Sister Survivor: Improving Access to Survivorship Care Plan
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Introduction: Our pilot study showed that African–American breast cancer survivors (AABCS) had unmet healthcare resources needs. Therefore, we will implement a peer navigator (PN) intervention and evaluate its impact on access and adherence to survivorship care planning (SCP) to increase access to health preserving and life saving resources. The trial will compare the outcomes of AABCS who are randomly assigned to receive 5 peer navigation sessions and materials (informational brochure) or materials, only. This study capitalizes on the mission and strengths of Carolyn Tapp at Women of Color Breast Cancer Survivors Support Project and current lead organization of our Sister Survivor: African American Breast Cancer Survivor Coalition, and Dr. Kimlin Ashing-Giwa who are working together to benefit the community.
 
 
 
 
 
 Primary Hypotheses: H1. Subjects receiving the PN intervention will have greater access to a SCP from their oncology provider at 3 months, relative to pre-intervention baseline and adjusted for subjects’ demographic and clinical characteristics, and other confounding variables (i.e., treating facility; insurance). 
 
 
 
 
 
 Secondary Hypotheses: H2. Participants in the PN condition will have greater medical efficacy at 3 months; H3: Participants in the PN condition will have greater improvement at 3 months in preparedness for life as a new survivor; H4. Participants in the PN condition will have greater improvement at 3 months in physical functioning; H5. Socio-ecological factors including higher income, education and higher income zip-codes will be associated with overall better HRQOL outcomes; H6. Participants in the PN condition will have greater access to a SCP from their oncology provider at 12 months; H7. Socio-ecological factors and PN condition will be associated with adherence at 12 months to SCP recommendations. 
 
 
 
 
 
 Methodology: 25 PN will be trained to provide navigation to AABCS recruited from the California Cancer Registry, collaborating support groups, hospitals, clinics, and civic and religious organizations. 120 participants will be randomized to either PN intervention (n=60) or control (n=60) conditions. The peer navigation sessions will be delivered via face-to face or by telephone. The Peer Navigator trial is accomplished through 5 processes: 1) Information: PN provide education and resources about the effects of breast cancer and its treatments, care planning, physical functioning; 2) Patient activation: coaching in medical efficacy and communication; 3) Providing support: PN listen, share, and attend to the human side; 4) Access: facilitate utilization of healthcare resources/services, access to SCP; 5) Coordination: facilitate utilization of healthcare, adherence to SCP. 
 
 
 
 
 
 Innovative elements: The findings from this project have the potential for translation into broad community benefit and community clinical practice by 1) increasing understanding and adherence to SCP for improving follow-up care and reducing the medical, physical and survivorship burden among AABCS, 2) providing outcomes on the effectiveness of PN to inform the growing body of work on diverse models of survivorship care, and 3) coalition and research capacity building among the Sister Survivor Coalition. In an effort to improve outcomes and potentially reduce morbidity and increase disease free survival, our proposed intervention study addresses major health care resources concerns of BCS via a community-based, cost effective, scientifically rigorous and evidence-based approach. 
 
 
 
 
 
 Community involvement: Carolyn Tapp, Sister Survivor Coalition and Dr. Kimlin Ashing-Giwa are equitable partners. We have an active community advisory committee that includes other grass-roots and larger advocacy groups (e.g., ACS) to guide us. Each Coalition leader takes a key role: Ms. Tapp chairs the community advisory committee and leads on PN, recruitment and protocol development; Ms. Holbert-Santifer at Celebrate Life is our media spokes-person; Ms. Clark from Healthy Heritage is advertising director; Ms. Martin at Sisters BC Support Network leads on the community resources; Ms. Vickie and Mark Race from Faith Hope and Charity lead on community engagement; Ms. Mitchell at QCOC/Witness Project leads on PN trainings; and Ms. McDowell at KSIBCF leads on findings, interpretation and dissemination. 
 
 
 
 
 
 Future Plans: We will disseminate our findings through traditional scientific/academic avenues like journal articles and conference presentations. We will disseminate our findings to the community through community forums, community-based organization websites including ACS, and established African-American support groups, African-American newspapers including the Sentinel, Journal and Voice. These efforts are to inform community members and leaders about social support needs, collaborative efforts to advance clinical and community based research, and practices to improve outcomes for our most vulnerable survivors. Our future goal is to expand the reach of this research program outside our original geographic area to benefit AABCS and other underserved BCS nationally. We plan to evaluate the effectiveness of PN via a multisite study with support groups in California, New York and New Orleans.