Promoting Resilience in Stress Management (PRISM) for women with breast cancer: a qualitative analysis of patient impressions and recommendations.

PURPOSE: The Promoting Resilience in Stress Management (PRISM) intervention is a brief, positive psychological skills-based intervention delivered by lay-coaches with demonstrated efficacy at decreasing distress in young adults with cancer. We recently completed a pilot trial of "PRISM for women with breast cancer" (PRISM-BC) and demonstrated feasibility. Here, we conducted qualitative analyses to better understand the experiences of women who participated in PRISM-BC.

METHODS

For this single-armed, pilot study of PRISM-BC, we recruited women who were receiving chemotherapy for any stage of breast cancer. All received the PRISM intervention, including six individual, virtual sessions and access to a companion mobile app for skill practice. Following PRISM completion, participants completed a 30-60-minute semi-structured, qualitative interview. We employed coding reliability thematic analysis to identify themes, with two team members applying codes to ensure satisfactory inter-rater reliability.

RESULTS

Women (N=33) were on average 54.1 years old (SD=9.5); most had early stage disease (76%), identified as Black/African American (58%), and downloaded the companion app (70%). We identified four themes: 1) PRISM was helpful due to both new skill acquisition and experiential relevance; 2) The app was helpful to many, but barriers prevented use among some; 3) Both facilitators and barriers to PRISM engagement were present; 4) Opportunities exist to tailor PRISM further to the specific needs of breast cancer survivors

CONCLUSION

PRISM was well-received among women with breast cancer. Future work should examine the efficacy of PRISM in larger, controlled trials in breast oncology incorporating suggested modifications (e.g., content around medication adherence).