Abstract IA053: Grateful strides toward spiritual well-being and exercise self-efficacy for Black breast cancer survivors
Authors: Cousin Lakeshia , Braithwaite Dejana , Anton Stephen , Zhang Zhongyue , Lee Ji-Hyun , Leeuwenburgh Christiaan , Lyon Debra 
Published: September 2024

Abstract
Background: Breast cancer (BC) survivorship care poses significant psychosocial and physical challenges, with survivors experiencing stress, inflammation, and poor lifestyle behaviors that impact their well-being and health-related quality of life. Black women with BC, who often experience higher rates of metabolic syndrome and related health complications, are particularly vulnerable. Black women with BC face unique health disparities, including a higher prevalence of metabolic syndrome, contributing to poorer prognoses. Spiritual well-being, particularly through practices such as gratitude journaling, has shown potential in improving psychological and physiological outcomes, but its effectiveness in Black BC survivors remains underexplored. Purpose: This pilot study aimed to assess the feasibility, acceptability, and preliminary efficacy of a gratitude journaling intervention tailored for Black BC survivors to enhance spiritual well-being, exercise self-efficacy, and mitigate inflammatory biomarkers. Methods: A two-group parallel random-assignment experimental design was used to compare a gratitude journaling intervention group with a general memory journaling control group over eight weeks. Twenty-six Black women with a history of BC in the community were enrolled and randomized. Surveys and biospecimen collections were conducted at baseline and post-intervention. Psychosocial measures included dispositional gratitude, spiritual well-being, perceived stress, Superwoman Schema dimensions, and exercise self-efficacy. Inflammatory biomarkers (TNF-α, IL-6, GDF15, CRP) were also measured. Results: Feasibility analysis indicated high recruitment (95%) and baseline assessment completion (100%), with 73% completing baseline and post-intervention assessments. Participants reported high satisfaction with the intervention. Significant improvement in spiritual well-being (p=0.014, ES=0.57) was observed in the intervention group, alongside large effect sizes in exercise self-efficacy (p=0.10, ES=0.391). Changes in dispositional gratitude, perceived stress, and Superwoman Schema dimensions were not statistically significant, although trends suggested positive impacts. Inflammatory biomarkers showed mixed results, with some indicating potential improvements but no significant differences overall. Discussion: The study highlighted the importance of culturally tailored interventions for Black BC survivors, demonstrating significant benefits in spiritual well-being and potential improvements in exercise self-efficacy. While changes in dispositional gratitude and perceived stress were not significant, the intervention group showed positive trends, suggesting potential benefits. Although the impact on inflammatory biomarkers was inconclusive, the study underscores the holistic approach of gratitude interventions in promoting overall well-being among Black BC survivors. Future research should focus on larger, randomized controlled trials to further elucidate the efficacy of gratitude-based interventions in this population.
Citation Format: Lakeshia Cousin, Dejana Braithwaite, Stephen Anton, Zhongyue Zhang, Ji-Hyun Lee, Christiaan Leeuwenburgh, Debra Lyon. Grateful strides toward spiritual well-being and exercise self-efficacy for Black breast cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr IA053.