Abstract
Background: Latina survivors appear to have greater distress related to their diagnosis and treatment than non-Latina White women due to lower access to care, financial, linguistic barriers & cultural issues. These concerns have a significant influence on women's quality of life yet research indicates their impact may be buffered by the presence of mental health and social support services. Based on this data and the lived experiences of Latinas with breast cancer in the Washington, DC area, NV was founded in 1996 by a group of Latina breast cancer survivors and health professionals. Purpose: The goal of this community based organization-academic partnership project is to evaluate the impact of NV's social support model on levels of self-efficacy, psychological distress, and quality of life. The NV model provides comprehensive services including patient navigation, support groups, individual counseling, peer support, and information. This study is looking at the impact of this model on participants over one year.
Methods: A time-series design with time 1 (T1) data collection on the day of initial contact with NV, time 2 (T2) within 3–10 days of initial contact, time 3 (T3) at 4 months, and time 4 (T4) at 12 months. The instruments used in this study include: Cancer Behavior Inventory - Version 2.0 (CBI) measuring self-efficacy, the Brief Symptom Inventory-18 (BSI-18) measuring psychological distress, and the Satisfaction with Life Domains Scale-Breast Cancer (SLDS-BC) measuring quality of life. The sample includes women diagnosed with breast cancer who contacted NV and agreed to participate in the study. The interventions offered over the course of the twelve months include, individual counseling, various support group participation, patient navigation, and peer support.
Results: Data collection took place between March 2008 to December 2010. Eighty-nine participants completed data at Time 1, 69 at T2, 64 at T3, and 57 at T4. At T1 62.9% of the participants reported distress needing psychosocial intervention. This is almost twice as the prevalence rate of 32.8% for breast cancer among the general population reported by Zabora et al. (2001). There was a statistically significant decrease in depression (p< .05), overall distress (p< .05), and QOL (p < .01). There was a decrease in anxiety (p = .07) and somatization (p =.07) but no change in level of self-efficacy.
Conclusions: The findings support the model that NV uses in improving the lives of Latinas diagnosed with breast cancer. Its findings demonstrate that a community based organization with comprehensive social support services can help reduce distress levels and increase quality of life. The high rate of distress is an important finding and highlights the need for community organizations to be prepared to provide support for Latinas with breast cancer. No change in self-efficacy has brought into question the instrument selected to measure this variable in this population.
Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A58.