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Tarver WL, Justice Z, Jonnalagadda P, Rahurkar S, Obeng-Gyasi S, Krok-Schoen JL, Petrecca A, Paskett ED. A scoping review of the evidence on survivorship care plans among minority, rural, and low-income populations. J Cancer Surviv 2024:10.1007/s11764-024-01609-z. [PMID: 38907799 DOI: 10.1007/s11764-024-01609-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 04/19/2024] [Indexed: 06/24/2024]
Abstract
PURPOSE Despite recent advances in cancer control and the number of cancer survivors increasing substantially over the past years, some cancer survivors continue to experience disparities due to barriers to recommended survivorship care. The use of survivorship care plans (SCPs) may be a way to help care for these individuals and their respective issues after they complete their primary treatment. The purpose of this scoping review is to understand the evidence on SCPs among minority, rural, and low-income populations: groups that experience disproportionately poorer cancer health outcomes. METHODS Computer-based searches were conducted in four academic databases. We included peer-reviewed studies published in the English language and conducted in the USA. We systematically extracted information from each paper meeting our inclusion criteria. RESULTS Our search identified 45 articles. The 4 major themes identified were (1) disparities in the receipt of SCPs where populations experience unmet needs; (2) benefits of SCPs, including improved care coordination and self-management of cancer; (3) needs and preferences for survivorship care; and (4) barriers and facilitators to using SCPs. CONCLUSIONS Despite the potential benefits, underserved cancer survivors experience disparities in the receipt of SCPs and continue to have unmet needs in their survivorship care. Survivorship care may benefit from a risk-stratified approach where SCPs are prioritized to survivors belonging to high-risk groups. IMPLICATIONS FOR CANCER SURVIVORS SCPs are a tool to deliver quality care for cancer survivors. While evidence is mixed on SCPs' benefits among the general population, SCPs show promise for underserved populations when it comes to proximal outcomes that contribute to disparities.
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Affiliation(s)
- Willi L Tarver
- James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA.
| | | | - Pallavi Jonnalagadda
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Saurabh Rahurkar
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Samilia Obeng-Gyasi
- Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- Division of Health Sciences, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Abigail Petrecca
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Electra D Paskett
- James Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
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Ko E, Woodruff SI, Zúñiga ML, Cardenas V, Lizarraga M, Urias A. Culturally-tailored survivorship care planning for rural Latina breast cancer patients: a pilot study. J Psychosoc Oncol 2022; 41:475-486. [PMID: 36357323 PMCID: PMC10169530 DOI: 10.1080/07347332.2022.2141168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To explore the feasibility and acceptability of Proyecto Mariposa, a culturally-tailored survivorship care program for rural Latina breast cancer patients. DESIGN Single group mixed-method approach. METHODS Feasibility of recruitment, intervention and evaluation, and perceptions about the intervention were assessed with 18 rural Latina breast cancer patients from the US/Mexico border region. Pre-post assessments evaluated change in patients' knowledge and concerns about survivorship care, and their self-efficacy about patient-physician interaction and managing chronic disease. FINDINGS Feasibility was generally promising but affected by the COVID-19 outbreak. Participants found the intervention to be acceptable and useful, particularly with regard to information provision and encouraging proactive behavior. There was modest pre-post improvement on self-efficacy for managing disease. CONCLUSIONS This pilot study suggested feasibility and acceptability of Proyecto Mariposa for rural Latina breast cancer patients. Change in outcomes was small indicating the need for research with a larger sample to establish reliable findings.
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Affiliation(s)
- Eunjeong Ko
- School of Social Work, San Diego State University, San Diego, CA, USA
| | - Susan I Woodruff
- School of Social Work, San Diego State University, San Diego, CA, USA
| | | | - Veronica Cardenas
- Department of Psychiatry, University of California, San Diego, Moores Cancer Center, San Diego, CA, USA
| | | | - Aday Urias
- Cancer Resource Center of the Desert, El Centro, CA, USA
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Anderson EA, Armer JM. Factors Impacting Management of Breast Cancer-Related Lymphedema (BCRL) in Hispanic/Latina Breast Cancer Survivors: A Literature Review. HISPANIC HEALTH CARE INTERNATIONAL 2021; 19:190-202. [PMID: 33550878 PMCID: PMC8353654 DOI: 10.1177/1540415321990621] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Breast cancer-related lymphedema (BCRL) is a treatment sequela with negative physical and psychological implications. BCRL is a lifetime concern for survivors and is currently incurable. With the increase in the Latino population in the United States, it is critical for the cancer care community to address factors that increase BCRL risk and negatively impact long-term quality of life. This literature review undertook to identify successful intervention strategies for BCRL among Latina survivors. METHODS Multiple databases were searched for published articles from 2006 to 2020. PRISMA guidelines were utilized. Data were extracted related to physical activity, diet, and psychosocial stress concerns of Latinas at risk for or living with BCRL. RESULTS Eleven interventions combined education and skill-building techniques to address physical activity, diet, and stress management for BCRL. Family involvement, peer-mentoring, culturally tailored education, and self-care skill development were identified as important for Latina survivors. CONCLUSION Latina survivors may benefit from culturally tailored BCRL education programs and self-management interventions. Health care professionals and researchers should consider cultural influences when developing clinical intervention strategies to enhance outcomes for Latinas at risk for living with BCRL. In addition, including family members and/or peers in such strategies may be helpful to Latina survivors.
