Teletia R Taylor’s research while affiliated with Howard University and other places

54 Background: For individuals navigating cancer, unaddressed psychosocial needs can adversely impact quality of life, treatment adherence, and healthcare expenditures. It is recognized that African American cancer survivors are more likely to experience distress, yet they are underrepresented in studies that evaluate interventions. Mind Over Matter (MOM) is a five-week psychoeducational program aimed at bolstering emotional coping skills. A previous study among predominantly White female-identifying breast cancer survivors revealed improvements from pre to post-MOM for anxiety, depression, and physical symptom severity and interference; no data exists for women who identify as Black and/or African American. This presentation will illustrate the strategies and processes implemented to recruit, consent, and retain Black and African American cancer survivors to test the feasibility and acceptability of MOM. Methods: In forming the research team, the diversity in institutions, experience, racial and cultural identities, and professional perspectives were prioritized. As a result of this process, team members were social workers and psychologists, one was at an HBCU institution, and another was a patient advocate from the Black community who was hired and trained enabling full participation in the research process. To improve access all aspects of the study were available online and the intervention was offered virtually in the evening to support participants' availability. Efforts were made to build relationships with non-profit organizations, then disseminating the study through emails, healthcare systems, and social media. Results: During the 3-month recruitment period, 79 individuals expressed interest in the study via email and the study website. Of these, 40 participants (50.6%) enrolled in the study, surpassing the goal of 27. Half of the enrolled survivors learned about the study through community, medical, and academic organizations, while 20% and 10% were referred via the home health system and social media, respectively. 17.5% were referred from unspecified sources. Conclusions: Through robust team development, strategic community partnerships, using a study design that addressed common barriers (e.g., program hours and delivery method, tech orientation, incentives) and a high touch approach, this study successfully enrolled half of the Black and African American female-identified cancer survivors who expressed interest in this mixed-methods study. Clinical trial information: NCT06168825 .

Background Allostatic load comprises cardiovascular, metabolic, and inflammatory markers, which is characterized by abdominal obesity, high blood glucose levels, impaired glucose tolerance, dyslipidemia, and hypertension and associated with an increased risk in breast cancer.Methods The study was a 6-month, 3-arm randomized controlled trial of two moderate-intensity exercise interventions (compared with a control group) among obese, physically inactive, postmenopausal Black women aged 45 to 65 years, who were at increased risk for breast cancer based on the CARE model. Two hundred thirteen participants were randomly assigned to (1) supervised, facility-based aerobic exercise intervention (n = 73), (2) home-based exercise intervention (n = 69), or (3) a wait-listed control group (n = 71). The intervention effects of exercise on allostatic load were examined with intent-to-treat analyses using generalized linear models.ResultsIt was revealed that statistically significant decreases in allostatic load over the 6-month period for both exercise intervention groups (i.e., home-based and supervised arms) compared to the controls were observed among the total population, pc-h = 0.023 and pc-s = 0.035, as well as among women with a family history of breast cancer, pc-h = 0.006 and pc-s = 0.012.Conclusions Short-term aerobic activity improved allostatic load scores in metabolically unhealthy postmenopausal Black women at increased risk for cancer.Trial RegistrationClinical trial registration number NCT02103140.

Background Women who engage in higher levels of exercise while trying to quit smoking have been shown to be less likely to relapse and to sustain their smoking abstinence longer. This study sought to examine the benefits of exercise for improving smoking cessation among Black women. Methods We evaluated the feasibility of a 12-week smoking and exercise intervention, Quit and Fit, tailored for Black women. All participants (intervention and control) received 12 weeks of smoking cessation counseling via telephone and 9 weeks of nicotine lozenges. Participants who were randomly assigned to the intervention condition were also assigned to a 12-week exercise group. Results Thirty-eight women were enrolled and 27 completed a 12-week follow-up assessment. Women from the intervention group were more likely to complete the 12-week follow-up assessment compared to participants in the control group (80% vs. 61%). Overall, 7 of the 38 participants (18%) were abstinent at 12 weeks (biochemically verified by expired carbon monoxide). Among the 25 women who completed the 12-week follow-up, abstinence was reported in 33% of the intervention group and 20% of the control group. Using an intent-to-treat approach, 25% of women in the intervention group were abstinent at 12 weeks (n = 5), compared to 11.1% for the control group (n = 2). These differences were not statistically significant. Conclusions The overall retention rate was 71% (27/38) at 12 weeks with higher among the intervention group (16/20; 80%) compared to the control group (11/18; 61%). The study demonstrates that it is feasible to retain African-American women in a short-term study of smoking cessation and exercise.

Objective: Insomnia is a significant concern among African‐American breast cancer survivors (BCS). Social constraints (SC)‐ receiving unsupportive or critical responses when expressing trauma‐related emotions‐ and fear of recurrence (FOR) have been associated with insomnia. We examined FOR as a mediator in the relationship between SC and insomnia in African‐American BCS. We hypothesized a direct effect of SC on insomnia, and an indirect effect of SC on insomnia through FOR. Methods: 64 African‐American BCS completed a questionnaire assessing demographics, clinical characteristics, SC, FOR, and insomnia. Participants were an average of M = 8.41 (SD = 5.8) year survivors. The mediation was tested using PROCESS for SPSS. Results: The direct effect of SC on insomnia was significant (direct effect = .17, SE = .08, P = .04). Also, the indirect effect of SC on insomnia through FOR was significant (indirect effect = .19, SE = .10, 95% CI = .05, .41). Conclusions: Experiencing SC from family and friends could produce cognitions that impact sleep for BCS and FOR could be one of those cognitions. Family‐based models of care that emphasize the emotional needs of survivors and families could be a relevant strategy to address the SC that impact sleep. This article is protected by copyright. All rights reserved.

