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. 2025 Jun:11:e2400474.
doi: 10.1200/GO-24-00474. Epub 2025 Jun 18.

Baseline Distress and Effectiveness of Survivor Video Narratives on Cancer-Associated Distress in Botswana: A Pilot Study

Yehoda M Martei  1 , Maanasa Gurram  2 , Lebogang T Mokokwe  3   4 , Ngwao Ngwako  4 , Keaobaka Kebuang  5 , Dipho I Setlhako  5 , Peter Vuylsteke  4 , Baaitse Bontswanetse  5 , Tumisang Segadimo  5 , Mosepele Mosepele  4 , Lawrence N Shulman  1 , Frances Barg  6 , Babe E Gaolebale  5
Affiliations

Baseline Distress and Effectiveness of Survivor Video Narratives on Cancer-Associated Distress in Botswana: A Pilot Study

Yehoda M Martei et al. JCO Glob Oncol. 2025 Jun.

Abstract

Purpose: To evaluate baseline distress among patients with breast cancer in Botswana, and assess the impact of culturally tailored peer survivor video narratives on distress and its mediators.

Methods: We enrolled patients with stage I-IV breast cancer at Princess Marina Hospital. A Setswana-translated National Comprehensive Cancer Network distress thermometer (DT) and problem list (PL) were used for distress screening. DT score of ≥4 was considered a positive screen for moderate to high (moderate-high) distress. We analyzed independent PL factors associated with moderate-high distress using logistic regression. Participants then watched one to two videos and completed a postintervention DT/PL assessment after each video at 4 and 8 weeks. We conducted descriptive statistics to explore the impact of the videos.

Results: One hundred six participants were enrolled, of whom 103 completed baseline DT and 106 completed baseline PL. Sixty-seven percent (69/103) of participants screened positive for moderate-high distress at baseline. Fear (odds ratio [OR], 11.25 [95% CI, 1.66 to 76.49]; P = .01) and appearance (OR, 4.96 [95% CI, 1.03 to 23.80]; P = .046) were PL factors significantly associated with moderate-high distress in the multivariable model. Sixty-eight and 47 participants completed postvideo assessments at approximately 4 and approximately 8 weeks, respectively. The greatest impact was observed at 8 weeks after watching two videos-29.8% of participants with moderate-high distress had no or mild distress. Similarly, there was a 29% (44%-15%; P = .005) and 17% (32%-15%; P = .03) absolute decrease from baseline to 8 weeks, in the proportion of patients who identified fear and appearance as sources of distress, respectively.

Conclusion: Two thirds of patients with breast cancer screened positive for moderate-high distress. Fear and appearance were sources of distress significantly associated with a positive screen. Our results show promising potential of peer survivor videos to mitigate distress and its potential mediators among patients with breast cancer.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

Lawrence N. Shulman

Consulting or Advisory Role: Genentech

No other potential conflicts of interest were reported.

Figures

FIG 1
FIG 1
Patient flow diagram showing the number of participants enrolled at baseline and the number of participants who completed interval DT and PL assessments after the video interventions. DT, distress thermometer; NCCN, National Comprehensive Cancer Network; PL, problem list.
FIG 2
FIG 2
Frequency of problems identified by >25% of participants enrolled.
FIG 3
FIG 3
Impact of survivor video narratives on proportion of patients who selected fear and appearance as sources of distress at baseline, and at 4 and 8 weeks (after video intervention).
See this image and copyright information in PMC

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