Abstract PO3-27-11: Exploring Associations among Breast Cancer Survivor Empowerment, Peer Support, and Patient Navigation: Implications for Community-Based Care Planning
Authors: Jr Marcelo Sleiman , Yockel Mary Rose , Fleischmann Adina , Liu Mingqian , Young Olivia , Arumani Sahana , Tercyak Kenneth 
Published: May 2024

Abstract
Background: Women surviving with breast cancer (BC) may utilize peer support and patient navigation to augment their medical care–potentially leading to greater patient empowerment. However, the quality of support and navigation services vary widely among community-based organizations (CBOs) delivering such care, and often due to patients’ psychosocial status and program-specific determinants: outcome studies could inform care planning. Method: We analyzed secondary data from N=733 BC survivors participating in a CBO’s annual evaluation of its patient navigation program, assessing patients’ emotional distress, perceived navigation quality, care satisfaction, peer support, and empowerment. Bivariate associations explored program factors associated with these attributes; those significantly associated were retained in a multivariable model of patient empowerment. Results: Overall, patient empowerment was high as most BC survivors felt more informed (66.4%) and confident (71.2%) in managing their own care. Quality of navigation was also very high (91%) because it was: helpful (92.7%), informative (92.6%), timely (92.2%), effective (88.7%), supportive (91.3%), reliable (91.5%), and recommendable to others (93.9%). Regarding satisfaction, BC survivors felt helped (91.6%), understood (92.0%), and supported by abundant resources (92.8%) and programs (91.2%). Peer support, in particular, was offered to &gt;25% of patients and 85.1% reportedly engaged with their assigned peer supporter. Regarding quality of life, 25.3% were in fair/poor health and 25.6% endorsed frequent mental distress–with an average of 8.3 physically unhealthy days, 8.16 mentally unhealthy days, and 6.71 activity-limited days. Interestingly, disparities in patient engagement were observed as a function of their quality of life: lowest among those with more frequent mental distress (t=-2.13, p&lt; .05), mentally unhealthy days (r=-.083, p&lt; .05), and activity-limited days (r=-.058, p&lt; .05)). These burdens may have influenced survivors’ perceptions of their own empowerment–especially among those without peer support program engagement (t=3.77, p&lt; .001), who downgraded the quality of the navigation services they received (t=.60, p&lt; .01), and were least satisfied with their supportive care (t=.57, p&lt; .01). In a multivariable model of empowerment controlling for frequent mental distress (B=-.318, SE=.144, p&lt; .05), both care satisfaction (B=.194, SE=.019, p&lt; .001) and speaking with a peer supporter (B=.610, SE=.151, p&lt; .005) were positively associated with empowerment. Specifically, those who spoke with a peer and who rated their care satisfaction higher felt more empowered. Conclusion: The CBO’s patient navigation model among &gt;700 respondents was strong and helped BCsurvivors feel more empowered to manage their health needs. The majority of BC survivors were better informed and in control of their futures. Where disparities existed were among those with the lowest CBO satisfaction and who had frequent mental distress. Outreach may strengthen navigation and the delivery of peer support for those with the poorest mental health in order to better empower their BC survivorship.
Citation Format: Marcelo Sleiman Jr, Mary Rose Yockel, Adina Fleischmann, Mingqian Liu, Olivia Young, Sahana Arumani, Kenneth Tercyak. Exploring Associations among Breast Cancer Survivor Empowerment, Peer Support, and Patient Navigation: Implications for Community-Based Care Planning [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-27-11.