Trained peers called compañeras (companions) delivered the stress management intervention, Nuevo Amanecer (New Beginnings), in participants' homes for eight weeks. Each week, a 90-minute module was presented to participants using visual aids and hands-on exercises to teach concepts and skills. Compañeras were bilingual or Spanish-monolingual Latina breast cancer survivors who completed active treatment and had participated in three consecutive eight-hour training sessions.
To address the high rates of emotional distress and poor quality of life experienced by Spanish-speaking Latinas with breast cancer, we developed a stress management program with input from Latina breast cancer survivors, health care professionals and researchers.
Nuevo Amanecer is an individualized Spanish-language eight-week intervention cognitive-behavioral therapeutic intervention in which compañeras (breast cancer survivors who have received training to deliver the program) teach Latinas who have breast cancer coping skills to manage stress and emotions related to breast cancer survivorship.
In a randomized controlled trial (RCT), Nuevo Amanecer improved self-reported physical well-being, emotional well-being, breast cancer concerns and overall quality of life, and reduced depressive and body symptoms over a period of six months, as compared with a group of Spanish-speaking Latinas with breast cancer who received usual care while waiting to receive the Nuevo Amanecer intervention at a later time. One of the greatest improvements occurred in somatization, or "distress arising from perceptions of bodily dysfunction" (Napoles et al., 2015), as measured using the Somatization subscale of the Brief Symptom Inventory (Derogatis, 1983).
Results suggest that translation of evidence-based programs from clinical settings into community settings can reduce psychological health disparities in Latinas with breast cancer.
To our knowledge, this is the first successful RCT demonstrating that breast cancer survivors can be trained to deliver effectively cognitive-behavioral stress management programs (CBSM) that usually are delivered by health care professionals in cancer centers.
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). This trial is registered with ClinicalTrials.gov (NCT01383174).