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Cognitive changes may occur after cancer treatment and interfere with day-to-day activities of breast cancer survivors. Current guidelines recommend validating cognitive concerns, increasing patient education, and suggesting appropriate interventions. Educational programs, including Think Well: Healthy Living to Improve Cognitive Function, can increase the awareness of cognitive changes and provide strategies for self-management to breast cancer survivors and their family and friends.

In the United States, about 11% (26,393) of those diagnosed with breast cancer in 2016 will be young or less than 45 years old. Young breast cancer survivors, compared to older cancer survivors, are a disparate group that experience higher incidence of advanced disease, greater mortality, and poorer quality of life, and are often faced with difficulty locating support that meet the unique needs of young women. The Gulf States Young Breast Cancer Survivor Network, composed of three sister networks, formed a partnership aimed at harnessing the power of social media to reach and impact the lives of young women with breast cancer. The collaborative partnership framework and the power of synergy are shown in merging two existing programs and incorporating a third new program.

Aim: This study was a pilot test of the Latina Breast Cancer Survivorship Intervention, a survivorship self-management intervention delivered via telephone. Materials and methods: This study used a wait-list control design with random assignment to either (1) support and early education or (2) support and delayed education. Latina breast cancer survivors were recruited through the Florida Cancer Data System Registry. Latinas with stage I–III breast cancer who completed primary cancer treatment 3 years prior to study enrollment were eligible. The Latina Breast Cancer Survivorship Intervention consisted of three education sessions delivered weekly via telephone and six telephone support calls, both delivered by a native Spanish speaker. Primary outcome variables included physical well-being, emotional well-being, fatigue, pain, and depressive symptoms. Data collection occurred at baseline, 3 months, and 6 months. Results: In total, 40 Latina breast cancer survivors who were middle-aged to older, married, with health insurance, and Spanish as preferred language enrolled in the Latina Breast Cancer Survivorship Intervention. Data were analyzed using mean change scores. Overall, physical and emotional well-being remained similar over time with well-being scores poorer compared with the general population. Pain levels improved over 6 months and showed a high effect size. Fatigue scores improved at 3 months and showed a moderate effect size. Depressive symptoms remained elevated but were not clinically significant. Conclusion: Telephone-based Latina Breast Cancer Survivorship Intervention reached Latina breast cancer survivors for survivorship education and support. Self-management of pain and fatigue showed improvement over time.

Aim: About 120,000 Latina breast cancer survivors (LBCS) live in the USA with the numbers expected to increase. LBCS experience survivorship disparities and report poor quality of life outcomes. Despite poor outcomes, few survivorship interventions for LBCS are available. Adapting evidence-based interventions for Latinas may be one strategy to reduce disparities. Materials & Methods: An evidence-based intervention called the Breast Cancer Education Intervention was adapted for Latinas. First, certified translation and cognitive interview to assess cultural relevance were conducted. Next, a pilot sample of 40 Latinas who participated in the intervention were asked to provide follow-up evaluation of their satisfaction with and usefulness of the translated education manual and intervention. Results: Thirty LBCS completed the intervention, and 14 LBCS submitted an evaluation summary expressing satisfaction with usefulness, readability and relevance. Conclusion: The process by which translation and cultural adaptation of an evidence-based intervention provides beginning foundation to support and reduce disparities among LBCS.

The Young Breast Cancer Survivors Network (Network) is an academic and community-based partnership dedicated to education, support, and networking. The Network used a multi-pronged approach via monthly support and networking, annual education seminars, website networking, and individual survivor consultation. Formative and summative evaluations were conducted using group survey and individual survivor interviews for monthly gatherings, annual education meetings, and individual consultation. Google Analytics was applied to evaluate website use. The Network began with 4 initial partnerships and grew to 38 in the period from 2011 to 2017. During this 5-year period, 5 annual meetings (598 attendees), 23 support and networking meetings (373), and 115 individual survivor consultations were conducted. The Network website had nearly 12,000 individual users and more than 25,000 page views. Lessons learned include active community engagement, survivor empowerment, capacity building, social media outreach, and network sustainability. The 5-year experiences with the Network demonstrated that a regional program dedicated to the education, support, networking, and needs of young breast cancer survivors and their families can become a vital part of cancer survivorship services in a community. Strong community support, engagement, and encouragement were vital components to sustain the program.

