Group Intervention for Women at High Risk for Breast Cancer

Institution: University of California, Los Angeles
Investigator(s): David Wellisch, Ph.D. -
Award Cycle: 1995 (Cycle I) Grant #: 1IB-0032 Award: $42,836
Award Type: IDEA
Research Priorities
Community Impact of Breast Cancer>Sociocultural, Behavioral, and Psychological Issues: the human side



Initial Award Abstract (1995)
This study is a group intervention for women at high risk for breast cancer. It addresses the Breast Cancer Research Program's priority issue involving improved access for underserved populations, specifically women at a high risk of developing breast cancer. Thus far, no viable group interventions have been developed for this population. The purpose of this study is to identify and develop a multidisciplinary and multispecialty organizational model of service delivery by defining the content and characteristics of the best group model to increase education, prevent the development of psychological symptoms and problems, and increase adaptation and coping to the threat these women live with daily. A special effort will be made to recruit minority women, since to date, most work in this area has been on Caucasian women. The study additionally addresses the psychosocial and behavioral consequences of elevated genetic risk for breast cancer.

Specific aims of the project include: 1) to test the viability of the group model in terms of content, interest, effectiveness, attendance, and optimal participant mix; 2) to test the feasibility of the group model in terms of decreasing the participants' adverse psychological and behavioral symptomatology; 3) to test the feasibility of the group model in terms of increasing knowledge of nutrition and its relationship to increased cancer risk; 4) to test the feasibility of the group model to facilitate a more realistic assessment of personal cancer risk; 5) to test the feasibility of the group model in terms of increasing knowledge of positive coping methods; and 6) to test the feasibility of the group model in reduction of grief symptoms.

If this group model proves feasible, it will be possible to shift focus to long-tem retention of high risk women in appropriate clinics and other settings which would promote earlier detection and diagnosis, thus reducing mortality and morbidity from this disease.


Final Report (1996)
The purpose of this project was: 1) to define the content and characteristics of the best group model to increase education, prevent the development of psychological symptoms and problems, and increase adaptation and coping to the threat that women at high risk of breast cancer live with daily; and 2) to define the optimal group mix for this model.

Six specific aims were established to achieve these purposes of the project. These are: 1) test the general feasibility of our model; 2) determine whether the model decreases participants' affective symptoms; 3) assess whether the model facilitates participants' more realistic assessment of personal risk; 4) see if model increases participants' nutritional knowledge; 5) assess whether, through use of the model, participants' grief symptoms are reduced; and, 6) determine whether use of the model increases participants' coping options.

The project has had 6 cycles of groups to date. As this report is written, 5 cycles are totally completed and the 6th cycle has completed 4 of 6 meetings. Data analysis for this report is on groups 1-4, a total of 21 subjects.

Significant Findings

Depression Symptoms: At the baseline measurement, 38% of participants were classified as exhibiting a clinical range of depressive symptoms; at post-testing, 22.5% of participants were in the clinical range of depression, a decline of 15.5%.

Anxiety Symptoms: At baseline measurement, 50% of participants were in a clinical range of anxiety symptoms; at post-testing, 35% of participants were in the clinical range, a decline of 15%.

Perceived Risk Rating for Breast Cancer: On a scale of 0-100% perceived lifetime risk, the baseline mean of perceived lifetime risk was 40.30% and 61% of the women perceived their risk to be over 40%; at follow-up, the mean was 37.5% lifetime risk, with 50% over the 40% risk rating, a decline of 11%.

Basic Nutritional Knowledge: On a test with a range of 0-10 correct, the baseline mean correct was 4.7; at follow-up, the mean correct was 5.21, an increase of 0.51 questions, a 5% knowledge increase.

Grief Symptoms: On the Despair Scale used for the study, the baseline percent above the mean was 36; at follow-up, the percent above the mean was 31%, an improvement of 4%. On the Death Anxiety Scale, the baseline percent above the mean was 84%; at follow-up, 50% were above the mean, a decline of 34%. On the Rumination Scale, the baseline percent above the mean was 42%; at follow-up 31% were above the mean, a decline of 11%.

We feel that the use of the model thus far has had positive results in all areas, some very impressive. In the area of reduction of perceived risk, the results indicate need for a stronger model. For grief symptoms, the picture is mixed, with decline in despair being modest, but a significant decline in the area of death anxiety that may reflect gains from genetic knowledge.