The Attitudes, Communication, Treatment and Support Intervention to Reduce Breast Cancer Treatment Disparity

The 5-year survival after a first diagnosis of breast cancer is 13% lower in black than in
white American women, an alarming disparity that cannot be explained by stage of disease at
presentation. Nonadherence to breast cancer treatment and treatment delays from diagnosis to
initiation of treatment may be among the reasons for worse breast cancer outcomes in black
women. This recognition is critical because it suggests that breast cancer survival disparity
can be decreased through clinical interventions that increase adherence to chemotherapy. The
ACTS (Attitudes, Communication, Treatment, Support) Intervention is a onetime, intensive
psycho-educational intervention using a race-matched breast cancer survivor interventionist
to: address Attitudes, including perceptions and stressors, that may impact adherence to
clinical visits and treatment; encourage and model patient Communication with health care
providers regarding physical and emotional needs, with attention to race-discordant
situations; and provide tailored, understandable information about Treatment and its
rationale. The Support component is threaded throughout the intervention via the presence of
a race-matched breast cancer survivor and supportive video messages from the black community.
This study is a randomized controlled trial that will test the efficacy of the ACTS
Intervention vs. Usual Care on the primary outcomes of adherence to recommended breast cancer
chemotherapy.

Inclusion Criteria:

- African American, as determined by patient self report on their demographic form
completed at first medical oncology visit

- Female

- Age 18 or older

- Diagnosed with invasive breast cancer

- Recommended (prescribed) chemotherapy by participating medical oncologists

Exclusion Criteria:

- Impaired cognition, as determined by a score of less than 22 on the Mini Mental Status
Exam

- An inability to understand English