African American (AA) women are more likely to be given a diagnosis of breast cancer at an early age, experience morbidity after treatment, and exhibit disparities in survivorship. Although psychosocial well-being is largely studied among breast cancer survivors, data are sparse regarding young AA survivors. This integrative review examined psychosocial concerns in survivorship among young AA survivors using a quality-of-life framework. PubMed, CINHAL, EMBASE, PsychINFO, and Scopus were searched for articles exploring psychosocial well-being in young AA survivors. The search yielded 237 articles that were retrieved and reviewed for relevance. Of these, 16 articles were selected based on inclusion/exclusion criteria. Data were evaluated and synthesized based on the quality-of-life model. Selected articles omitted the study of several psychological subconstructs and identified existing psychosocial concerns that require mitigation. The review revealed key areas of psychosocial concerns among young AA survivors including ongoing anxiety/depression, cognitive changes, and relationships. Identified gaps include paucity of research with young AA survivors and their residual psychosocial concerns. Review findings indicate a need to increase survivorship research on young AA survivors. Researchers, clinicians, and young AA survivors must partner in efforts to understand psychosocial concerns and translate findings into clinical practice (ie, use of psychosocial distress tools, distress de-escalation protocols, and individualized survivorship care plans) toward reduction of quality-of-life health disparities among young AA survivors.

Little is known about cognitive changes among African American (AA) breast cancer survivors (BCS). Here, we report our experience with engagement of leaders of urban AA churches in Birmingham, Alabama to deliver and evaluate Think Well: Healthy Living to Improve Cognitive Function, an educational cognitive health program for BCS. The Think Well team engaged leaders of urban AA churches using a 7-step process: 1) identify leaders, 2) develop connection with leaders, 3) assess AA community preferences, 4) tailor for cultural relevance, 5) plan seminars, 6) deliver seminars, and 7) evaluate cultural relevance and overall program quality. Program evaluation was via a 22-item survey and sociodemographic questionnaire. Data from AA participants were analyzed using SPSS. The engagement process resulted in sustained partnerships with three urban AA churches and delivery of three Think Well seminars to 172 participants. Of the 172 participants, 138 (80%) AA participants (40 BCS, 98 co-survivors) returned the program survey. Respondents reported Think Well to be culturally relevant (90%) and of high quality (94%). Think Well was developed and evaluated with the collaboration of urban AA church leaders. Engaging church leaders facilitated reach of AA BCS. Partnership facilitated a culturally relevant, high quality program for AA BCS and co-survivors.

Rural breast cancer survivors experience gaps in post-treatment education and support. We report the development and delivery of Reach Out to Rural Breast Cancer Survivors Program. Community-based participatory research and multi-level assessment were used to (a) engage rural community leaders, survivors, and providers; (b) analyze and report results of discussion groups to understand survivorship concerns and preferences; (c) integrate discussion group findings to develop, tailor, and deliver Reach Out; and (d) evaluate Reach Out with regard to satisfaction and helpfulness. In total, 16 rural breast cancer survivors participated in discussion groups. Four major concerns were identified through content analysis: lost in transition, self-management in survivorship, preference for support, and cancer surveillance. Major concerns and survivor preferences were integrated into Reach Out. A 15-item evaluation survey was used to assess the acceptability and helpfulness of Reach Out. In all, 72 participants attended three Reach Out programs; 96% completed evaluations of acceptability and helpfulness. In all, 68 were breast cancer survivors (99%), 88.4% were interested in the information; 91% indicated that personal objectives were met. Content about maintaining health, lymphedema management, and sexuality were ranked as most helpful. Rural survivorship concerns were similar to non-rural survivors, the major difference being access to services. In conclusion, multi-level assessment and community engagement were keys to understand rural survivorship and to develop and deliver content that attended to rural breast cancer survivors’ preferences.