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Affiliation(s)
| | - Jane M. Armer
- S312 Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
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Buki LP, Schwartz JR, McInerney EEW. Creating community: Expanding access to psychosocial programs for Latina breast cancer survivors. Psychooncology 2021. [PMID: 33555106 DOI: 10.1002/pon.5646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/29/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Breast cancer survivors often derive benefits from psychosocial interventions, but less is known about Latina women's experiences. Given the disproportionately high disease burden faced by Latina survivors, it is critical to examine ways to enhance access for this population. Thus, the present study aimed to (a) examine women's perceptions of factors associated with effective delivery of a psychosocial program designed for Spanish speaking women with limited access to care, and (b) identify the mechanisms by which the program enhanced women's psychological well-being. METHODS In a qualitative study, in-depth interviews were conducted with 15 immigrant Latina breast cancer survivors who previously received psychosocial services at a community-based organization. Grounded theory was used to analyze the data. RESULTS Through open, axial, and selective coding, we arrived at the core category achieving a sense of community. The psychosocial program promoted access and enhanced women's psychological well-being by creating a sense of community among participants. This was facilitated by three primary aspects of service provision: access factors, a holistic approach to health, and therapeutic factors imparted through a biweekly support group. CONCLUSIONS Psychosocial services promoted a sense of community among Latina breast cancer survivors while reflecting their cultural values and unique psychosocial needs. Findings may guide the development of interventions to increase access to care, enhance health outcomes, and create and maintain a sense of community among medically underserved populations.
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Affiliation(s)
- Lydia P Buki
- Department of Educational and Psychological Studies, University of Miami, Coral Gables, Florida, USA
| | - Jessica R Schwartz
- Department of Educational and Psychological Studies, University of Miami, Coral Gables, Florida, USA
| | - Elizabeth E W McInerney
- Department of Educational and Psychological Studies, University of Miami, Coral Gables, Florida, USA
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Krok-Schoen JL, Naughton MJ, Noonan AM, Pisegna J, DeSalvo J, Lustberg MB. Perspectives of Survivorship Care Plans Among Older Breast Cancer Survivors: A Pilot Study. Cancer Control 2020; 27:1073274820917208. [PMID: 32233798 PMCID: PMC7143997 DOI: 10.1177/1073274820917208] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The Commission on Cancer’s standard 3.3 represents a paradigm shift in the care
of cancer survivors, recommending that survivors receive a treatment summary and
survivorship care plan (SCPs). A focus on older breast cancer survivors is
needed, as they are the majority of the breast cancer population and their
experiences and perspectives of SCPs is limited in the literature. This pilot
study utilized a mixed methods approach (focus groups and self-report
questionnaire data) to gather information on older (≥65 years) breast cancer
survivors’ perspectives of their SCPs, cancer survivorship, and communication
with their health-care providers. The questionnaire was completed individually
by the participants prior to the focus group and contained items on basic
demographics and their health status following cancer treatment. The focus
groups indicated that only a minority of women actually developed a SCP. Those
who developed a SCP in collaboration with their providers valued the personal
care and attention received. However, some participants reported poor
communication with their providers and within their health-care team, resulting
in frustration and confusion. Participants’ suggestions for ideal SCPs included
better education and personalization, particularly in appropriate nutrition and
exercise, and managing side effects and comorbidities. Lastly, the women
believed that additional long-term care resources, such as health coaches, were
important in improving their survivorship. These findings provide insight into
enhancing the content, communication, and application of SCPs to improve the
survivorship experience of older breast cancer survivors.
