School of Nursing, Office of Research and Scholarship, University of Alabama at Birmingham, Birmingham, AL, USA.
O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
J Cancer Surviv. 2020 Aug;14(4):494-503. doi: 10.1007/s11764-020-00866-y. Epub 2020 Mar 10.
To compare two implementation telephone-based strategies of an evidence-based educational and support intervention to Rural Breast Cancer Survivors (RBCS) in which education was delivered early or after the support component.
Florida RBCS participated in a 12-month randomized clinical trial (RCT) with two arms: Early Education and Support (EE-S) and Support and Delayed Education (S-DE). Arms differed in the timing of 6 support and 3 education sessions. Main outcome was quality of life (QOL, SF-36 physical and mental composite scores [PCS, MCS]). Secondary outcomes were depressive symptoms (Centers for Epidemiologic Studies Depression Scale, CES-D), mood (Profile of Mood States, POMS), and social support (Medical Outcomes Study Social Support Survey, MOS-SSS). Outcomes were analyzed longitudinally using repeated measures models fitted with linear mixed methods.
Of 432 RBCS (mean 25.6 months from diagnosis), about 48% were 65+, 73% married/partnered, and 28% with ≤high school education. There were no differences between EE-S and S-DE in demographics or outcomes at baseline (mean (standard deviation): SF-36 PCS, 44.88 (10.6) vs. 45.08 (10.6); MCS, 49.45 (11.1) vs. 48.1 (11.9); CES-D, 10.11 (9.8) vs. 10.86 (10.5); POMS-SF, 23.95 (38.6) vs. 26.35 (38.8); MOS-SSS, 79.2 (21.2) vs. 78.66 (21.2)) or over time. One exception was slightly worse mean scores at month 9 in MCS (Cohen's d, - 0.22; 95% CI, - 0.38, - 0.06) and POMS (Cohen's d, 0.23; 95% CI, 0.07, 0.39) for EE-S vs. S-DE.
The implementation strategies were equivalent.
Enhancing support may be considered before delivering not-in-person interventions to RBCS.
比较两种基于电话的实施策略，即对农村乳腺癌幸存者（RBCS）实施基于证据的教育和支持干预，其中一种策略是早期提供教育，另一种策略是在提供支持后提供教育。
佛罗里达州的 RBCS 参与了一项为期 12 个月的随机临床试验（RCT），分为两组：早期教育和支持（EE-S）和支持和延迟教育（S-DE）。两组在 6 次支持和 3 次教育课程的时间安排上有所不同。主要结局是生活质量（SF-36 身体和心理综合评分[PCS，MCS]）。次要结局是抑郁症状（流行病学研究中心抑郁量表，CES-D）、情绪（状态-特质焦虑量表，POMS）和社会支持（医疗结局研究社会支持量表，MOS-SSS）。使用线性混合方法拟合重复测量模型对结局进行纵向分析。
在 432 名 RBCS 中（平均诊断后 25.6 个月），约 48%的患者年龄在 65 岁以上，73%已婚/有伴侣，28%的患者受教育程度≤高中。EE-S 和 S-DE 在基线时的人口统计学特征或结局没有差异（平均值（标准差）：SF-36 PCS，44.88（10.6）与 45.08（10.6）；MCS，49.45（11.1）与 48.1（11.9）；CES-D，10.11（9.8）与 10.86（10.5）；POMS-SF，23.95（38.6）与 26.35（38.8）；MOS-SSS，79.2（21.2）与 78.66（21.2））或随时间推移。一个例外是在 MCS（Cohen's d，-0.22；95%CI，-0.38，-0.06）和 POMS（Cohen's d，0.23；95%CI，0.07，0.39）中，EE-S 组在 9 个月时的平均评分略差。
实施策略是等效的。
在向 RBCS 提供非面对面干预之前，可能需要增强支持。
