Feasibility of Implementing Acupuncture into a Federally Qualified Health Center to Alleviate Multiple Symptoms Among Breast Cancer Survivors Receiving Endocrine therapy

项目总结 近94%的乳腺癌幸存者在内分泌治疗期间或之后会出现一种或多种症状。 关节疼痛、潮热、睡眠障碍、疲劳、抑郁和焦虑是最常见的并发症状。 症状，其中一些可以持续5到10年。这些症状会对遵守 治疗和妥协人们的功能状态、生活质量和工作功能。针灸是一种 单一疗法，几乎没有副作用，全面解决多种症状。针灸的效果 对于接受内分泌治疗的乳腺癌幸存者的多种症状，还没有进行调查。 此外，以实施为重点的针灸研究侧重于私人保险的诊所设置和 忽视健康的社会决定因素。迫切需要消除障碍，确保 在乳腺癌幸存者中平等获得这种循证治疗的机会有限 针灸。联邦合格的健康中心(FQHC)为经历重大疾病的人提供护理 获得医疗保健的障碍。迄今为止，关于针灸在癌症中的应用的数据有限。 在FQHC接受治疗的幸存者。本研究的目的有两个：(1)检验本研究的可行性和可接受性 在FQHC肿瘤诊所实施针灸，作为管理多种症状(疼痛、热)的一种方式 接受内分泌治疗的乳腺癌幸存者的闪光、疲劳、睡眠障碍、抑郁、焦虑) 治疗，以及(2)使用混合方法方法来确定与 在FQHC内实施针灸。长期目标是促进广泛的 针灸治病的实施、推广和持续利用 在全国范围内的FQHC接受内分泌治疗的医疗服务不足的乳腺癌幸存者，以及 最终促进针灸的更广泛的保险覆盖。这项拟议的研究具有重要意义 因为它有潜力确保平等获得针灸，这是一种循证干预。结果将 为更大规模的多站点混合有效性奠定基础--整合的实施试验 将针灸纳入FQHC为乳腺癌幸存者提供的服务。

PROJECT SUMMARY Nearly 94% of breast cancer survivors experience one or more symptoms during or after endocrine therapy. Joint pain, hot flashes, sleep disturbance, fatigue, depression, and anxiety are the most common concurrent symptoms, some of which can persist for 5 to 10 years. These symptoms negatively affect adherence to treatment and compromise people’s functional status, quality of life, and work functioning. Acupuncture is a single therapy with few side effects that holistically addresses multiple symptoms. The effect of acupuncture on multiple symptoms among breast cancer survivors receiving endocrine therapy has not been investigated. Further, implementation-focused acupuncture research focuses on privately insured clinic settings and ignores social determinants of health. There is an urgent need to remove barriers and ensure equal access to this evidence-based treatment among breast cancer survivors with limited access to acupuncture. Federally qualified health centers (FQHC) provide care to people who experience significant barriers to health care access. To date, limited data exist about the use of acupuncture among cancer survivors attending FQHCs. This research study has 2 aims: (1) to test the feasibility and acceptability of implementing acupuncture within an FQHC oncology clinic as a way to manage multiple symptoms (pain, hot flashes, fatigue, sleep disturbance, depression, anxiety) among breast cancer survivors receiving endocrine therapy, and (2) to use a mixed methods approach to identify barriers and facilitators associated with the implementation of acupuncture within an FQHC. The long-term goal is to facilitate the widespread implementation, dissemination, and sustained utilization of acupuncture for symptom management among medically underserved breast cancer survivors receiving endocrine therapy in FQHCs nationwide, and ultimately to promote broader insurance coverage for acupuncture. The proposed research is significant because of its potential to ensure equal access acupuncture, an evidence-based intervention. Results will provide the foundation for a larger multi-site hybrid effectiveness-implementation trial of integrating acupuncture into services provided at FQHCs for breast cancer survivors.