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Reese JB , Sorice KA , Pollard W , Handorf E , Beach MC , Daly MB , Porter LS , Tulsky JA , Lepore SJ
Efficacy of a multimedia intervention in facilitating breast cancer patients' clinical communication about sexual health: Results of a randomized controlled trial
Psychooncology. 2021 May;30(5) :681-690
PMID: 33305520    PMCID: PMC8113064   
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OBJECTIVE: Many women with breast cancer (BC) hesitate to raise sexual concerns clinically. We evaluated a multimedia intervention to facilitate BC patients' communication about sexual/menopausal health, called Starting the Conversation (STC). METHODS: Female BC patients (N = 144) were randomly assigned to either STC (20-min video, workbook, and resource guide) or control (resource guide only). Audio-recorded dialogue from patients' next oncology clinic encounter was coded for patients' sexual health communication. Self-report surveys assessed patients' beliefs about sexual health communication, self-efficacy for clinical interactions, sexual function/activity, anxiety/depression symptoms, and quality of life at baseline, post-intervention, and 2-month follow-up. T-tests or mixed-effects logistic regression compared study arms. RESULTS: Women in the STC arm were more likely to raise the topic of sexual health (51%; OR = 2.62 [1.02, 6.69], p = 0.04) and ask a sexual health question (40%; OR = 2.85 [1.27, 6.38], p = 0.01) during their clinic encounter than those in the control arm (30% and 19% for raise and ask, respectively). At follow-up, women in the STC arm showed greater improvements in sexual health communication self-efficacy (p = 0.009) and in anxiety symptoms (p = 0.03), and more women were sexually active at follow-up, compared to the control arm (OR = 1.5, 70% vs. 46%, p = 0.04). CONCLUSIONS: The STC intervention facilitated women's clinical communication about sexual health and reduced women's anxiety, possibly due to increased confidence in expressing their medical needs. Helpful information gained from clinical discussions could have improved women's willingness or ability to engage in sexual activity. Future studies should identify aspects of the clinical encounter most critical to improving women's sexual outcomes.
1099-1611 Reese, Jennifer B Orcid: 0000-0001-9341-2407 Sorice, Kristen A Pollard, Whitney Handorf, Elizabeth Beach, Mary C Daly, Mary B Porter, Laura S Tulsky, James A Orcid: 0000-0002-7458-0453 Lepore, Stephen J Orcid: 0000-0001-7370-6280 P30 CA006927/CA/NCI NIH HHS/United States Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Psychooncology. 2021 May;30(5):681-690. doi: 10.1002/pon.5613. Epub 2020 Dec 23.