Grant Number:	5R37CA214785-03 Interpret this number
Primary Investigator:	Blinder, Victoria
Organization:	Sloan-Kettering Inst Can Research
Project Title:	The Breast Cancer and the Workforce Communication App: a Randomized Controlled Trial of an English/Spanish Intervention to Promote Long-Term Job Retention
Fiscal Year:	2020

ABSTRACT Of the many stressors associated with a breast cancer diagnosis, job loss is one of the most impactful yet understudied. Long-term financial consequences can include difficulty paying bills, accumulation of debt, and bankruptcy. Importantly, bankruptcy in cancer survivors has been linked to decreased treatment adherence and increased mortality. Women with access to work accommodations, such as schedule flexibility, are more likely to work during chemotherapy and to retain their jobs in the long term. Similarly, women with adequate sick leave may choose to take time off while maintaining job security. However, low-income minorities are less likely to have such accommodations, leading to higher rates of job loss and financial distress. For these patients, finding a way to continue to work during treatment is critical. In the Breast Cancer and the Workforce study, which focuses on immigrant and minority women, symptom burden and lack of work accommodations were both linked to job loss. Only 57% of pre-diagnosis employed low-income women retained their jobs after treatment completion, compared to 93% of higher-income women. Of those not working, 84% attributed their lack of employment to cancer symptoms or treatment. Low-income women were less than half as likely as higher-income women to have accommodating employers and only one-fourth as likely to retain their jobs. However, patients whose confidence in asking for work accommodations improved over time were more than five times as likely to retain their jobs than those whose confidence did not improve. There is a compelling need for an effective intervention to support working during treatment in low-income immigrant and minority breast cancer patients in order to improve long-term job retention and financial stability. The goal of the proposed study is to evaluate the effectiveness of a mobile application (app) developed to promote working during adjuvant (curative) breast cancer chemotherapy. The app has a two-pronged approach: it will help women communicate with clinicians to optimize symptom control, and it will help them communicate with employers to negotiate for accommodations. Our study is grounded in evidence that communication behaviors can be taught to patients of varying English proficiency, resulting in improved responsiveness to patients' needs. Furthermore, patient-physician communication strategies can be adapted for use in the work setting. Our app applies these principles to the workplace as well as the clinic. The use of an app to deliver the intervention is appealing in light of barriers our target population faces in accessing support and the high prevalence of smartphone use. We will randomly assign English- and Spanish-speaking women who are about to undergo chemotherapy for stage I-III breast cancer to receive the app or an informational booklet (control). Participants will complete surveys at baseline and during chemotherapy to assess symptom burden and work accommodations. Surveys 4 months and 1 and 2 years post-treatment will measure long-term job retention.




An interactive mobile application versus an educational booklet to promote job retention in women undergoing adjuvant chemotherapy for breast cancer: a randomized controlled trial.
Authors: Blinder V.S. , Patil S. , Finik J. , Makower D. , Muppidi M. , Lichtenthal W.G. , Parker P.A. , Claros M. , Suarez J. , Narang B. , et al. .
Source: Trials, 2022-10-03 00:00:00.0; 23(1), p. 840.
EPub date: 2022-10-03 00:00:00.0.
PMID: 36192754
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Work Status Reduction and Cost-Related Nonadherence during Cancer Treatment.
Authors: Doherty M. , Finik J. , Blinder V. .
Source: Health & Social Work, 2022-03-07 00:00:00.0; , .
EPub date: 2022-03-07 00:00:00.0.
PMID: 35253845
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Vulnerabilities in workplace features for essential workers with breast cancer: Implications for the COVID-19 pandemic.
Authors: Klugman M. , Patil S. , Gany F. , Blinder V. .
Source: Work (reading, Mass.), 2022-03-03 00:00:00.0; , .
EPub date: 2022-03-03 00:00:00.0.
PMID: 35253716
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Effects of patient-reported outcome assessment order.
