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Randomized Trial of Peer Counseling on Reproductive Health in African American Breast Cancer Survivors

Leslie R. Schover, Rosell Jenkins, Dawen Sui, Jennifer Harned Adams, Michelle S. Marion, Karen Eubanks Jackson

From The University of Texas M.D. Anderson Cancer Center and Sisters Network Inc, National Headquarters, Houston, TX.

Address reprint requests to Leslie R. Schover, PhD, Department of Behavioral Science–Unit 1330, UT M.D. Anderson Cancer Center, P.O. Box 301439, Houston, TX 77230-1439; e-mail: Lschover{at}mdanderson.org

PURPOSE: We designed a peer counseling program to improve sexual function, increase knowledge about reproductive health, and decrease menopausal symptoms and infertility-related distress for African American breast cancer survivors.

PATIENTS AND METHODS: Women were randomly assigned to immediate counseling or a 3-month waitlist. Three peer counselors conducted a 3-session intervention using a detailed workbook. Questionnaires at baseline, after the waitlist period, at posttreatment, and at 3-month follow-up assessed spirituality, sexual function, menopause symptoms, emotional distress, relationship satisfaction, fertility concerns, and knowledge about reproductive health and breast cancer. At the postcounseling assessment, women rated the workbook, their counselor, and the program.

RESULTS: Of 93 women screened, 60 women (65%) enrolled in the study. Women who completed counseling (80%; N = 48) had a mean age of 49 years (standard deviation [SD], 8 years) and a mean follow-up of 4.5 years (SD, 3.8 years) since cancer diagnosis. Almost all rated the workbook as very easy to understand (94%) and their counselor as very knowledgeable (96%) and very skillful (98%). Eighty-one percent rated the program as "very useful to me." Immediate counseling and waitlist groups did not differ at baseline in psychologic adjustment, nor did scores change during the waitlist period. Therefore, the groups were combined in analyzing outcomes. Knowledge of reproductive issues improved significantly from baseline to 3-month follow-up (P < .0001), as did emotional distress (P = .0047) and menopause symptoms (P = .0128). Sexually dysfunctional women became less distressed (P = .0167).

CONCLUSION: Women valued the Sisters Peer Intervention in Reproductive Issues After Treatment program highly and found it relevant. The program had positive effects on knowledge and target symptoms.

Supported by two grants from the National Cancer Institute, Bethesda, MD, Grants No. 3P30 CA16672-2652 Cancer Center Supplement Grant and No. 1RO1 CA 102097-01 SPIRIT: Reproductive Counseling for Breast Cancer.

Presented in part at the 9th Biennial Symposium on Minorities, the Medically Underserved, and Cancer, Intercultural Cancer Council, Washington, DC, March 24-28, 2004.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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