Pilot Testing a Peer-Led Self-Management Program for Women After Breast Cancer

Different approaches exist to support self-management in breast cancer (BC) survivors. The aim of this project was to cocreate a new version of an existing peer-led program to meet the needs of BC survivors in Switzerland. In a pilot study, the preliminary efficacy in terms of self-management skills and symptom burden and the feasibility of implementing it in two Swiss university hospitals was assessed. A prospective nonequivalent pretest-posttest control group design with two consecutive cohorts of women with early-stage BC who had completed primary treatment was applied. BC survivors (peers) led the 7-week course of weekly small-group sessions of 2.5 to 3 hours. The primary outcome was change in self-management skills; secondary outcomes included change in self-efficacy, symptom burden, and health literacy. Between-group changes were assessed using the Mann-Whitney U or X² test, individual changes using the Reliable Change Index. Feasibility was assessed using qualitative methods. Of the 95 BC survivors screened for inclusion criteria, 68 were eligible, 18 agreed to participate in the control group and 20 in the intervention group. No significant differences were found between the groups for any of the outcomes. Individual changes in self-management skills were noted in both groups. Several issues related to course delivery and feasibility were identified. The current form of the program did not fully meet the needs of BC survivors, and implementation into the clinical care pathway appeared to be challenging. The program may benefit from providing the possibility of spontaneous interaction and discussion and considering elements of e-health interventions.