title: Peer-counseling for women newly diagnosed with breast cancer: A randomized community/research collaboration trial.
abstract: BACKGROUND
  We conducted a randomized controlled trial of peer-counseling for newly diagnosed breast cancer (BC) patients as a community/research collaboration testing an intervention developed jointly by a community-based-organization serving women with cancer and university researchers.
  
  
  METHODS
  We recruited 104 women newly diagnosed with BC at any disease stage. Prior to randomization, all received a one-time visit with an oncology nurse who offered information and resources. Afterwards, we randomized half to receive a match with a Navigator with whom they could have contact for up to 6 months. We recruited, trained, and supervised 30 peer counselors who became "Navigators." They were at least one-year post-diagnosis with BC. Controls received no further intervention. We tested the effect of intervention on breast-cancer-specific well-being and trauma symptoms as primary outcomes, and several secondary outcomes. In exploratory analyses, we tested whether responding to their diagnosis as a traumatic stressor moderated outcomes.
  
  
  RESULTS
  We found that, compared with the control group, receiving a peer-counseling intervention significantly improved breast-cancer-specific well-being (p=0.01, Cohen's d=0.41) and maintained marital adjustment (p=0.01, Cohen's d=0.45) more effectively. Experiencing the diagnosis as a traumatic stressor moderated outcomes: those with a peer counselor in the traumatic stressor group improved significantly more than controls on well-being, trauma and depression symptoms, and cancer self-efficacy.
  
  
  CONCLUSIONS
  Having a peer counselor trained and supervised to recognize and work with trauma symptoms can improve well-being and psychosocial morbidity during the first year following diagnosis of BC. Cancer 2016;122:2408-2417. © 2016 American Cancer Society.
authors.affiliation: Psychosocial Oncology Division, Department of Oncology, University of Calgary, Calgary, Alberta, Canada.|Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada.|Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
authors.forename: Janine
authors.initials: J
authors.lastname: Giese-Davis
authors.affiliation: WomenCARE, Santa Cruz, California.
authors.forename: Caroline
authors.initials: C
authors.lastname: Bliss-Isberg
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
authors.forename: Lynne
authors.initials: L
authors.lastname: Wittenberg
authors.affiliation: Psychosocial Oncology Division, Department of Oncology, University of Calgary, Calgary, Alberta, Canada.|Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: White
authors.affiliation: WomenCARE, Santa Cruz, California.
authors.forename: Path
authors.initials: P
authors.lastname: Star
authors.affiliation: Psychosocial Oncology Division, Department of Oncology, University of Calgary, Calgary, Alberta, Canada.|Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
authors.forename: Lihong
authors.initials: L
authors.lastname: Zhong
authors.affiliation: Martinez Outpatient Clinic and Community Living Center, VA Northern California Health Care System, Martinez, California.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Cordova
authors.affiliation: WomenCARE, Santa Cruz, California.
authors.forename: Debra
authors.initials: D
authors.lastname: Houston
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
authors.forename: David
authors.initials: D
authors.lastname: Spiegel
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003376:Counseling; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D010379:Peer Group; D012307:Risk Factors
keywords: breast neoplasms; counseling; patient-navigation; posttraumatic stress; quality of life