Pilot randomized controlled trial of eHealth cognitive-behavioral therapy for insomnia among Spanish-speaking breast cancer survivors

Abstract

Cognitive-Behavioral Therapy for Insomnia (CBT-I) is the gold-standard treatment for insomnia, which is common among breast cancer survivors (BCS). This pilot randomized controlled trial tested the first CBT-I intervention for Spanish-speaking BCS delivered using eHealth. Participants (N = 30) were Spanish-speaking BCS with insomnia symptoms recruited in Puerto Rico and randomized to a 6-week eHealth CBT-I group intervention or a waitlist control. Primary outcomes were acceptability (recruitment, treatment satisfaction) and feasibility (retention, attendance). Secondary outcomes were group differences in sleep outcomes post-treatment (i.e., insomnia symptoms, sleep disturbance, sleep efficiency). Recruitment (95%) and retention (97%) were excellent. All CBT-I participants (100%) attended ≥ 3 of 6 sessions. Satisfaction with CBT-I was acceptable. Post-intervention, there were medium to large group differences for average insomnia symptoms ( d = 1.02), sleep disturbance ( d = 1.25), and sleep efficiency ( d = 0.77) favoring CBT-I. There were small/medium to medium/large group differences for the proportion of participants with clinically significant insomnia symptoms ( d = 0.52), sleep disturbance ( d = 0.67), and low sleep efficiency ( d = 0.33) favoring CBT-I. Spanish-language eHealth CBT-I for BCS was acceptable and feasible and showed preliminary efficacy. ClinicalTrials.gov TRN: NCT04101526 (Posted September 24, 2019).

A systematic review and meta‐analysis of psychosocial interventions for immigrant and limited English proficient cancer patients

“… c Twenty six studies did not report foreign‐born status and were not included 34–36,38–45,47,48,51–63 …”

Leveraging Telehealth for the Management of Breast Cancer: A Systematic Review

“…Part of that process is to create a table that lists the characteristics of each study analyzed: participants, intervention, results, medical outcomes, and study design (see Table 1 : PICOS). The 33 studies are broken down into the following years: 2012(0), 2013(0), 2014(1) [ 19 ], 2015(2) [ 20 , 21 ], 2016(1) [ 22 ], 2017(4) [ 23 , 24 , 25 , 26 ], 2018(4) [ 27 , 28 , 29 , 30 ], 2019(1) [ 31 ], 2020(7) [ 32 , 33 , 34 , 35 , 36 , 37 , 38 ], 2021(8) [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ], 2022(5) [ 47 , 48 , 49 , 50 , 51 ]. All studies involved adults as participants.…”

“…Five themes and one observation were recorded in 49 occurrences. The most frequently observed theme was the need to train users, which occurred in 20/49 (41%) of the occurrences [ 19 , 20 , 27 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 39 , 40 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. The second barrier was the cost (set up, maintenance, and equipment), which appeared in 18/87 (37%) of the occurrences [ 22 , 23 , 24 , 25 , 26 , 27 , 29 , 38 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ].…”

“…The most frequently observed theme was the need to train users, which occurred in 20/49 (41%) of the occurrences [ 19 , 20 , 27 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 39 , 40 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. The second barrier was the cost (set up, maintenance, and equipment), which appeared in 18/87 (37%) of the occurrences [ 22 , 23 , 24 , 25 , 26 , 27 , 29 , 38 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. The intervention took time of the providers and presented unusual workflow appeared in 6/49 (12%) of the occurrences [ 21 , 28 , 37 , 42 , 43 , 46 ].…”

“…Methodologies were strong among the group for analysis, and the results of the studies showed positive effects in at least one area [ 19 , 21 , 22 , 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 39 , 40 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. Telehealth interventions showed improvements in both mental health [ 19 , 23 , 30 , 34 , 36 , 39 , 40 , 46 , 49 , 50 ], physical health [ 22 , 24 , 26 , 27 , 31 , 34 , 35 , 43 , 44 , 49 ], sleep outcomes [ 20 , 22 , 28 , ...…”