Researchers have found that the cancer peer support program Stronger Together may provide critical social support to patients with cancer, particularly in low-resource settings in low- and middle-income countries, according to a recent study published by Le et al in JCO Global Oncology.
Background
Having cancer has been shown to be one of the most physically and emotionally draining experiences of a person’s life. However, navigating the disease without adequate support or resources could make the treatment and recovery process more burdensome.
The Stronger Together model is an adaptation of the Woman to Woman program that originated at Mt. Sinai Hospital in New York City. The researchers adapted the model to the Vietnam cancer care context. Both programs paired patients newly diagnosed with cancer with trained volunteers who were cancer survivors, placing them in a unique position to provide emotional support and mentorship as well as discuss concerns. The volunteers were supervised by site coordinators who were health-care providers or community health workers.
Study Methods and Results
In the pilot study, the researchers evaluated the Stronger Together peer support intervention model among patients newly diagnosed with breast and gynecologic cancers in Vietnam. They selected 186 volunteers who completed a Stronger Together training curriculum in Vietnam and paired them with patients—matching them based on cancer type, age, personal preferences, availability, and other shared factors. The mentors and patients met virtually, as a result of COVID-19 restrictions, between March 2021 and September 2022, for as often and as long as the patient indicated was necessary—which equated to two to three times for 15 to 60 minutes over the study period.
Through participant survey data and standardized questionnaires on mental health conditions, the researchers analyzed mental health and wellness outcomes among patients in the Stronger Together program as well as those who did not participate in the program.
Both groups of participants had high baseline levels for distress, depression, anxiety, and stress. Among the patients receiving peer support, the researchers observed reductions in participants’ depression, anxiety, and stress as well as improvements in quality of life—including overall physical, mental, and social functioning and general health perceptions.
The greatest improvement in these outcomes occurred within the first 2 months of support among the patients participating in the Stronger Together program and more so among the patients with breast cancer compared with gynecologic cancers. Although the patients who did not participate in the Stronger Together program also experienced these improvements—likely after becoming acclimated to treatments and better understanding their diagnosis—this progress occurred later in the study period, between 4 and 6 months into the program. Further, those who received the peer support improved at a much faster rate compared with those who did not.
Conclusions
The findings demonstrated the potential for a scalable, low-cost program that could be implemented in any setting, especially low- and middle-income countries, where the mental health burden among patients with cancer may be high and resources low.
“This study confirms the importance and positive benefits of having peer support interventions for patients with cancer, especially immediately after patients receive the cancer diagnosis,” highlighted lead study author PhuongThao Le, PhD, MPH, Assistant Professor of Community Health Sciences at the Boston University School of Public Health. “In Stronger Together, cancer survivors’ lived experiences are highlighted, and their ability to provide hope and social support to new patients is strengthened through a culturally and contextually relevant program structure and training curriculum,” she added.
The researchers are currently piloting the Stronger Together program in other limited-resource and cultural settings to continue gathering evidence of the program’s real-world impact and applications. The current results may help inform peer mentoring programs for racial/ethnic communities in the United States, particularly those with limited English proficiency.
“Because the program promotes shared lived experiences in the mentee-mentor relationships, including linguistic and cultural backgrounds, different Stronger Together networks can be established for other racial/ethnic populations, rural communities, and other groups to address the community-specific needs,” Dr. Le concluded.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
