Randomized trial of peer counseling on reproductive health in African American breast cancer survivors

Abstract

Purpose: We designed a peer counseling program to improve sexual function, increase knowledge about reproductive health, and decrease menopausal symptoms and infertility-related distress for African American breast cancer survivors.

Patients and methods: Women were randomly assigned to immediate counseling or a 3-month waitlist. Three peer counselors conducted a 3-session intervention using a detailed workbook. Questionnaires at baseline, after the waitlist period, at posttreatment, and at 3-month follow-up assessed spirituality, sexual function, menopause symptoms, emotional distress, relationship satisfaction, fertility concerns, and knowledge about reproductive health and breast cancer. At the postcounseling assessment, women rated the workbook, their counselor, and the program.

Results: Of 93 women screened, 60 women (65%) enrolled in the study. Women who completed counseling (80%; N = 48) had a mean age of 49 years (standard deviation [SD], 8 years) and a mean follow-up of 4.5 years (SD, 3.8 years) since cancer diagnosis. Almost all rated the workbook as very easy to understand (94%) and their counselor as very knowledgeable (96%) and very skillful (98%). Eighty-one percent rated the program as "very useful to me." Immediate counseling and waitlist groups did not differ at baseline in psychologic adjustment, nor did scores change during the waitlist period. Therefore, the groups were combined in analyzing outcomes. Knowledge of reproductive issues improved significantly from baseline to 3-month follow-up (P < .0001), as did emotional distress (P = .0047) and menopause symptoms (P = .0128). Sexually dysfunctional women became less distressed (P = .0167).

Conclusion: Women valued the Sisters Peer Intervention in Reproductive Issues After Treatment program highly and found it relevant. The program had positive effects on knowledge and target symptoms.