Despite long-standing disparities in symptom burden due to structural barriers and racism, Black and Latina Breast Cancer Survivors (BCS) persistently have worse physical health than White BCS. Integrative care approaches (e.g., yoga, aerobic training) help BCS manage symptoms to improve physical functioning. Yet, barriers remain to wide-spread adoption of these approaches. Self-administered acupressure (SA), is a low-cost, low-intensity, time flexible, and safe method of managing symptoms that could improve physical functioning for Black and Latina BCS.
We conducted a pilot Randomized-Controlled Trial (RCT) of a culturally adapted SA training video in English and Spanish. BCS diagnosed at stage 0-IV with limited physical functioning at baseline were randomized 2:1 to either the SA intervention or Usual Care (UC, a BCS fact sheet). The SA group learned SA for three acupoints daily (6 mins total) in an educational video and live training. We enrolled 47 BCS of whom 34 completed baseline (T0) and an 8 week follow-up (T1; 18 Black, 16 Latina; age Mean [M] = 54.55; 72.35% retention; n=21 in SA, n=13 in UC). The PROMIS 6-item short form assessed physical functioning. Preliminary analysis of SA impact on physical functioning was assessed with between and within group t-tests. We also explored whether the SA impact differed between BCS with high (at least 75% of days practiced) and low engagement in SA as documented by daily logs.
The SA group and UC group’s demographics and baseline physical functioning did not significantly differ, but SA experienced more symptoms (M=20) at baseline than UC (M=13). However, the SA group (mean difference; MD=1.90, p=0.07) improved their physical functioning from T0 to T1 slightly more than the UC group (MD=1.07, p=0.19). The improvement between the two groups was not significantly different. Within the SA group, the 13 BCS (62%) with high SA engagement (vs. 8 low) had clinically significant increases in physical functioning (MD=3.37) relative to low engagement (MD=-0.50).
This pilot RCT demonstrated the initial feasibility of SA for Black and Latina BCS who engaged in SA practice. The limited difference between SA and UC in physical functioning may have been impacted by 38% of the SA group having low SA engagement in practice, highlighting a need for targeting engagement in future trials. We are currently conducting interviews with BCS to gather feedback about maximizing engagement in a future RCT.