This randomized controlled trial examined the effectiveness of low-impact yoga on sleep quality among Black/African-American breast cancer survivors. Participants in yoga the yoga condition showed improvements in depressive symptoms. Self-reported sleep quality was not significantly improved, but participants did report high satisfaction with participating in this randomized controlled trial- a group with historically lower enrollment in clinical trial research.

I designed and led a community-based cross-sectional survey research study examining social-environmental antecedents and psychological and functional consequences of fear of recurrence in African-American breast cancer survivors. Data indicated that experiencing social constraints from family and friends when engaging in emotional expression of cancer-related emotions is associated with fear of cancer recurrence. We also found that emotional intelligence moderated the relationship where social constraints were not related to fear of recurrence when participants had higher levels of emotional intelligence.

BACKGROUND This study examined the effects of supervised and home‐based exercise interventions on changes in metabolic syndrome (MetS) according to breast cancer risk (high vs low) in black women enrolled in the Focused Intervention on Exercise to Reduce Cancer (FIERCE) trial. METHODS Postmenopausal, obese, metabolically unhealthy black women, 45 to 65 years old, were randomized to supervised aerobic exercise (73 women), home‐based walking‐based exercise (69 women), or a control arm (71 women). Participants in the exercise arms underwent a 6‐month intervention with study assessments conducted at the baseline and 6 months. The primary outcome measure was MetS (fasting glucose, waist circumference, blood pressure, serum triglycerides, and high‐density lipoprotein [HDL]). The intervention effects on MetS, stratified by breast cancer risk as measured by the family history of breast cancer and model‐based projected breast cancer risk, were examined with intent‐to‐treat analyses using generalized estimating equation models. RESULTS Among women with a family history of breast cancer, the exercise arms had lower mean MetS z scores, which suggested an improvement in the metabolic profile, than controls at 6 months (controls, + 0.55; home‐based arm, –0.97, P < .01; supervised arm, –0.89, P < .01). Stratified analyses by projected breast cancer risk suggested similar but statistically nonsignificant findings, with those at high risk having more favorable changes in the MetS z score in the exercise arms versus the control arm. These changes were primarily attributable to changes in blood pressure, triglycerides, and HDL. CONCLUSIONS Short‐term aerobic activity regimens may improve the metabolic profile and thereby reduce breast cancer risk in obese, metabolically unhealthy black women at high risk for cancer. Cancer 2018. © 2018 American Cancer Society.

Purpose: African-American women have a higher incidence and mortality from breast cancer compared to most other racial/ethnic groups. African-American women are also more likely to be metabolically unhealthy than White women. Several studies have suggested that metabolic syndrome affects health-related quality of life (HRQoL). Despite numerous exercise studies reporting improvements in metabolic syndrome, no study to date has examined the effect of exercise on HRQoL in metabolically unhealthy African-American women. Methods: This study examined the effect of the Focused Intervention on Exercise to Reduce CancEr (FIERCE) trial, (a 6-month, 3-arm: (supervised exercise, home-based exercise, control) randomized exercise controlled trial (RCT)) on HRQoL among 213 obese, metabolically unhealthy, postmenopausal African-American women at high projected risk of breast cancer. Assessments (socio-demographics, lifestyle, BMI and HRQoL) were measured at baseline and 6 months. Change scores from baseline to 6 months in HRQoL were observed by study group. Results: Baseline education level, marital status, smoking, and BMI were related to dimensions of baseline HRQoL. There were no significant differences in HRQoL change scores between the 3 study groups, however although non-significant, data indicated that HRQoL was more favorable in the supervised group. Conclusion: Our findings suggest that certain dimensions of HRQoL are associated with baseline participant characteristics. While we did not observe any significant effects of exercise on HRQoL over time, we did see a non-significant trend for improved HRQoL in the supervised exercise group. Additional research is needed to further explore this topic.

This study evaluated whether a self-administered stress management training (SSMT) could improve quality of life (QOL) and reduce distress among Hispanics receiving chemotherapy across multiple community clinical settings. Participants were randomized to receive SSMT (n = 106) or usual care (UCO) (n = 113). The primary outcome-QOL (SF-36) and secondary outcomes depression (CES-D), and anxiety (STAI) were assessed longitudinally over four chemotherapy cycles. Acculturation (BAS) and patients' intervention adherence were assessed. About 63% of participants reported distress after the initial chemotherapy cycle. Hispanics with lower acculturation reported greater STAI-Trait scores (p = .003). No significant treatment effects on outcomes measures were observed for participants receiving SSMT. SSMT intervention techniques were reported useful and improved mental health scores were observed with patients on a psychotropic agent (p = .04). Hispanics experience an elevated level of distress, yet SSMT did not significantly improve primary outcomes. SSMT may be potentially effective when combined with a psychotropic agent. SSMT enhancing strategies are discussed.