PROJECT SUMMARY
Nearly 94% of breast cancer survivors experience one or more symptoms during or after endocrine therapy.
Joint pain, hot flashes, sleep disturbance, fatigue, depression, and anxiety are the most common concurrent
symptoms, some of which can persist for 5 to 10 years. These symptoms negatively affect adherence to
treatment and compromise people’s functional status, quality of life, and work functioning. Acupuncture is a
single therapy with few side effects that holistically addresses multiple symptoms. The effect of acupuncture
on multiple symptoms among breast cancer survivors receiving endocrine therapy has not been investigated.
Further, implementation-focused acupuncture research focuses on privately insured clinic settings and
ignores social determinants of health. There is an urgent need to remove barriers and ensure
equal access to this evidence-based treatment among breast cancer survivors with limited access to
acupuncture. Federally qualified health centers (FQHC) provide care to people who experience significant
barriers to health care access. To date, limited data exist about the use of acupuncture among cancer
survivors attending FQHCs. This research study has 2 aims: (1) to test the feasibility and acceptability of
implementing acupuncture within an FQHC oncology clinic as a way to manage multiple symptoms (pain, hot
flashes, fatigue, sleep disturbance, depression, anxiety) among breast cancer survivors receiving endocrine
therapy, and (2) to use a mixed methods approach to identify barriers and facilitators associated with the
implementation of acupuncture within an FQHC. The long-term goal is to facilitate the widespread
implementation, dissemination, and sustained utilization of acupuncture for symptom management among
medically underserved breast cancer survivors receiving endocrine therapy in FQHCs nationwide, and
ultimately to promote broader insurance coverage for acupuncture. The proposed research is significant
because of its potential to ensure equal access acupuncture, an evidence-based intervention. Results will
provide the foundation for a larger multi-site hybrid effectiveness-implementation trial of integrating
acupuncture into services provided at FQHCs for breast cancer survivors.
