Peer support program shows promise for cancer patients in Vietnam

Boston University School of Public HealthNov 25 2024

Having cancer can be one of the most physically and emotionally draining experiences of a person's life, but navigating this disease without adequate support or resources makes this journey even more burdensome. A new study led by Boston University School of Public Health (BUSPH) has found that the cancer peer support program Stronger Together shows promise for providing this critical social support, particularly in low-resource settings in low- and middle-income countries.

Published in JCO Global Oncology, a journal of the American Society of Clinical Oncology, the pilot study evaluated this peer support model among patients with breast and gynecological cancers in Vietnam, and found that the program can help improve psychological outcomes, including depression, anxiety, stress, and overall physical and mental health quality of life. Cancer patients who did and did not participate in the Stronger Together program experienced these improvements, but the patients who received the peer support improved at a much faster rate than those who did not.

The study is the first to examine a peer support intervention model for patients with cancer in Vietnam. The results show promise for a scalable, low-cost program that could be implemented in any setting, but especially LMICs, where the mental health burden among cancer patients is high and resources are 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. In Stronger Together, cancer survivors' lived experiences are highlighted, and their ability to provide hope and social support to new patients are strengthened through a culturally and contextually relevant program structure and training curriculum."

Dr. PhuongThao Le, study lead and corresponding author, assistant professor of community health sciences at BUSPH

The Stronger Together model is an adaptation of the Woman to Woman program that originated at Mt. Sinai Hospital in New York City. Dr. Le partnered with Carolyn Taylor, founder of Global Focus on Cancer, to adapt the model to the Vietnam cancer care context. Both programs pair newly diagnosed cancer patients with trained volunteers who are cancer survivors, placing them in a unique position to provide emotional support and mentorship, and discuss concerns. The volunteers are supervised by site coordinators who are healthcare providers or community health workers.

For the pilot study, the research team selected 186 volunteers who completed a Stronger Together training curriculum in Vietnam and paired them with patients newly diagnosed with breast or gynecological cancer, matching them based on cancer type, age, personal preferences, availability, and other shared factors. The mentors and patients met virtually (due to COVID-19 restrictions) between March 2021 and September 2022, for as often and as long as the patient indicated was necessary-;which was, on average, 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 Stronger Together, 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 team observed reductions in participants' depression, anxiety, 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 among Stronger Together patients, within the first two months of support, and more so among patients with breast cancer than gynecological cancers. While patients who did not receive peer support saw improvements in their physical and mental well-being-;perhaps after becoming acclimated to treatments and better understanding their diagnosis-;this progress occurred later in the study period, between four and six months into the program.

The researchers are 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, Dr. Le says. The current results can inform peer mentoring programs for racial/ethnic communities in the US, 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," says Dr. Le.

The study's senior authors are Dr. Tran Thanh Huong, vice director of the National Institute for Cancer Control at Hanoi Medical University in Hanoi, Vietnam, and Dr. Ophira Ginsburg, currently senior scientific advisor for clinical research at the National Cancer Institute's Center for Global Health, and an associate professor in the Departments of Population Health and Medicine at NYU Grossman School of Medicine at the time of the study.