Feasibility trial of health coaching-based navigation after breast cancer treatment.

Abstract

1637 Background: Following breast cancer diagnosis, 25% of survivors experience psychosocial needs like depression, anxiety, and fear of recurrence. Integrative survivorship support services address these needs, but participation is lower among Black women, who report higher psychosocial distress. Patient navigation has emerged as a strategy to reduce these barriers. This study piloted a navigation-based intervention aimed at improving psychosocial symptom management over 6 months. Methods: A single-arm feasibility trial was conducted with Black breast cancer survivors from November 2022-June 2024. Women aged 18+ with non-metastatic breast cancer were recruited. A trained lay navigator provided personalized support and resource facilitation to address psychosocial and healthcare challenges. Interactions were analyzed qualitatively to assess preliminary impact. Surveys administered at baseline and post-intervention included the Life and Longevity after Cancer, Patient Reported Outcomes Measurement Information System, and Breast Cancer Survivorship Experience Survey, with responses measured on a Likert scale. Quantitative data were analyzed descriptively. Results: Of 21 Black women who consented (mean age 64), 18 began the study while 3 did not proceed beyond consent. Of these, 44.4% completed all six months, while 61.1% completed three months. Eight participants completed post-surveys. All participants found the study easy to join, 5/8 found its length appropriate, and 6/8 were satisfied with session intervals. All would recommend the program, and 4 preferred in-person sessions. Participants reported confidence in accessing future support programs. Key benefits included managing stress, family stressors, and improving community support. Qualitative analysis of 108 transcripts from 17 participants identified six themes: managing health challenges, communication, emotional well-being, resilience in daily life, program support, and future planning. Survey results showed improvements in well-being and self-efficacy. LILAC scores increased from 52.7 to 63.9, PROMIS physical scores rose from 12.4 to 13.3, and mental scores improved from 13.3 to 15.6. Self-efficacy decreased slightly in BCSES scores from 53.6 to 52.5. Conclusions: Among Black breast cancer survivors, 61% completed biweekly sessions during the first 3 months, with a drop in participation after transitioning to monthly sessions. Participants reported benefits in addressing distress and accessing support programs. Future efforts should focus on tailored strategies to enhance engagement and retention.