title: The attitudes, communication, treatment, and support intervention to reduce breast cancer treatment disparity.
abstract: OBJECTIVE
  to test the effect of a supportive, one-time psychoeducational intervention on treatment adherence among African American women receiving first adjuvant therapy for breast cancer.
  
  
  METHODS
  a pilot, randomized, controlled clinical trial, two-group design, with one-time intervention and four data collection points.
  
  
  METHODS
  two University of Pittsburgh Cancer Institute clinics.
  
  
  METHODS
  24 African American women.
  
  
  METHODS
  the Attitudes, Communication, Treatment, and Support (ACTS) intervention is a 45-minute one-on-one session with an African American woman recommended to have chemotherapy for breast cancer. The interventionist is an African American breast cancer survivor. The intervention consists of a discussion about chemotherapy and the importance of communicating knowledge needs and distress, an explanation of the specific treatment plan according to pathology, and support through the survivor testimonial and video clips from the African American community.
  
  
  METHODS
  dose of chemotherapy received and dose of chemotherapy prescribed.
  
  
  RESULTS
  Twenty patients completed chemotherapy, and four chose not to begin or discontinued recommended chemotherapy. The groups were equal in key sociodemographic variables. Compared to usual care, the ACTS intervention participants demonstrated trends toward initiation of chemotherapy (100% versus 82%), overall adherence to chemotherapy (92% versus 73%), and percentage of total dose of chemotherapy received or prescribed (94% versus 74%). Compared to usual care, the ACTS intervention participants demonstrated more rapid initiation of chemotherapy and better overall adherence to chemotherapy.
  
  
  CONCLUSIONS
  the pilot ACTS intervention shows promise as a psychoeducational intervention to assist with chemotherapy decision making among African American women.
  
  
  CONCLUSIONS
  African American women are at high risk of not receiving the full dose of prescribed chemotherapy for breast cancer for multiple reasons. Nurses must be sensitive to the unique fears and concerns of this population regarding chemotherapy decisions. An intervention addressing these fears and concerns may help to increase adherence.
authors.affiliation: University of Pittsburgh School of Nursing, Pennsylvania, USA. mros@pitt.edu
authors.forename: Margaret
authors.initials: M
authors.lastname: Rosenzweig
authors.forename: Adam
authors.initials: A
authors.lastname: Brufsky
authors.forename: Priya
authors.initials: P
authors.lastname: Rastogi
authors.forename: Shannon
authors.initials: S
authors.lastname: Puhalla
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Simon
authors.forename: Sandra
authors.initials: S
authors.lastname: Underwood
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000188:drug therapy / Q000451:nursing / Q000523:psychology; D017024:Chemotherapy, Adjuvant; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009859:Oncology Nursing / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000523:psychology; D010865:Pilot Projects; D012944:Social Support
chemical_list: D000970:Antineoplastic Agents