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Psychosocial intervention for rural women with breast cancer

The sierra stanford partnership

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Abstract

OBJECTIVE: This study was initiated by breast cancer survivors living in a rural community in California. They formed a partnership with academic researchers to develop and evaluate a low-cost, community-based Workbook-Journal (WBJ) for improving psychosocial functioning in geographically and economically isolated women with primary breast cancer.

DESIGN: A randomized controlled trial was used to compare the WBJ intervention plus educational materials to educational materials alone (usual care).

SETTING: One rural cancer center and several private medical, surgical, and radiation oncology practices in 7 rural counties in the Sierra Nevada Foothills of California.

PARTICIPANTS: One hundred women with primary breast cancer who were either within 3 months of diagnosis or within 3 months of completing treatment.

INTERVENTION: A community-initiated, theoretically-based Workbook-Journal, designed by rural breast cancer survivors and providers as a support group alternative. It included compelling personal stories, local rural resources, coping strategies, and messages of hope.

RESULTS: Community recruiters enrolled 83% of the women referred to the study. Retention at 3-month follow-up was 98%. There were no main effects for the WBJ. However, 3 significant interactions suggested that women who were treated in rural practices reported decreased fighting spirit and increased emotional venting and posttraumatic stress disorder symptoms if they did not receive the WBJ. Among women who received the WBJ, 74% felt emotionally supported.

CONCLUSIONS: This community-based Workbook-Journal may be an effective psychosocial intervention for rural, isolated, and low-income women with breast cancer. Community involvement was essential to the success of this project.

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Author information

Authors and Affiliations

  1. Received from the Oregon Research Institute and the Department of Counseling Psychology, College of Education, University of Oregon, Eugene, Ore

    Karyn L. Angell PhD

  2. Sierra College, Grass Valley, Calif

    Mary Anne Kreshka MA

  3. Sierra Nevada Memorial Cancer Center, Grass Valley, Calif

    Rebecca McCoy MSW

  4. Sierra Nevada Memorial Breast Imaging Center, Grass Valley, Calif

    Patricia Donnelly RN

  5. the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif

    Patricia Donnelly RN, Helena C. Kraemer PhD & Cheryl Koopman PhD

  6. the Department of Psychology, University of Kent at Canterbury, Canterbury, United Kingdom

    Julie M. Turner-Cobb PhD

  7. Graddy Graphic Design and Illustration, San Francisco, Calif

    Kathy Graddy BA

Authors
  1. Karyn L. Angell PhD
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  2. Mary Anne Kreshka MA
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  3. Rebecca McCoy MSW
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  4. Patricia Donnelly RN
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  5. Julie M. Turner-Cobb PhD
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  6. Kathy Graddy BA
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  7. Helena C. Kraemer PhD
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  8. Cheryl Koopman PhD
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Additional information

This project was supported by a Community-Initiated Research Collaboration (CIRC) award from the Breast Cancer Research Program (BCRP) CIRC Pilot Award #3AB-1301 to Dr. Koopman and Ms. Kreshka.

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Angell, K.L., Kreshka, M.A., McCoy, R. et al. Psychosocial intervention for rural women with breast cancer. J GEN INTERN MED 18, 499–507 (2003). https://doi.org/10.1046/j.1525-1497.2003.20316.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.2003.20316.x

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