Grant R21CA191354

Phone-Based Intimacy Enhancement Intervention for Couples facing Breast Cancer

The majority of women diagnosed and treated for breast cancer survive 5 years past diagnosis, making quality of life (QOL) concerns highly salient. Sexual concerns are common and distressing for many women with breast cancer and serve as a major source of QOL impairment. Unlike other aspects of QOL that improve over time after breast cancer treatment, sexual concerns often persist and do not typically resolve without intervention. Yet these concerns are typically neglected in patients' care, leaving them underdiagnosed and undertreated. Addressing breast cancer survivors' sexual concerns can reduce distress, support their intimate relationships, and foster effective adjustment. However, existing sexual QOL interventions that address the sexual concerns of breast cancer survivors suffer from limitations in both content and format. For instance, existing sexual QOL interventions do not include current management recommendations and are not generally in a format that can be widely disseminated. A telephone-based format is a viable, effective alternative to in- person counseling that would enhance the potential for dissemination and be ideal for reaching long-term survivors. Previously, the PI demonstrated that demonstrated that a 4-session telephone-based Intimacy Enhancement (IE) intervention improved intimacy and sexual outcomes for colorectal cancer patients and their partners. This intervention holds promise for addressing the concerns of breast cancer survivors, but additional work is needed to tailor this intervention to breast cancer survivors because these populations differ in their experiences of sexual concerns, in the risk factors for worse sexual morbidity, and in appropriate management approaches. The central goal of the proposed research is to tailor the telephone-based IE intervention to breast cancer survivors and conduct a preliminary test of the intervention in a controlled trial. First, qualitative focus groups will identify patient preferencs for content and structure which will be used to tailor the intervention to the needs of this population subsequent cognitive interviews will ensure comprehensibility. Second, the pilot trial will examine the feasibility, acceptability, and preliminary efficacy on patient and partner sexual QOL and relationship outcomes, and on patient psychosocial outcomes (e.g., body image distress). Finally, based on the rationale that barriers exist that limit participation in intensiv sexual QOL interventions for breast cancer survivors, an innovative developmental aim will investigate the perspectives of study-eligible patient candidates who opt out of participating in the pilot trial. This developmental investigation will identify the participation barriers and intervention preferences of breast cancer survivors with sexual concerns who opt out of the intensive trial in order to inform the development of different interventions for future study. Ultimately, this program of research will lead to the availability of a range of interventions well equipped to address the undertreated area of sexual QOL for those with breast and potentially other cancers.