Authors: Novotny P.J. , Dueck A.C. , Satele D. , Frost M.H. , Beebe T.J. , Yost K.J. , Lee M.K. , Eton D.T. , Yount S. , Cella D. , et al. .
Source: Clinical Trials (london, England), 2022-01-28 00:00:00.0; , p. 17407745211073788.
EPub date: 2022-01-28 00:00:00.0.
PMID: 35088616
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Pain, Financial Hardship, and Employment in Cancer Survivors.
Authors: Blinder V.S. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2021-11-18 00:00:00.0; , p. JCO2101812.
EPub date: 2021-11-18 00:00:00.0.
PMID: 34793249
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Updated Standardized Definitions for Efficacy End Points (STEEP) in Adjuvant Breast Cancer Clinical Trials: STEEP Version 2.0.
Authors: Tolaney S.M. , Garrett-Mayer E. , White J. , Blinder V.S. , Foster J.C. , Amiri-Kordestani L. , Hwang E.S. , Bliss J.M. , Rakovitch E. , Perlmutter J. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2021-08-20 00:00:00.0; 39(24), p. 2720-2731.
EPub date: 2021-05-18 00:00:00.0.
PMID: 34003702
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Neoadjuvant endocrine therapy use in early stage breast cancer during the covid-19 pandemic.
Authors: Park K.U. , Gregory M. , Bazan J. , Lustberg M. , Rosenberg S. , Blinder V. , Sharma P. , Pusztai L. , Shen C. , Partridge A. , et al. .
Source: Breast Cancer Research And Treatment, 2021 Jul; 188(1), p. 249-258.
EPub date: 2021-03-02 00:00:00.0.
PMID: 33651271
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The association between housing and food insecurity among medically underserved cancer patients.
Authors: Gany F. , Melnic I. , Ramirez J. , Wu M. , Li Y. , Paolantonio L. , Roberts-Eversley N. , Blinder V. , Leng J. .
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2021-06-24 00:00:00.0; , .
EPub date: 2021-06-24 00:00:00.0.
PMID: 34169329
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Breast Cancer-Related Employment Disruption and Financial Hardship in the Sister Study.
Authors: Meernik C. , Sandler D.P. , Peipins L.A. , Hodgson M.E. , Blinder V.S. , Wheeler S.B. , Nichols H.B. .
Source: Jnci Cancer Spectrum, 2021 Jun; 5(3), p. pkab024.
EPub date: 2021-03-17 00:00:00.0.
PMID: 34104865
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Immunomodulatory Activity of a Colony-stimulating Factor-1 Receptor Inhibitor in Patients with Advanced Refractory Breast or Prostate Cancer: A Phase I Study.
Authors: Autio K.A. , Klebanoff C.A. , Schaer D. , Kauh J.S.W. , Slovin S.F. , Adamow M. , Blinder V.S. , Brahmachary M. , Carlsen M. , Comen E. , et al. .
Source: Clinical Cancer Research : An Official Journal Of The American Association For Cancer Research, 2020-11-01 00:00:00.0; 26(21), p. 5609-5620.
EPub date: 2020-08-26 00:00:00.0.
PMID: 32847933
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Use of patient-reported controls for secular trends to study disparities in cancer-related job loss.
Authors: Blinder V.S. , Eberle C.E. , Tran C. , Bao T. , Malik M. , Jung G. , Hwang C. , Kampel L. , Patil S. , Gany F.M. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2020-10-26 00:00:00.0; , .
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Dermatologic adverse events related to the PI3Kα inhibitor alpelisib (BYL719) in patients with breast cancer.
Authors: Wang D.G. , Barrios D.M. , Blinder V.S. , Bromberg J.F. , Drullinsky P.R. , Funt S.A. , Jhaveri K.L. , Lake D.E. , Lyons T. , Modi S. , et al. .
Source: Breast Cancer Research And Treatment, 2020 Aug; 183(1), p. 227-237.
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Impact of Cancer on Employment.
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