Abstract P1-09-22: Improving quality of life among Latino breast cancer survivors: A national randomized control trial of patient navigators using LIVESTRONG's Cancer Navigation Center
Authors: Amelie G Ramirez, Edgar Muñoz, Sandra San Miguel, Kip Gallion, Arely Perez, Leo Castillo, Sarah R Arvey, Frank Penedo
Journal: Cancer Research (2015)

Abstract Purpose: Latina breast cancer survivors experience an unequal burden of unmet needs after treatment, which compromise their health care and wellness, experts recommend providing psychological services as an integral part of quality cancer care. Methods: Redes En Accion: The National Latino Cancer Research Network and LIVESTRONG partnered to conduct a randomized control trial utilizing trained, bilingual, bicultural patient navigators to improve wellness and access to psychosocial services among non-metastatic Latino breast cancer survivors from Texas and Chicago. The trial tests the efficacy of patient navigation (PN) in improving general and disease-specific quality of life (QoL), treatment compliance, and identification of mechanisms that may promote quality of life. The study involves a 2 X 4 randomized repeated measures design with an experimental condition (combined PN over three months with access to the LIVESTRONG Cancer Navigation Center [LCNC] services [PN+LCNC]) versus a control condition (PN only) as the between-groups factor, and time-point (baseline/pre-randomization [T1]; post-PN [3-months post T1; T2], and 6 [T3] and 12 months [T4] follow up after T2) as the within groups factor. LCNC provides free, bilingual support to U.S. cancer survivors throughout the cancer journey. LCNC also refers to survivors to services addressing their medical, economic and psychosocial needs, and monitors client contact and access outcomes. Preliminary Results: A total of 128 Latina women with early stage breast cancer have been randomized into either our control (Standard Patient Navigation; PN) or our experimental (Enhanced Patient Navigation; EPN) conditions. Complete data for multiple regression analysis on 76 randomized Latina women who completed baseline and first follow up assessment is available. At baseline, we identified major stated needs by our participants. These included fear of recurrence, more information regarding their disease, and assistance in communicating with the medical team. The top three physical functioning concerns stated by our participants included lack of energy/fatigue, interference with daily routines and poor physical well-being. Consistent with prior work with Hispanic cancer survivors, our sample reported significantly lower (over 1.5 standard deviation below) general health related quality of life, physical well-being and emotional well-being as measured by the FACT-G. Exploratory analyses have begun to reveal that there are several significant moderators of the effects of the intervention across several outcomes. At conference, we will present quality of life data on breast cancer participants, exploratory analysis, and lessons learned. Discussion: Limited work has addressed the psychosocial needs of Latina breast cancer survivors. Culturally sensitive patient navigation (PN) could address these needs and significantly improve breast cancer survivorship. Citation Format: Amelie G Ramirez, Edgar Muñoz, Sandra San Miguel, Kip Gallion, Arely Perez, Leo Castillo, Sarah R Arvey, Frank Penedo. Improving quality of life among Latino breast cancer survivors: A national randomized control trial of patient navigators using LIVESTRONG's Cancer Navigation Center [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-22.