Approximately 35% of breast cancer survivors (BCS) report changes in cognitive function after cancer treatment. The purpose of this abstract is to compare self-reported cognitive changes between Caucasian (CAU) and African American (AA) BCS who participated in the Think Well program. Think Well is an educational program to increase awareness of cognitive function and promote healthy living. Sixteen Think Well seminars were delivered in-person to urban and rural counties throughout North Central Alabama. Following each seminar, participants completed an evaluation of demographic information and cognitive changes. Descriptive statistics and chi-squared tests were used. Data were analyzed using SPSS v23. Among BCS who completed the evaluation, 82 (54%) were CAU, and 62 (41%) were AA. Many BCS were employed (32%) or disabled/retired (51%). CAU were more likely to be married than AA BCS (p CAU BCS self-reported poorer cognitive function and changes since cancer treatment. Differences in self-reported changes between AA and CAU may be contributed to geographic location, racial differences in perception of cognitive function, or marital status. Race-related stigmas may affect self-reporting of cognitive function. Future research is warranted to examine factors that contribute to racial differences in cognitive function and interventions aimed at improving cognitive function among both AA and CAU BCS. Acknowledgement: Think Well is supported by a grant from the North Central Alabama Affiliate of Susan G. Komen. Authors are also supported by funding: Susan G. Komen Graduate Traineeship in Disparities Research, Robert Wood Johnson Foundation Future of Nursing Scholarship, and American Cancer Society Doctoral Degree Scholarship in Cancer Nursing (DSCN-17-076-01). Citation Format: Kayla A. Lewis, Jacqueline B. Vo, Kendra J. Royston, Silvia Gisiger-Camata, Karen Meneses. Comparing self-reported cognitive function among Caucasian and African American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5275.

Disparities in cancer survivorship exist among specific populations of breast cancer survivors, specifically rural African American breast cancer survivors (AA-BCS). While effective survivorship interventions are available to address and improve quality of life, interventions must be culturally tailored for relevance to survivors. Here, we report the results of our formative research using focus groups and in-depth interview to better understand unique rural AA-BCS survivorship experiences and needs in the Alabama Black Belt. Surveys were used to gather sociodemographic and cancer treatment data. Fifteen rural AA-BCS shared their experiences and concerns about keeping their cancer a secret, lack of knowledge about survivorship, lingering symptoms, religion and spirituality, cancer surveillance, and general lack of survivorship education and support. Rural AA-BCS were unwilling to share their cancer diagnosis, preferring to keep it a secret to protect family and friends. Quality-of-life issues like lymphedema body image and sexuality were not well understood. They viewed spirituality and religion as essential in coping and accepting cancer. Participants also discussed the importance of and barriers to maintaining health through regular check-ups. They needed social support from family and friends and health care providers. Overall, rural AA-BCS expressed their need for knowledge about survivorship self-management by providing a vivid picture of the realities of cancer survival based on shared concerns for survivorship support and education within the context of culture.

