SPIRIT:Reproductive Peer Counseling for Breast Cancer

描述(申请人提供)：生殖健康问题是乳腺癌治疗最麻烦和最长期的后遗症。非洲裔美国女性在45岁之前被诊断为乳腺癌的风险更高，总体来说，与高加索女性相比，他们的死亡率更高。关于种族和社会经济地位对癌症存活率的影响的研究才刚刚开始，该项目的目标是评估同伴咨询计划的有效性，以改善非裔美国乳腺癌幸存者的生殖健康知识和结果(更年期症状、性问题、对不孕不育/怀孕和后代健康的痛苦、对家庭癌症风险的担忧)。同伴咨询计划在一项试点可行性研究中得到了参与者的高度重视，并在知识方面取得了显著进展。我们将在一个40小时的密集研讨会上培训30名同伴辅导员和7名区域协调员。每月的电话会议将促进项目沟通和此后的质量控制。900名非裔美国女性将被姐妹网络公司的20个分会招募，该组织是一个为非裔美国人乳腺癌幸存者服务的全国性倡导组织。女性将被随机分配，接受完整的3节个别同伴咨询计划，或者接受最低限度的接触版本，包括只有练习册和30分钟或更少的与咨询师的可选电话联系。评估医疗和人口因素、精神健康、性功能、更年期症状、生育问题的痛苦、关系满意度或约会担忧、乳腺癌后生殖健康知识、情绪痛苦和生殖健康服务利用情况的问卷将在基线、治疗后和6个月和12个月的随访时邮寄给妇女。我们假设两个计划都是有效的，但完整的计划会更好。该项目的次要目标是确定基线下生殖健康结果的相关因素，包括癌症治疗变量、年龄、更年期状况、社会经济状况、情绪困扰、关系状况和痛苦以及精神健康。我们还将研究这些中介变量对干预条件有效性的影响。此外，我们将对45岁以下的幸存者进行50次半结构化、定性的电话采访，以更好地识别和描述这一年轻的高危群体的担忧。

DESCRIPTION (provided by applicant): Reproductive health problems are the most troublesome and long-term sequellae of breast cancer treatment. African-American women are at increased risk for breast cancer diagnosis before age 45, and have higher mortality in general compared to Caucasian women. Research is just beginning to examine the impact of ethnicity and socioeconomic status on cancer survivorship, The goal of this project is to evaluate the effectiveness of a peer counseling program to improve the reproductive health knowledge and outcomes (menopause symptoms, sexuality problems, distress about infertility/pregnancy and health of offspring, concern about cancer risk in the family) in African-American breast cancer survivors. The peer counseling program has been highly valued by participants in a pilot feasibility study and produced significant gains in knowledge. We will train 30 peer counselors and 7 regional coordinators in an intensive, 40-hour workshop. Monthly teleconferences will facilitate project communication and quality control thereafter. Nine hundred African-American women will be recruited by 20 chapters of Sisters Network, Inc., a national advocacy organization for African-American breast cancer survivors. Women will be randomized using minimization to receive either the full, 3-session individual peer counseling program or a minimal contact version including just workbook and 30 minutes or less of optional phone contact with the counselor. Questionnaires assessing medical and demographic factors, spiritual well-being, sexual function, menopause symptoms, distress about childbearing issues, relationship satisfaction or dating concerns, knowledge about reproductive health after breast cancer, emotional distress, and utilization of reproductive health services will be sent to women in the mail at baseline, post-treatment, and at 6 and 12 months' follow-up. We hypothesize that both programs will be effective, but the full program will be superior. Secondary goals of the project are to identify correlates of reproductive health outcomes at baseline, including cancer treatment variables, age, menopausal status, socioeconomic status, emotional distress, relationship status and distress, and spiritual well-being. We will also examine the impact of these mediating variables on the effectiveness of the intervention conditions. In addition, we will conduct 50 semi-structured, qualitative phone interviews with survivors diagnosed under age 45, to better identify and characterize concerns of this young, at-risk group.