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Affiliation(s)
- Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.,Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Michelle J Naughton
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Anne M Noonan
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Janell Pisegna
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Jennifer DeSalvo
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Maryam B Lustberg
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,College of Medicine, The Ohio State University, Columbus, OH, USA
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Polek C, Hardie T, Deatrick JA. Breast Cancer Survivorship Experiences of Urban Hispanic Women. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:923-929. [PMID: 31098836 DOI: 10.1007/s13187-019-01543-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to explore determinates of health that impact survivorship of urban Hispanic breast cancer survivors who are at risk for experiencing poorer outcomes than others. Some challenges have been characterized, but gaps in our knowledge of the impact of some of the social determinates of health remain. Challenges likely exist prior to a diagnosis of cancer and may amplify in intensity during survivorship, potentially shortening survival and quality of life of these women. A narrative, focus group was conducted with a group of urban Hispanic breast cancer survivors. A series of linked vignettes describing survivorship challenges and late effects of breast cancer pathology and treatment were used to stimulate discussion. Three themes impacting survivorship were identified. The themes included communication (health literacy), isolation, and social support and financial cost. Communication issues resulted in delays in treatment denial of services. While these themes in cancer survivors are independent of residence (rural, suburban, or urban) and across ethnic groups, some unique issues were identified in urban Hispanic breast cancer survivors. Members of the healthcare team are in a unique position to enhance survivor's health literacy, advocate for programmatic efforts to enhance navigation roles in the hospital and communities, decrease delays in initiating care, and decrease the rate of patients lost.
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Affiliation(s)
| | - Thomas Hardie
- University of Pennsylvania, Philadelphia, PA, 19104, USA
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Development of a Survivorship Care Plan (SCP) Program for Rural Latina Breast Cancer Patients: Proyecto Mariposa-Application of Intervention Mapping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165784. [PMID: 32785081 PMCID: PMC7460525 DOI: 10.3390/ijerph17165784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 01/22/2023]
Abstract
Latina breast cancer survivors are less likely to receive a comprehensive Survivorship Care Plan (SCP) than non-Latina Whites. Evidence-based and theory driven interventions are needed to promote a culturally and linguistically responsive SCP. This paper describes the application of Intervention Mapping (IM) in the development of Proyecto Mariposa, a comprehensive SCP program targeting Latina breast cancer survivors living in a rural U.S.–Mexico border region. We conducted a needs assessment using focus groups (n = 40) and individual interviews (n = 4) with stakeholders to elicit their needs and preferences relating to SCPs and SCP aid (Step1). Content analysis of transcripts was conducted using Atlas.ti. The findings informed the development of a matrix of change objectives where we selected specific behavioral theories to ground the practical application of the SCP program (Step 2). We identified behavioral theories and the practical application of behavioral change (Step 3) and designed and developed a comprehensive SCP program which consisted of a culturally—and linguistically—adapted SCP document and animated video as an SCP aid (Step 4). The systematic application of the IM framework resulted in the development of a comprehensive and culturally tailored SCP intervention. Stakeholder active involvement in the cultural tailoring of the program was imperative and strengthens the SCP intervention.
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The use of survivorship care plans by female racial and ethnic minority breast cancer survivors: a systematic review. J Cancer Surviv 2020; 14:806-825. [PMID: 32514908 DOI: 10.1007/s11764-020-00894-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/07/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE Racial/ethnic breast cancer survivorship disparities persist as minority breast cancer survivors (MBCSs) report fragmentation in survivorship care, namely in the access and delivery of survivorship care plans (SCPs). To better understand care coordination of MCBS, this review elucidated concerns of female MBCS about their preparation for post-treatment survivorship care, the preferred practices for the delivery of a SCP, and the associated content to improve post-treatment survivorship care understanding. METHODS A systematic search of articles from PubMed, Ovid-Medline, CINAHL databases, and bibliographic reviews included manuscripts using keywords for racial/ethnic minority groups and breast cancer survivorship care coordination terms. Salient themes and article quality were analyzed from the extracted data. RESULTS Fourteen included studies represented 5,854 participants and over 12 racial/ethnic groups. The following themes of post-treatment MBCS were identified from the review: (1) uncertainty about post-treatment survivorship care management is a consequence of sub-optimal patient-provider communication; (2) access to SCPs and related materials are desired, but sporadic; and (3) advancements to the delivery and presentation of SCPs and related materials are desired. CONCLUSIONS Representation of only 14 studies indicates that the MBCSs' perspective post-treatment survivorship care is underrepresented in the literature. Themes from this review support access to, and implementation of, culturally tailored SCP for MBCS. There was multi-ethnic acceptance of SCPs as a tool to help improve care coordination. IMPLICATIONS FOR CANCER SURVIVORS These findings highlight the importance of general education about post-treatment survivorship, post-treatment survivorship needs identification, and the elucidation of gaps in effective SCP delivery among MBCS.
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Integrative review of breast cancer survivors’ transition experience and transitional care: dialog with transition theory perspectives. Breast Cancer 2020; 27:810-818. [DOI: 10.1007/s12282-020-01097-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/15/2020] [Indexed: 12/16/2022]
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Exploring the ‘Patient Experience’ of Individuals with Limited English Proficiency: A Scoping Review. J Immigr Minor Health 2018; 21:853-878. [DOI: 10.1007/s10903-018-0816-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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