title: Sisters Peer Counseling in Reproductive Issues After Treatment (SPIRIT): a peer counseling program to improve reproductive health among African American breast cancer survivors.
abstract: BACKGROUND
  African American breast cancer survivors may be at high risk for reproductive health problems, including menopause symptoms, sexual dysfunction, and distress about cancer-related infertility. The authors partnered with Sisters Network Inc. to create the Sisters Peer Counseling in Reproductive Issues After Treatment (SPIRIT) program, a culturally sensitive intervention program that combined a written workbook and peer counseling.
  
  
  METHODS
  Three hundred women were randomized to receive either the workbook plus 3 in-person sessions with a trained peer counselor or the workbook plus ≤ 30 minutes of telephone counseling to be initiated by the participant. Questionnaires at baseline, post-treatment, and at 6-month and 12-month follow-up assessed emotional distress, sexual function, relationship satisfaction, spirituality, menopause symptoms, and knowledge. Satisfaction with the program and the use of medical care also were assessed.
  
  
  RESULTS
  Both groups of women improved significantly in knowledge, decreased in distress, and had decreased hot flashes. Sexually active women had improved sexual function at 6-month follow-up but not at 1 year. However, peer counseling had little incremental benefit over the telephone counseling.
  
  
  CONCLUSIONS
  The SPIRIT program was rated very useful by 66% of women. Outcomes justify continued use of the workbook and further research to optimize the impact of peer counseling.
authors.affiliation: Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, Texas 77230-1439, USA. ischover@mdanderson.org
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Schover
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Rhodes
authors.forename: George
authors.initials: G
authors.lastname: Baum
authors.forename: Jennifer Harned
authors.initials: JH
authors.lastname: Adams
authors.forename: Rosell
authors.initials: R
authors.lastname: Jenkins
authors.forename: Pamela
authors.initials: P
authors.lastname: Lewis
authors.forename: Karen Eubanks
authors.initials: KE
authors.lastname: Jackson
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000359:Aftercare; D001943:Breast Neoplasms / Q000523:psychology*; D003376:Counseling; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010379:Peer Group; D060728:Reproductive Health; D012657:Self-Help Groups; D019529:Sexuality; D011795:Surveys and Questionnaires; D017741:Survivors