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Evaluating the Implementation of a Translational Peer-Delivered Stress Management Program for Spanish-Speaking Latina Breast Cancer Survivors

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Abstract

Information is needed on implementation processes involved in translating evidence-based interventions (EBIs) into health disparity communities. In an RCT, Nuevo Amanecer, a cognitive-behavioral stress management (CBSM) program delivered by breast cancer survivors (compañeras) in community settings to Spanish-speaking Latina breast cancer survivors, was effective in improving quality of life and decreasing breast cancer concerns and depressive and bodily symptoms. Using mixed methods, we evaluated the processes of implementing Nuevo Amanecer. Program delivery was assessed by direct observation. Treatment receipt was assessed by participants’ mastery and homework completion. Perceived benefits, quality, ease of use, usefulness of components, and suggested improvements were evaluated through participant surveys and semi-structured interviews of participants and compañeras. Eighty percent of women completed six or more of eight sessions. Observer ratings of program delivery indicated compañeras demonstrated fidelity 80–90% of the time for three components (e.g., following the manual), but only 10% for two components (e.g., modeling skills). Regarding treatment receipt, most participants completed all homework. Knowledge and skills mastery was high (mostly >85%). In program evaluations, 93% indicated the program helped them cope with breast cancer “quite a bit/extremely.” Participants reported improved self-management skills and knowledge. Suggested improvements were to add more sessions to practice cognitive-behavioral coping skills and simplify exercises and homework. We conclude that CBSM programs can be delivered in community settings by trained peers with high fidelity, acceptability, and perceived usefulness. Results provided some areas where the program could be improved. Our rigorous evaluation illustrates methods for evaluating processes of translating EBIs for community implementation. Trial registration: NCT01383174 (ClinicalTrials.gov).

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Acknowledgements

This research was supported by the California Breast Cancer Research Grants Program Office of the University of California (15BB-1300 and 15BB-1301), National Cancer Institute (1U54CA153511), and National Institute on Aging (1 P30 AG15272).

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Authors and Affiliations

  1. Department of Medicine, University of California San Francisco (UCSF), 3333 California Street, Suite 335, San Francisco, CA, 94118-1944, USA

    Anna María Nápoles & Jasmine Santoyo-Olsson

  2. Institute for Health and Aging, UCSF, San Francisco, CA, USA

    Anita L. Stewart

  3. Círculo de Vida Cancer Support and Resource Center, San Francisco, CA, USA

    Carmen Ortiz

  4. New York University Medical Center, New York, NY, USA

    Maria García-Jímenez

Authors
  1. Anna María Nápoles
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  2. Jasmine Santoyo-Olsson
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  3. Anita L. Stewart
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  4. Carmen Ortiz
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  5. Maria García-Jímenez
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Corresponding author

Correspondence to Anna María Nápoles.

Ethics declarations

The protocol was approved by the University of California San Francisco and San Mateo Medical Center institutional review boards. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Written informed consent was obtained from all individual participants included in the study. The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Nápoles, A.M., Santoyo-Olsson, J., Stewart, A.L. et al. Evaluating the Implementation of a Translational Peer-Delivered Stress Management Program for Spanish-Speaking Latina Breast Cancer Survivors. J Canc Educ 33, 875–884 (2018). https://doi.org/10.1007/s13187-017-1202-y

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  • DOI: https://doi.org/10.1007/s13187-017-1202-y

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