Peer Connect for African American breast cancer survivors and caregivers: a train-the-trainer approach for peer support

Abstract

Racial disparities in breast cancer survivorship are a major concern nationally. How survivors cope with cancer and re-frame their lives is a critical part of survivorship. Community-academic research partnerships may facilitate access to much-needed psychosocial support for African American survivors and caregivers in rural areas, but drivers of successful intervention implementation are not well understood. The purpose of this study was to describe the training and evaluation of Community Coaches and Guides (i.e., peer supporters) using the Peer Connect program for African American breast cancer survivors and caregivers. Community engagement strategies were used to implement the training component of Peer Connect, an evidence-based program grounded in the Diffusion of Innovation Theory utilizing motivational interviewing techniques (MI) and a "train-the-trainer" model. Quantitative and qualitative methods examined implementation outcomes of feasibility, MI fidelity, and acceptability-precursor outcomes that must be achieved before examining intervention impact vis-à-vis changes in support care. Training was feasible to implement and replicable by the trained Community Coaches. Beyond feasibility and replicability, success was modest regarding MI fidelity. Benefits (e.g., serving as role models and having safe sources of support) and lessons learned (e.g., need for additional quality control) were identified as both facilitators and barriers to implementation and as factors that could impact the effectiveness of community-engaged programs to improve survivorship outcomes. Peer Connect, like other programs that employ community-engagement strategies, holds promise to meet the psychosocial support needs of diverse rural cancer survivor populations.

Visualizing the Invisible—The Needs and Wishes of Childhood Cancer Survivors for Digitally Mediated Emotional Peer Support

“…The participants were of the opinion that safety could be achieved by using a moderator of the peer support forum in order to control things such as abusive language or uncomfortable situations or to notice if any of the participants seem to be in need of support. The use of a moderator has been proved valuable in situations where participants need support and help [ 40 ].…”

Opportunities and challenges in conducting community-engaged dissemination/implementation research

“…The element that makes this article reflective of D&I research (specifically implementation) is the focus on evidence-based quality improvement with the Veterans Administration setting. Partnerships are also highlighted in the article by Allicock [22] and colleagues, which discusses the use of community coaches and guides to help navigate African American cancer survivors and caregivers in rural areas. The authors note the promise of train-the-trainer models to improve effective community engagement in the delivery of services to rural cancer survivors.…”

Rural Resilience in Cancer Survivors: Conceptual Analysis of a Global Phenomenon

“…Negative aspects that increased psychosocial distress included: describing inaccurate beliefs about cancer (Livaudais et al, 2010); explaining how rurality caused poor health outcomes (Katz et al, 2010); describing how rural cancer survivors ended up isolated from their communities (Rogers-Clark, 2002); and describing a lack of care-seeking behaviors (Gunn et al,2019). Positive aspects of the concept included: strong coping strategies (Cahir et al, 2017); inner strength (Gunn et al,2019); informal community support systems (Allicock et al, 2017); changing negatives into positives (Gisiger-Camata et al, 2016); improved health outcomes (Rogers et al, 2019); buffers to emotional distress (Reid-Arndt & Cox, 2010); reduced distress (Angell et al, 2003); maintaining social standing during survivorship (López et al, 2005); improved self-efficacy (Olson et al, 2014); returning to normalcy (Torres et al, 2016) a positive survivorship narrative (Allen & Roberto, 2014). Nursing and Health Care, 21(1) https://doi.org/10.14574/ojrnhc.v21i1.676 164 Several antecedents were consistently found during the phenomenon of rural resilience in cancer survivors.…”