SPIRIT:Reproductive Peer Counseling for Breast Cancer

描述（由申请人提供）：生殖健康问题是乳腺癌治疗最麻烦和最长期的后遗症。 非洲裔美国妇女在45岁之前被诊断为乳腺癌的风险增加，与白人妇女相比，死亡率一般较高。研究刚刚开始检查种族和社会经济地位对癌症生存率的影响，该项目的目标是评估同伴咨询计划在改善非洲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，不孕/怀孕和后代健康的困扰，对家庭癌症风险的关注）方面的有效性。同伴咨询方案在一项试点可行性研究中得到了参与者的高度评价，并在知识方面取得了重大进展。我们将在40小时的密集讲习班中培训30名同伴辅导员和7名区域协调员。每月电话会议将促进项目沟通和此后的质量控制。姐妹篇网络公司的20个分会将招募900名非洲裔美国妇女，一个为非裔美国乳腺癌幸存者服务的全国性倡导组织。女性将使用最小化进行随机分组，以接受完整的3次单独同伴咨询计划或最小接触版本，包括仅工作簿和30分钟或更少的可选电话咨询。评估医疗和人口因素、精神健康、性功能、更年期症状、生育问题困扰、关系满意度或约会问题、乳腺癌后生殖健康知识、情绪困扰和生殖健康服务利用情况的问卷将在基线、治疗后以及6个月和12个月随访时通过邮件发送给妇女。我们假设这两种方案都有效，但完整的方案将是上级。该项目的次要目标是确定基线生殖健康结果的相关性，包括癌症治疗变量、年龄、绝经状态、社会经济地位、情绪困扰、关系状态和困扰以及精神健康。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岁以下确诊的幸存者进行50次半结构化、定性的电话访谈，以更好地识别和描述这一年轻高危群体的担忧。

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.