Expanding Rural Access: Distance Delivery of Support Groups

Institution: Stanford University
Investigator(s): Cheryl  Koopman , Ph.D. - Mary Anne  Kreshka , M.A. - Susan  Ferrier , R.N. -
Award Cycle: 2004 (Cycle 10) Grant #: 10AB-2801 Award: $62,656
Award Type: CRC Pilot Award
Research Priorities
Sociocultural, Behavioral, and Psychological Issues>Sociocultural, Behavioral, and Psychological Issues: the human side

This is a collaboration with: 10AB-2800 -

Initial Award Abstract (2004)
Women with breast cancer living in rural areas have less access to psychosocial support than their urban counterparts due to geographic distances from sources of support, inclement weather, and confidentiality concerns in small communities. Videoconferencing can be used to increase access to psychosocial support for women with breast cancer.

Northern Sierra Rural Health Network (NSRHN) is collaborating with Stanford University School of Medicine to determine whether the technology resources already in place can be used to expand access to support services for women living with breast cancer. The study has three primary aims:
Aim 1: Determine the feasibility and acceptability of using an existing videoconferencing network to reduce rural/urban inequities in access to psychosocial support for women with breast cancer residing in rural northeastern California.
Aim 2: To evaluate whether the psychosocial support needs of women with breast cancer living in rural northeastern California, as they are understood by the women themselves, can be met through the use of videoconferencing
Aim 3: Support the capacity of the communities in the target region to use videoconferencing to improve access to psychosocial support for women with breast cancer.

We plan to recruit 40 rural women living with breast cancer from Plumas, Modoc, and Siskiyou Counties for the research. Each participant will provide informed consent, complete baseline assessments on validated quality of life measures, participate in 8 weekly support groups conducted by vide conferencing and complete a follow-up assessment that will include a brief interview to elicit feedback about the intervention and the mode of delivery.

This research has the potential to inform the design and implementation of technology-based intervention that would be readily accessible to rural women with breast cancer. This would tap the potential of technology that is already in use in the nine rural counties served by NSRHN for providing psychosocial support. Our future plans are to disseminate the findings and train health care providers with the hope of establishing one or more types of psychosocial support delivered via videoconferencing as part of routine care for rural women with breast cancer on a continuous basis.


Progress Report 1 (2005)
Northern Sierra Rural Health Network (NSRHN) and Stanford University School of Medicine are collaborating to determine whether the video-conferencing technology resources already in place can be used to expand access to support services for women living with breast cancer. The study has three primary aims: Aim 1: Determine the feasibility and acceptability of using an existing videoconferencing network to reduce rural/urban inequities in access to psychosocial support for women with breast cancer residing in rural northeastern California. Aim 2: To evaluate whether the psychosocial support needs of women with breast cancer living in rural northeastern California, as they are understood by the women themselves, can be met through the use of videoconferencing. Aim 3: Support the capacity of the communities in the target region to use videoconferencing to improve access to psychosocial support for women with breast cancer.

We are recruiting 40 rural women living with breast cancer from Plumas, Modoc, and Siskiyou Counties for the research. Each participant provides informed consent, completes baseline assessments on validated quality of life measures, participates in 8 weekly support groups conducted by video conferencing, receives the workbook-journal One In Eight, and completes a follow-up assessment. A brief interview is included in the follow-up assessment to elicit feedback about the intervention and the mode of delivery.

Thus far, two groups have been completed that used videoconferencing to provide facilitated group support to 14 women with breast cancer. Follow-up assessments are being conducted for these 14 women. Attendance in the first two groups has been excellent. Participants, including the older women, have adapted quickly to the technology, readily turning to the content of discussion. Participants are excited about pioneering the use of videoconferencing to provide social support for women with breast cancer. These women have expressed appreciation at being able to learn from women in other geographic areas about how breast cancer is treated in other communities. The group facilitator has found it more difficult to use visual cues to augment auditory ones in a group using the video-conferencing modality. Also, she finds it more challenging to encourage interaction because of the time lag in the sound of speech.

This project is continuing its outreach activities, with Mary Anne Kreshka, Susan Ferrier, and Rebecca Parsons are traveling to strengthen and expand community relations for the purposes of recruiting more women into this study. This research has the potential to inform the design and implementation of technology-based intervention that would be readily accessible to rural women with breast cancer. Our future plans are to disseminate the findings and train health care providers with the hope of establishing one or more types of psychosocial support delivered via videoconferencing as part of routine care for rural women with breast cancer on a continuous basis.