Nuevo Amanecer-II Baseline Paper Data

Objectives: Adapt a cognitive-behavioral stress management program (Nuevo Amanecer or NA) for rural Spanish-speaking Latina breast cancer survivors. <br> Methods: Applied a community-engaged translational model called the Transcreation Framework to develop the adapted program (NA-II), design a randomized control trial for community settings, identify recruiters and interventionists, and implement the trial. Assessed outcomes of breast cancer-specific quality of life (Functional Assessment of Cancer Therapy - Breast total and subscale scores; FACT-B), distress (Brief Symptom Inventory anxiety and somatization scales, PHQ-8 depression scale), and stress (Perceived Stress Scale-10); higher scores=more of the construct. <br>Results: Core components of NA were retained. Adaptations included simplifying materials, increasing skills practice, and adding stress management videos and graphics, healthy lifestyles information, and survivorship information. Interventionists were trained Latina breast cancer survivors. Rural Spanish-speaking Latinas with non-metastatic breast cancer were recruited and enrolled by community advocates. Of 231 women approached, 24% refused, 10% were ineligible, and 153 (66%) were randomized to the intervention or a wait-list control group. Age ranged from 28–88 years (mean 54.8, SD 10.5). The sample was vulnerable: 69% had &lt; high school education, and more than half had only Medicaid or no insurance. Ninety-one percent were foreign born and 48% reported financial hardship in the past year. Baseline mean scores (SD; possible range) were: FACT-B total score, 73.7 (15.1; 0-108); emotional well-being, 14.4 (4.3; 0-20); functional well-being, 11.0 (2.9;0-16); social/family well-being, 13.6 (4.1; 0-20); physical well-being 17.4 (5.3; 0-24); breast cancer concerns 17.4 (4.7; 0-28); anxiety, 0.70 (0.76; 0-4); somatization, 0.70 (0.64; 0-4); depression, 6.7 (5.3;0-24); and perceived stress, 15.7 (7.3; 0-40). <br>Conclusions: Applying the Transcreation Framework to engage stakeholders in the design and implementation of community-based RCTs enhanced congruence with community contexts and recruitment of this vulnerable population. Baseline outcome levels suggest there is room for improvement.