JMIR Publications

ABSTRACT

Background:

Spanish-speaking Latina breast cancer survivors experience disparities in knowledge of breast cancer survivorship care, psychosocial health, lifestyle risk factors, and symptoms, compared to their white counterparts. Survivorship care planning programs (SCCP) could help these women receive optimal follow-up care and manage their condition.

Objective:

Evaluate the feasibility, acceptability and preliminary efficacy of a culturally and linguistically suitable SCPP, called the Nuevo Amanecer (New Dawn) Survivorship Care Planning Program, for Spanish-speaking breast cancer patients in public hospital settings, approaching the end of active treatment.

Methods:

The 2-month intervention was delivered via a written bilingual survivorship care plan and booklet, Spanish-language mobile phone application with integrated activity tracker, and telephone coaching. This single-arm feasibility study used mixed methods to evaluate the intervention. Acceptability and feasibility were examined via tracking of implementation processes, debriefing interviews, and post-intervention satisfaction surveys. Preliminary efficacy was assessed via baseline and 2-month interviews using structured surveys and pre- and post-intervention average daily steps count based on activity tracker data. Primary outcomes were self-reported fatigue, health distress, knowledge of cancer survivorship care, and self-efficacy for managing cancer follow-up health care and self-care. Secondary outcomes were emotional well-being, depressive and somatic symptoms, and average daily steps.

Results:

All women (n=23) were foreign-born and limited English proficient, 13 (57%) had an elementary school education or less, 16 (70%) were of Mexican origin, and all had public health insurance. Coaching calls lasted on average 15 minutes each (SD 3.4). Nineteen of 23 participants (83%) completed all five coaching calls. The majority (17; 81%) rated the overall quality of the app as “very good or excellent” (all rated it as at least “good”). Women checked their daily steps graph on the app between 4.2 to 5.9 times/week. Compared to baseline, post-intervention fatigue (ß = -.26, P = .02) and health distress levels (ß = -.36, P = <.01) were significantly lower, and knowledge of recommended follow-up care and resources (ß = .41, P = .03) and emotional well-being improved significantly (ß = 1.42, P = .02); self-efficacy for managing cancer follow-up care did not change. Average daily steps increased significantly from 6,157 to 7,469 (ß = 1311.8, P = .02).

Conclusions:

We found preliminary evidence of program feasibility, acceptability and efficacy, with significant two-month improvements in fatigue, health distress, and emotional well-being, and increased knowledge of recommended follow-up care and average daily steps. Tailored smartphone and health coaching SCPPs could help to ensure equitable access to these services and improve symptoms and physical activity levels among Spanish-speaking Latina breast cancer survivors.