PREPARATORY INTERVENTIONS FOR LIFE AFTER BREAST CANCER

University Of Colorado Denver, Aurora CO

Investigators

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Abstract

In the United States, over 2 million women live with a history of breast cancer. The re-entry transition from cancer patient to survivor is an understudied and challenging period. Using a theory-driven conceptual framework, Project 3 of this Cancer Information Service Research Consortium (CISRC) proposal involves development and testing of interventions to promote informed re-entry to life after breast cancer treatment. The six primary aims are to: (1) develop and test a highly innovative multimedia educational intervention (CD-ROM and internet delivery), the Virtual Cancer Information Service (V-CIS); (2) develop and test a telephone callback interview conducted by the NCI's Cancer Information Service (CIS) Information Specialists; (3) evaluate these interventions in a randomized, 3-group stepped design for those with computer access: (a) Group 1=a control group receiving standard CIS service and print material (e.g., NCI's Facing Forward); (b) Group 2=Group 1 + V-CIS; (c) Group 3=Group 2 + CIS telephone callback. A 2-group randomized feasibility study will be conducted for those without computer access: (d) Group 1A=controMsame as Group 1; (e) Group 2A=Group 1A + CIS intervention callback; (4) evaluate a theory-driven test of mediators (i.e., self-efficacy, perceived coping skill, perceived information utility) of intervention effects; (5) explore potential moderators (e.g., age, baseline distress) of intervention effects; (6) with the CIS, plan dissemination. To test the efficacy of the intervention, breast cancer callers to the CIS will be enrolled, and depending on computer access, randomized to the 3-group design (n = 1,080 at baseline) or the 2-group design (n = 150 at baseline), and followed at 2, 6, and 12 months post-baseline. Conforming to a dose-response gradient, the primary hypothesis is that Group 3 > Group 2 > Group 1 (and Group 2A > Group 1 A) on the primary outcomes (i.e., cancer-specific distress and vitality) and additional outcomes in the domains of psychological health, physical health, interpersonal functioning, and life perspectives. Questions regarding how (i.e., mediators) and for whom (i.e., moderators) the interventions are effective also will be examined. Project 3 is unique in that it examines a state-of-the-science software program and a proactive CIS-initiated telephone callback, thus addressing the primary service mission of the CIS. Contingent upon findings from the 3-group stepped design, the goal is to prepare the interventions for dissemination within the CIS, as well as other service programs nationwide, while the 2- group feasibility study is intended to provide essential preliminary evidence for designing a future efficacy trial to be conducted by the CISRC.