Charles S. Carver

Lechner, S. C., Ennis-Whitehead, N., Vargas, S., Annane, D. W., Robertson, B. R., Carver, C. S., Kobetz-Kerman, E., & Antoni, M. H. (2014). Does a community-based stress management intervention affect psychological adaptation among underserved black breast cancer survivors? Journal of the National Cancer Institute Monographs, 50, 315-322.

Background: In this randomized trial, Project CARE, we examined whether participation in a cognitive-behavioral stress management (CBSM) and breast cancer wellness and education program (CW) improved psychological outcomes among a sample of underserved Black breast cancer survivors.

Methods: Both complementary medicine interventions were 10-sessions, manualized, group-based, and were culturally adapted for Black women in the community from evidence-based interventions. Participants were 114 Black women (mean age = 51.1, 27-77 years) who had completed breast cancer treatment 0-12 months prior to enrollment (stages 0-IV, mean time since cancer diagnosis = 14.1mo). Women were enrolled upon completion of curative treatment (i.e., surgical, chemotherapy, radiation oncology) and randomized to receive CBSM or CW.

Results: There was a remarkable 95% retention rate from baseline to six month follow-up. Participants in both conditions showed statistically significant improvement on indices of psychological well-being, including overall quality of life (FACT-B), intrusive thoughts (IES-R), depressive symptoms (CESD), and stress levels (PSS) over the six-month post-intervention follow-up (all repeated measures ANOVA within-subjects time effects: p<.05, except for overall mood (POMS-SV). Contrary to hypotheses, however, condition x time effects were not statistically significant.

Conclusions: Findings suggest that improvements in multiple measures over time may have been due to intensive training in stress management, extensive provision of breast cancer information, or participation in an ongoing supportive group of individuals from a similar racial background. Implications bear on decisions about appropriate control groups, the timing of intervention delivery during the treatment trajectory, and perceived support from the research team.

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