Background: Due in part to the growing number of breast cancer survivors, organizations such as the Institute of Medicine recommend that all cancer patients receive a Survivorship Care Plan to communicate individualized patient management of recurrence risk. Thus, the primary objective of the Breast Cancer Risk Information Materials (BRIM) was to assess the impact of personalized cancer recurrence risk counseling and booklet for breast cancer patients in Appalachia.
Sample and setting: The Appalachian region is a federally-designated region which is medically-underserved, with lower education and higher poverty than other regions of the US. Participants (n=131) had a mean age of 58.5 years, and 95.4% were White, consistent with Census data of the region.
Procedures: Guided by a Dynamic Communication Model, a randomized trial compared the BRIM to a waitlist control. Pre- and post-intervention surveys were conducted to assess worry, patient satisfaction, and perceived knowledge among breast cancer survivors.
Results: Repeated measures Analysis of Variance examined group (BRIM vs. control) and change from pre- to post-intervention. Cancer worry decreased for all participants from pre- to post-intervention (p=.01). For patient satisfaction, a trend for an interaction emerged, such that those assigned to the control group had higher patient satisfaction at baseline and decreased; those assigned to the intervention group had lower satisfaction at baseline and increased in satisfaction (p<.08). Perceived knowledge did not change.
Conclusion and clinical implications: As compared to our pilot data which evidenced changes in knowledge, the current randomized trial did not evidence improvements in subjective knowledge but did find a trend toward increased patient satisfaction. Thus, patients may value greater explanation of recurrence risk from providers, particularly in medically-underserved populations.