Peer-Led Support Intervention for Black Breast Cancer Survivors - PROJECT SUMMARY Compared to non-Hispanic White women, Black women with breast cancer have a 41% higher mortality rate and experience worse psychosocial outcomes, such as greater psychological distress and poorer health- related quality of life (HRQOL). Current psychosocial support interventions are not culturally sensitive to the lived experience of Black breast cancer survivors (BBCS), which is shaped by disproportionate and unjust exposure to social determinants of health (SDOH) and life course stress. BBCS report a greater need for emotional and informational support from other BBCS; therefore, psychosocial support interventions may be optimally delivered by peer health workers (peers) who in the context of a formal intervention, provide culturally sensitive support through the shared lived experience, knowledge, and characteristics of other BBCS. The purpose of the proposed K23 award is to examine the feasibility, acceptability, and preliminary efficacy of a peer-led, manualized, web-based support intervention to reduce distress and improve HRQOL among BBCS. In aim 1, we will recruit and establish a community advisory board (CAB) to collaborate on all phases of the study, including recruitment; developing and refining the intervention; piloting the randomized controlled trial (RCT); and analyzing and disseminating the findings. In aim 2, we will co-design and iteratively refine a peer- led support intervention through focus groups with BBCS (N=20) to identify the preferred content, format, and delivery of the intervention. We will manualize and further refine the intervention through individual qualitative interviews with a sub-sample of BBCS (N=10). In aim 3, we will conduct a pilot randomized controlled trial (RCT) to assess the feasibility, acceptability, and preliminary efficacy (on reducing distress and improving HRQOL) of the peer-led support intervention (N=30) (culturally sensitive educational support + peer support) compared to the control arm (N=30). To isolate the effect of the peer, the control arm will include culturally sensitive educational support delivered by an oncology nurse scientist (no peer support). Peer support will be guided by their shared lived experience and principles of motivational interviewing. from trained peers will provide culturally sensitive support to reduce distress and improve HRQOL of BBCS. The K23 will provide the essential mentoring and training to become an independent investigator focused on providing equitable cancer survivorship care for BBCS. The proposed mentoring team has the expertise to provide in-depth training to achieve the following goals: (1) obtain knowledge and experience with clinical trial design and community engaged (CEnR) methods to support the development and refinement of a peer-led support intervention focused on reducing distress and improving the HRQOL among BBCS; (2) obtain knowledge and skills in conducting research that incorporates multi-level social determinants of heath, especially as they pertain to health disparities and distress among BBCS; and (3) prepare and secure R01-level funding to test the efficacy of the peer-led support intervention in a larger, fully powered randomized controlled trial.
