The proposed project promotes public health goals because it addresses cancer health disparities experienced by vulnerable low-income Spanish-speaking men and women, who lack access to culturally and linguistically appropriate follow-up care once they complete acute cancer treatment. Because it uses a mode of delivery (mobile phones) that is popular among ethnically diverse low-SES populations and has great dissemination potential, this study is an important first step that could lead to widespread access to cancer survivorship support via a free application that can be disseminated to supplement clinical care.
Spanish-speaking Latinos with cancer experience disparities related to the need for information, communication with clinicians, quality of care, an increased risk of the sequelae of cancer and its treatment. Patient activation interventions, such as those that promote survivorship care planning (SCP) are critical to increase their self-efficacy and resources for addressing these disparities. The overall goal of this study is to enable Spanish-speaking cancer survivors to be active participants in their care once the acute cancer treatment phase has ended. The aims of this project are to evaluate the feasibility, acceptability, and preliminary efficacy of providing survivorship care planning and education through an interactive mobile phone application (mSCP) for Spanish-speaking men and women with breast or colorectal cancer as they approach the end of active treatment in public hospital settings. Mobile phones are an excellent delivery mode among Latinos due to their widespread use of web-enabled phones to access the internet. We will develop a low- literacy Spanish-language mobile phone application (mSCP) that helps cancer survivors understand their diagnosis and treatment, implement and track physical activity and stress management practices, recognize symptoms of recurrence or late effects of treatment, and communicate these symptoms to their health care providers. Through a pilot 3-month randomized controlled trial (RCT) among 50 Spanish-speaking Latinos with non-metastatic breast or colorectal cancer, we will compare the effects of the 3-month interactive mSCP intervention versus usual care on self-reported outcomes at 3 months including cancer coping self-efficacy, cancer-specific distress, fatigue, and walking. We also will assess knowledge of needed follow-up visits and surveillance exams. To assess the feasibility and acceptability of the intervention and study procedures, we will collect process evaluation data on: costs to produce a treatment summary; protocol adherence; adverse events; use of the mSCP; and key informants' (10 intervention group participants and 4 oncology providers) perceptions of the intervention, study procedures, and outcomes (e.g., perceived benefits, ease of use, burden). The mSCP will utilize daily diary and cumulative bar graphs for self-monitoring, immediate positive feedback on diary entries, daily stress management and exercise messages, and low-literacy modules with step-by-step guides to using the cancer coping skills. Results of this 2-year study will prepare us to conduct a large-scale RCT. Having SCP information in a user-friendly mobile phone application is a promising approach to promote high quality survivorship care. These types of interventions may be acceptable and economical ways of meeting the informational and self-care needs of Latino cancer survivors and help reduce disparities in health and cancer care. If proven effective in a subsequent study, this user-friendly, secure mobile phone tool could help Spanish-speaking cancer survivors, and potentially other vulnerable populations, meet evidence- based recommendations for health care and self-management after acute cancer treatment.