Currently accepted at: Journal of Medical Internet Research
Date Submitted: Oct 18, 2025
Open Peer Review Period: Oct 20, 2025 - Dec 15, 2025
Date Accepted: Mar 2, 2026
(closed for review but you can still tweet)
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/86097
The final accepted version (not copyedited yet) is in this tab.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A peer-led nurse-involved blended online and offline peer support program（PNO2PSP）on psychosocial adjustment of young to middle-aged breast cancer patients: A Cluster Randomized Clinical Trial
ABSTRACT
Background:
Young to middle-aged breast cancer patients face significant psychosocial challenges. Existing interventions often lack comprehensiveness, timely initiation, and specific tailoring to this population's unique needs.
Objective:
To evaluate the impact of a peer-led, nurse-involved, blended online and offline peer support intervention program (PNO2PSP) on psychosocial adjustment in young to middle-aged breast cancer patients.
Methods:
The PNO2PSP effectiveness was validated through a single-center cluster randomized controlled trial involving 70 newly diagnosed young to middle-aged breast cancer patients (35 in each group). The intervention group received an 8-week PNO2PSP in addition to routine care. Psychosocial adjustment, self-efficacy, social support, and coping modes were assessed pre-surgery and at 4, 8, and 12 weeks post-surgery. Generalized Estimating Equations (GEE) were used for intention-to-treat analysis. In-depth interviews with 9 participants explored their experiences.
Results:
Compared to the control group, the intervention group demonstrated significantly lower psychosocial adjustment scores at 4 weeks (T1) (Wald χ² = 6.466, P = 0.011) and 12 weeks (T3) (Wald χ² = 4.395, P = 0.036); Social support was higher at 8 weeks (T2) (Wald χ² = 8.175, P = 0.004). Confrontation coping scores were higher at T3 (Wald χ² = 4.189, P = 0.041), while avoidance coping scores were lower at T1 (Wald χ² = 7.051, P = 0.008), T2 (Wald χ² = 7.346, P = 0.007), and T3 (Wald χ² = 5.062, P = 0.024). Qualitative findings supported these quantitative results, highlighting the program's role in facilitating psychosocial adjustment, providing vital support, boosting treatment confidence, and fostering positive coping.
Conclusions:
The PNO2PSP effectively enhances psychosocial adjustment, social support, and positive coping in young to middle-aged breast cancer patients. Its scientifically validated, feasible, and patient-centered design supports its recommendation for wider clinical implementation, with continued training for peer supporters and sustained delivery of peer support. Clinical Trial: Registry: Chinese Clinical Trial Registry, TRN: ChiCTR2300076471, Registered 10/10/2023
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.