Background Spanish-speaking Latina breast cancer survivors experience disparities in knowledge of breast cancer survivorship care, psychosocial health, lifestyle risk factors, and symptoms compared with their white counterparts. Survivorship care planning programs (SCPPs) could help these women receive optimal follow-up care and manage their condition. Objective This study aimed to evaluate the feasibility, acceptability, and preliminary efficacy of a culturally and linguistically suitable SCPP called the Nuevo Amanecer (New Dawn) Survivorship Care Planning Program for Spanish-speaking breast cancer patients in public hospital settings, approaching the end of active treatment. Methods The 2-month intervention was delivered via a written bilingual survivorship care plan and booklet, Spanish-language mobile phone app with integrated activity tracker, and telephone coaching. This single-arm feasibility study used mixed methods to evaluate the intervention. Acceptability and feasibility were examined via tracking of implementation processes, debriefing interviews, and postintervention satisfaction surveys. Preliminary efficacy was assessed via baseline and 2-month interviews using structured surveys and pre- and postintervention average daily steps count based on activity tracker data. Primary outcomes were self-reported fatigue, health distress, knowledge of cancer survivorship care, and self-efficacy for managing cancer follow-up health care and self-care. Secondary outcomes were emotional well-being, depressive and somatic symptoms, and average daily steps. Results All women (n=23) were foreign-born with limited English proficiency; 13 (57%) had an elementary school education or less, 16 (70%) were of Mexican origin, and all had public health insurance. Coaching calls lasted on average 15 min each (SD 3.4). A total of 19 of 23 participants (83%) completed all 5 coaching calls. The majority (n=17; 81%) rated the overall quality of the app as “very good” or “excellent” (all rated it as at least “good”). Women checked their daily steps graph on the app between 4.2 to 5.9 times per week. Compared with baseline, postintervention fatigue (B=–.26; P= .02; Cohen d =0.4) and health distress levels (B=–.36; P= .01; Cohen d =0.3) were significantly lower and knowledge of recommended follow-up care and resources (B=.41; P= .03; Cohen d =0.5) and emotional well-being improved significantly (B=1.42; P= .02; Cohen d =0.3); self-efficacy for managing cancer follow-up care did not change. Average daily steps increased significantly from 6157 to 7469 (B=1311.8; P= .02; Cohen d =0.5). Conclusions We found preliminary evidence of program ...

National estimates project COVID-19 negatively influenced cancer screening, leading to an estimated deficit of 3.9 million breast cancer (BC) screenings among US adults. 1,2 In San Francisco, California, low-income neighborhoods disproportionately affected by COVID-19 bear the burden of higher BC stage at diagnosis. 3,4 We sought to evaluate the association of COVID-19 and BC screening in a safety-net hospital in San Francisco. MethodsThis cross-sectional study evaluated trends in BC screening at an urban integrated health system's safety-net hospital. We obtained the number of screening mammograms per month during 2019 from electronic health record (EHR) data, and aggregate numbers between September 1, 2019, and January 31, 2021, after the implementation of a new EHR. The number of screening mammograms per month was plotted against the 2019 baseline. Proportions of completed tests by phase of the pandemic (pre-COVID-19, first stay-at-home order, reopening, and second stay-at-home order) were compared by race/ethnicity and age with 2-sided, 2-sample proportion tests. Race/ethnicity was used as a proxy for the disproportionate burden of COVID-19 and experiences of individual and systemic racism experienced by minority communities. Analyses were conducted with Stata, version 16 (StataCorp LLC). P < .05 was used to determine significance. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for cross-sectional studies. 5 Deidentified data collected for quality improvement activities does not require approval from The University of California, San Francisco institutional review board; this study was therefore exempted from review.

Our study shows that cytokines secreted by Th17 cells play an important role in maintenance and spread of vitiligo as they increase in line with extent of disease. Also TNF-α increases in proportion with activity of disease, hence may act as biomarker for identifying patient with aggressive disease.