Background: Currently in the United States, there are an estimated 3.5 million breast cancer survivors (BCS), of which up to 75% in treatment and 35% after treatment report cognitive changes. To increase awareness of cognitive changes after treatment and promote healthy living to address those changes among BCS, Think Well: Healthy Living to Improve Cognitive Function (TW) was developed. The TW curriculum was evidence-based in knowledge of cognitive changes and potential compounding effects of unhealthy lifestyle behaviors (i.e., poor nutrition, lack of physical activity, and inadequate sleep hygiene), as well as complex issues occurring with return to work. The resulting TW program addressed cognitive health, cognitive changes after treatment, healthy living strategies to promote cognitive function (i.e., nutrition, physical activity, stress management, and sleep), brain exercises (i.e., crossword puzzles, problem solving, and learning new activities), and compensatory strategies (i.e., using a planner, setting reminders, and note taking). Through the use of community engagement, the TW program was delivered over a two year period (2014-2016) in community settings throughout North Central Alabama. Purpose: To assess the feasibility of disseminating a web-based TW. Methods: A web-based TW was developed from the existing evidence-based TW program consisting of: 1) cognitive changes after treatment; 2) healthy living strategies to promote cognitive function; 3) brain exercises; and 4) compensatory strategies. Delivery of the web-based TW was via the website (www.ThinkWell.tips) and employed: 1) videos; 3) downloadable tip sheets; 4) events calendar; and 4) links to other websites for additional resources. The website was launched October 15, 2015. Website use was measured via Google Analytics for the time period of October 15, 2015 - June 20, 2016. Results: Google Analytics revealed 1,546 sessions, 1,177 users, and 2,224 page views for the designated time period as well global users (i.e., United States, Russia, United Kingdom, China, Japan, Germany, Netherlands, Canada, and Brazil). The most visited pages included cognitive changes, nutrition, tip sheets, and events. Discussions/Conclusions: Results demonstrated that dissemination of a web-based TW was feasible and may have a global impact. To improve awareness of the TW website, future dissemination methods include distribution of business cards at professional/community events and engaging existing partners to disseminate via social media. Further TW website enhancements include a cognitive health blog and links to healthy living mobile applications and cognitive training platforms. Acknowledgement: Think Well is supported by a grant from the North Central Alabama Affiliate of Susan G. Komen. Authors are also supported by funding: Susan G. Komen Graduate Traineeship in Disparities Research, Robert Wood Johnson Foundation Future of Nursing Scholarship, American Cancer Society Doctoral Degree Scholarship in Cancer Nursing (DSCN-15-073-01 and DSCN-16-066-01), Jonas Nurse Leaders Scholarship, and Gladys Farmer Colvin Doctoral Fellowship. Citation Format: Jennifer Bail, Timiya S. Nolan, Jacqueline Bui, Silvia Gisiger-Camata, Karen Meneses. Assessing the feasibility of an online cognitive health education program to address cognitive changes among breast cancer survivors. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B15.

Background: African American women are more likely to be diagnosed with breast cancer at an early age, more likely to experience morbidity after treatment, and disparities in survivorship. While psychosocial well-being is well known among breast cancer survivors, data are few regarding minorities such as African Americans, particularly those who are young. Objective: This integrative review examines psychosocial concerns in survivorship among young African American breast cancer survivors (YAABCS) using a holistic quality of life framework. Methods: Pubmed, CINHAL, and Scopus were searched for articles exploring psychological or social well-being in YAABCS. Results: The search yielded 264 articles. Thirty-six articles were retrieved and reviewed for relevance. Of these, 14 articles were selected based on inclusion/exclusion criteria. Themes of YAABCS psychosocial concerns were sexuality, mood, social support, and spirituality. Conclusions: The review demonstrated need for further research in YAABCS quality of life to adapt a more fitting quality of life model and to develop culturally-appropriate survivorship interventions. Implications for Practice: Clinicians, researchers, and YAABCS must partner to increase knowledge of the multidimensional survivorship of YAABCS. With knowledge, we may be able to decrease health disparities among YAABCS. The project was funded by an American Cancer Society Doctoral Degree in Nursing Scholarship, Jonas Nurse Leadership Scholarship, and Gladys F. Colvin Doctoral fellowship. Additional support received from a Komen Graduate Training in Disparities Research Award. Citation Format: Timiya S. Nolan, Jennifer Frank, Silvia Gisiger-Camata, Karen Meneses. An integrative review of psychosocial concerns among young African American breast cancer survivors. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C24.