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A telephone-based education and support intervention for Rural Breast Cancer Survivors: a randomized controlled trial comparing two implementation strategies in rural Florida

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Abstract

Purpose

To compare two implementation telephone-based strategies of an evidence-based educational and support intervention to Rural Breast Cancer Survivors (RBCS) in which education was delivered early or after the support component.

Methods

Florida RBCS participated in a 12-month randomized clinical trial (RCT) with two arms: Early Education and Support (EE-S) and Support and Delayed Education (S-DE). Arms differed in the timing of 6 support and 3 education sessions. Main outcome was quality of life (QOL, SF-36 physical and mental composite scores [PCS, MCS]). Secondary outcomes were depressive symptoms (Centers for Epidemiologic Studies Depression Scale, CES-D), mood (Profile of Mood States, POMS), and social support (Medical Outcomes Study Social Support Survey, MOS-SSS). Outcomes were analyzed longitudinally using repeated measures models fitted with linear mixed methods.

Results

Of 432 RBCS (mean 25.6 months from diagnosis), about 48% were 65+, 73% married/partnered, and 28% with ≤high school education. There were no differences between EE-S and S-DE in demographics or outcomes at baseline (mean (standard deviation): SF-36 PCS, 44.88 (10.6) vs. 45.08 (10.6); MCS, 49.45 (11.1) vs. 48.1 (11.9); CES-D, 10.11 (9.8) vs. 10.86 (10.5); POMS-SF, 23.95 (38.6) vs. 26.35 (38.8); MOS-SSS, 79.2 (21.2) vs. 78.66 (21.2)) or over time. One exception was slightly worse mean scores at month 9 in MCS (Cohen’s d, − 0.22; 95% CI, − 0.38, − 0.06) and POMS (Cohen’s d, 0.23; 95% CI, 0.07, 0.39) for EE-S vs. S-DE.

Conclusions

The implementation strategies were equivalent.

Implications for Cancer Survivors

Enhancing support may be considered before delivering not-in-person interventions to RBCS.

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Acknowledgments

The authors thank our breast cancer survivor participants who gave generously of their time.

Funding

The research described was supported by a grant RO1-CA120638-07 (PI: Meneses) from the National Cancer Institute. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

Author information

Authors and Affiliations

  1. School of Nursing, Office of Research and Scholarship, University of Alabama at Birmingham, Birmingham, AL, USA

    Karen Meneses, Andres Azuero & Rachel Benz

  2. O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Karen Meneses & Maria Pisu

  3. School of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, MT 636, 1720 2nd Avenue South, Birmingham, AL, 35294-4410, USA

    Maria Pisu

  4. Department of Mathematical Sciences, The University of Texas at El Paso, El Paso, TX, USA

    Xiaogang Su

  5. School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA

    Patrick McNees

  6. PK LifeSciences Corp, Birmingham, AL, USA

    Patrick McNees

Authors
  1. Karen Meneses
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  2. Maria Pisu
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  4. Rachel Benz
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  5. Xiaogang Su
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Corresponding author

Correspondence to Maria Pisu.

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Conflict of interest

The authors report no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Disclosure

The Florida Cancer Incidence Data used in this report were collected by the Florida Cancer Data System under contract with the Department of Health. The views expressed herein are solely those of the authors and do not necessarily reflect those of the Florida Department of Health.

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Karen Meneses is deceased.

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Meneses, K., Pisu, M., Azuero, A. et al. A telephone-based education and support intervention for Rural Breast Cancer Survivors: a randomized controlled trial comparing two implementation strategies in rural Florida. J Cancer Surviv 14, 494–503 (2020). https://doi.org/10.1007/s11764-020-00866-y

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