Abstract
Background: The authors conducted a cluster randomized study to determine the effect of an exportable educational intervention for young women with breast cancer (YWI) on improving care. Methods: Sites were randomized 1:1 to the YWI or a contact time control physical activity intervention (PAI) stratified by academic or community site. Up to 15 women aged ≤45 years with newly diagnosed breast cancer were enrolled at each of 14 academic sites and 10 were enrolled at each of 40 community sites. The primary endpoint, attention to fertility, was ascertained by medical record review. Statistical inferences concerning the effect of the intervention used general estimating equations for clustered data. Results: A total of 467 patients across 54 sites were enrolled between July 2012 and December 2013. The median age of the patients at the time of diagnosis was 40 years (range, 22-45 years). Attention to fertility by 3 months was observed in 55% of patients in the YWI and 58% of patients in the PAI (P =.88). Rates were found to be strongly correlated with age (P <.0001), and were highest in patients aged <30 years. Attention to genetics was similar (80% in the YWI and 81% in the PAI), whereas attention to emotional health was higher in patients in the YWI (87% vs 76%; estimated odds ratio, 2.63 [95% confidence interval, 1.20-5.76; P =.016]). Patients rated both interventions as valuable in providing education (64% in the YWI and 63% in the PAI). Conclusions: The current study failed to demonstrate differences in attention to fertility with an intervention to improve care for women with breast cancer, although attention to fertility was found to be higher than expected in both groups and emotional health was improved in the YWI group. Greater attention to young women with breast cancer in general may promote more comprehensive care for this population.
Original language | English (US) |
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Journal | Cancer |
DOIs | |
State | Published - Jan 1 2019 |
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Keywords
- breast cancer
- exercise
- fertility
- oncology
- patient communication
- psychosocial distress
- young women
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
A randomized study to improve care for young women with breast cancer at community and academic medical oncology practices in the United States : The Young and Strong study. / Partridge, Ann H.; Ruddy, Kathryn J; Barry, William T.; Greaney, Mary L.; Ligibel, Jennifer A.; Sprunck-Harrild, Kim M.; Rosenberg, Shoshana M.; Baker, Emily L.; Hoverman, J. Russell; Emmons, Karen M.
In: Cancer, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A randomized study to improve care for young women with breast cancer at community and academic medical oncology practices in the United States
T2 - The Young and Strong study
AU - Partridge, Ann H.
AU - Ruddy, Kathryn J
AU - Barry, William T.
AU - Greaney, Mary L.
AU - Ligibel, Jennifer A.
AU - Sprunck-Harrild, Kim M.
AU - Rosenberg, Shoshana M.
AU - Baker, Emily L.
AU - Hoverman, J. Russell
AU - Emmons, Karen M.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: The authors conducted a cluster randomized study to determine the effect of an exportable educational intervention for young women with breast cancer (YWI) on improving care. Methods: Sites were randomized 1:1 to the YWI or a contact time control physical activity intervention (PAI) stratified by academic or community site. Up to 15 women aged ≤45 years with newly diagnosed breast cancer were enrolled at each of 14 academic sites and 10 were enrolled at each of 40 community sites. The primary endpoint, attention to fertility, was ascertained by medical record review. Statistical inferences concerning the effect of the intervention used general estimating equations for clustered data. Results: A total of 467 patients across 54 sites were enrolled between July 2012 and December 2013. The median age of the patients at the time of diagnosis was 40 years (range, 22-45 years). Attention to fertility by 3 months was observed in 55% of patients in the YWI and 58% of patients in the PAI (P =.88). Rates were found to be strongly correlated with age (P <.0001), and were highest in patients aged <30 years. Attention to genetics was similar (80% in the YWI and 81% in the PAI), whereas attention to emotional health was higher in patients in the YWI (87% vs 76%; estimated odds ratio, 2.63 [95% confidence interval, 1.20-5.76; P =.016]). Patients rated both interventions as valuable in providing education (64% in the YWI and 63% in the PAI). Conclusions: The current study failed to demonstrate differences in attention to fertility with an intervention to improve care for women with breast cancer, although attention to fertility was found to be higher than expected in both groups and emotional health was improved in the YWI group. Greater attention to young women with breast cancer in general may promote more comprehensive care for this population.
AB - Background: The authors conducted a cluster randomized study to determine the effect of an exportable educational intervention for young women with breast cancer (YWI) on improving care. Methods: Sites were randomized 1:1 to the YWI or a contact time control physical activity intervention (PAI) stratified by academic or community site. Up to 15 women aged ≤45 years with newly diagnosed breast cancer were enrolled at each of 14 academic sites and 10 were enrolled at each of 40 community sites. The primary endpoint, attention to fertility, was ascertained by medical record review. Statistical inferences concerning the effect of the intervention used general estimating equations for clustered data. Results: A total of 467 patients across 54 sites were enrolled between July 2012 and December 2013. The median age of the patients at the time of diagnosis was 40 years (range, 22-45 years). Attention to fertility by 3 months was observed in 55% of patients in the YWI and 58% of patients in the PAI (P =.88). Rates were found to be strongly correlated with age (P <.0001), and were highest in patients aged <30 years. Attention to genetics was similar (80% in the YWI and 81% in the PAI), whereas attention to emotional health was higher in patients in the YWI (87% vs 76%; estimated odds ratio, 2.63 [95% confidence interval, 1.20-5.76; P =.016]). Patients rated both interventions as valuable in providing education (64% in the YWI and 63% in the PAI). Conclusions: The current study failed to demonstrate differences in attention to fertility with an intervention to improve care for women with breast cancer, although attention to fertility was found to be higher than expected in both groups and emotional health was improved in the YWI group. Greater attention to young women with breast cancer in general may promote more comprehensive care for this population.
KW - breast cancer
KW - exercise
KW - fertility
KW - oncology
KW - patient communication
KW - psychosocial distress
KW - young women
UR - http://www.scopus.com/inward/record.url?scp=85060878351&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060878351&partnerID=8YFLogxK
U2 - 10.1002/cncr.31984
DO - 10.1002/cncr.31984
M3 - Article
C2 - 30707756
AN - SCOPUS:85060878351
JO - Cancer
JF - Cancer
SN - 0008-543X
ER -