Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2003 Jul;18(7):499-507.
doi: 10.1046/j.1525-1497.2003.20316.x.

Psychosocial intervention for rural women with breast cancer: The Sierra-Stanford Partnership

Karyn L Angell  1 , Mary Anne Kreshka, Rebecca McCoy, Patricia Donnelly, Julie M Turner-Cobb, Kathy Graddy, Helena C Kraemer, Cheryl Koopman
Affiliations
Clinical Trial

Psychosocial intervention for rural women with breast cancer: The Sierra-Stanford Partnership

Karyn L Angell et al. J Gen Intern Med. 2003 Jul.

Abstract

Objective: This study was initiated by breast cancer survivors living in a rural community in California. They formed a partnership with academic researchers to develop and evaluate a low-cost, community-based Workbook-Journal (WBJ) for improving psychosocial functioning in geographically and economically isolated women with primary breast cancer.

Design: A randomized controlled trial was used to compare the WBJ intervention plus educational materials to educational materials alone (usual care).

Setting: One rural cancer center and several private medical, surgical, and radiation oncology practices in 7 rural counties in the Sierra Nevada Foothills of California.

Participants: One hundred women with primary breast cancer who were either within 3 months of diagnosis or within 3 months of completing treatment.

Intervention: A community-initiated, theoretically-based Workbook-Journal, designed by rural breast cancer survivors and providers as a support group alternative. It included compelling personal stories, local rural resources, coping strategies, and messages of hope.

Results: Community recruiters enrolled 83% of the women referred to the study. Retention at 3-month follow-up was 98%. There were no main effects for the WBJ. However, 3 significant interactions suggested that women who were treated in rural practices reported decreased fighting spirit and increased emotional venting and posttraumatic stress disorder symptoms if they did not receive the WBJ. Among women who receive the WBJ, 74% felt emotionally supported.

Conclusions: This community-based Workbook-Journal may be an effective psychosocial intervention for rural, isolated, and low-income women with breast cancer. Community involvement was essential to the success of this project.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Interaction of intervention and months since diagnosis on posttraumatic stress disorder (PTSD). PCL-S, PTSD Checklist-Specific symptoms, where higher scores equal higher PTSD; Workbook, Workbook-Journal group; UC, usual care group.
FIGURE 2
FIGURE 2
Interaction of intervention and treatment site on fighting spirit from the Mental Adjustment to Cancer Scale (MAC). Workbook, Workbook-Journal group; UC, usual care group; SNCC, Sierra Nevada Memorial Cancer Center; Other, other rural practice.
FIGURE 3
FIGURE 3
Effect of site on behavioral disengagement from the Coping Operations Preference Enquiry (COPE). A higher value equals higher behavioral disengagement. Workbook, Workbook-Journal group; UC, usual care group; SNCC, Sierra Nevada Memorial Cancer Center; Other, other rural practice.
FIGURE 4
FIGURE 4
Interaction of intervention and treatment site on emotional venting from the COPE. A higher value equals higher emotional venting. Workbook, Workbook-Journal group; UC, usual care group; SNCC, Sierra Nevada Memorial Cancer Center; Other, other rural practice.
See this image and copyright information in PMC

References

    1. Spiegel D, Lazar SG. The need for psychotherapy in the medically ill. In: Lichtenberg J, Lazar SJ, editors. Psychoanalytic Inquiry. Hillsdale, NJ: The Analytic Press; 1996.
    1. Johnson J. The effects of a patient education course in persons with a chronic illness. Cancer Nurs. 1982;5:117–23. - PubMed
    1. Felic M, Goldman A, Kennedy BJ. Group counseling in adult patients with advanced cancer. Cancer. 1979;43:760–6. - PubMed
    1. Cain EN, Kohorn EI, Quinlan DM, Latimer K, Schwartz PE. Psychosocial benefits of a cancer support group. Cancer. 1986;57:183–9. - PubMed
    1. Spiegel D, Bloom JR, Yalom ID. Group support for patients with metastatic cancer: a randomized prospective outcome study. Arch Gen Psychiatry. 1981;38:527–33. - PubMed

Publication types