reduce anxiety and improve stress management skills among Latina breast cancer survivors. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
RCT Entities:
OBJECTIVE: We report results of a community-based multisite, randomized controlled trial of Nuevo Amanecer (NA-II), a 10-week stress management program for rural, low literacy Latina breast cancer survivors. METHODS: Trained peers delivered NA-II to Spanish-speaking Latinas with non-metastatic breast cancer in three rural communities. Women were randomized to receive the program immediately or wait 6 months. Assessments were conducted at baseline, 3 months, and 6 months. Primary outcomes were breast cancer-specific quality of life domains; secondary outcomes included general distress symptoms and stress management skills. Intention-to-treat analyses using repeated-measures linear regression models estimated changes in slope between groups. RESULTS: Of 153 participants (76 randomized to intervention, 77 to control group), 92% were retained at 6 months. Mean age was 54.8 years (SD = 10.5); 80% had less than high school education. There were no statistically significant treatment × time effects on quality of life. Compared to women in the control group, intervention group women reported greater improvements in anxiety at 6 months (-0.20 vs -0.02, P = .049; range 0-4) as well as three stress management skills: relaxation at 3 months (+0.98 vs -0.07, P < .0001; range 0-4) and 6 months (+0.82 vs +0.04, P < .001), awareness of tension at 3 months (+0.31 vs -0.19, P < .01; range 0-4) and 6 months (+0.29 vs -0.11, P < .05), and coping confidence at 3 months (+0.12 vs -0.23, P < .01; range 0-4). CONCLUSIONS:Stress management programs delivered by trained peers in rural community settings can reduce anxiety and improve stress management skills among Latina breast cancer survivors. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
Entities:
Keywords:
Latino/Hispanic; breast cancer survivors; cancer; community-based participatory research; psycho-oncology; psychological distress; quality of life; randomized controlled trial; rural communities; stress management
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