Racial differences in treatment adherence and response to acupuncture and cognitive behavioral therapy for insomnia among Black and White cancer survivors

Background Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and...

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Published inCancer medicine (Malden, MA) Vol. 13; no. 16; pp. e7344 - n/a
Main Authors Liou, Kevin T., Garland, Sheila N., Meghani, Salimah H., Kaye, Nadia M., Thompson, Embree, Li, Q. Susan, Mao, Jun J.
Format Journal Article
LanguageEnglish
Published United States John Wiley & Sons, Inc 01.08.2024
John Wiley and Sons Inc
Wiley
Subjects
Acupuncture
Acupuncture Therapy
Adult
Aged
Anxiety
Behavior modification
Black or African American - psychology
Cancer
Cancer Survivors - psychology
cancer survivorship
Cancer therapies
Cognitive behavioral therapy
Cognitive Behavioral Therapy - methods
Fatigue
Female
Humans
Inequality
Insomnia
Intervention
Latency
Male
Medical diagnosis
Mental depression
Mental disorders
Middle Aged
Neoplasms - complications
Neoplasms - ethnology
Neoplasms - psychology
Neoplasms - therapy
oncology
Pain
Patients
Population studies
Quality of life
Race
Racial differences
racial disparities
Sleep
Sleep disorders
sleep health
Sleep Initiation and Maintenance Disorders - therapy
Treatment Adherence and Compliance - psychology
Treatment Adherence and Compliance - statistics & numerical data
Treatment Outcome
White People - psychology
White People - statistics & numerical data
United States > US
Pittsburgh Pennsylvania
cognitive behavioral therapy
racial disparities
acupuncture
sleep health
cancer survivorship
oncology
insomnia
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Abstract Background Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT‐I) among Black and White cancer survivors. Methods We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT‐I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co‐morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants. Results Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT‐I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT‐I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (−3.0 points, 95% CI −5.4 to 0.4, p = 0.02). Conclusion This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT‐I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT‐I adherence and confirming the effectiveness of acupuncture in Black cancer survivors.
AbstractList Abstract Background Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT‐I) among Black and White cancer survivors. Methods We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT‐I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co‐morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants. Results Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT‐I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT‐I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (−3.0 points, 95% CI −5.4 to 0.4, p = 0.02). Conclusion This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT‐I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT‐I adherence and confirming the effectiveness of acupuncture in Black cancer survivors.
Racial disparities in sleep are well-documented. However, evidence-based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT-I) among Black and White cancer survivors. We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT-I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co-morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants. Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT-I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT-I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (-3.0 points, 95% CI -5.4 to 0.4, p = 0.02). This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT-I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT-I adherence and confirming the effectiveness of acupuncture in Black cancer survivors.
Background Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT‐I) among Black and White cancer survivors. Methods We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT‐I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co‐morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants. Results Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT‐I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT‐I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (−3.0 points, 95% CI −5.4 to 0.4, p = 0.02). Conclusion This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT‐I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT‐I adherence and confirming the effectiveness of acupuncture in Black cancer survivors.
Racial disparities in sleep are well-documented. However, evidence-based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT-I) among Black and White cancer survivors.BACKGROUNDRacial disparities in sleep are well-documented. However, evidence-based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT-I) among Black and White cancer survivors.We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT-I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co-morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants.METHODSWe conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT-I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co-morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants.Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT-I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT-I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (-3.0 points, 95% CI -5.4 to 0.4, p = 0.02).RESULTSAmong 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT-I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT-I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (-3.0 points, 95% CI -5.4 to 0.4, p = 0.02).This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT-I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT-I adherence and confirming the effectiveness of acupuncture in Black cancer survivors.CONCLUSIONThis study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT-I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT-I adherence and confirming the effectiveness of acupuncture in Black cancer survivors.
Background Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT‐I) among Black and White cancer survivors. Methods We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT‐I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co‐morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants. Results Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT‐I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT‐I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (−3.0 points, 95% CI −5.4 to 0.4, p = 0.02). Conclusion This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT‐I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT‐I adherence and confirming the effectiveness of acupuncture in Black cancer survivors.
Author Garland, Sheila N.
Thompson, Embree
Kaye, Nadia M.
Liou, Kevin T.
Meghani, Salimah H.
Li, Q. Susan
Mao, Jun J.
AuthorAffiliation 1 Department of Medicine, Integrative Medicine Service Memorial Sloan Kettering Cancer Center New York New York USA
4 Stuyvesant High School New York New York USA
5 Weill Cornell Medical College New York New York USA
3 Department of Biobehavioral Health Sciences, School of Nursing University of Pennsylvania Philadelphia Pennsylvania USA
2 Department of Psychology and Oncology Memorial University of Newfoundland St. John's Newfoundland and Labrador Canada
AuthorAffiliation_xml – name: 3 Department of Biobehavioral Health Sciences, School of Nursing University of Pennsylvania Philadelphia Pennsylvania USA
– name: 2 Department of Psychology and Oncology Memorial University of Newfoundland St. John's Newfoundland and Labrador Canada
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– name: 1 Department of Medicine, Integrative Medicine Service Memorial Sloan Kettering Cancer Center New York New York USA
– name: 4 Stuyvesant High School New York New York USA
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2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.
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Issue 16
Keywords cognitive behavioral therapy
racial disparities
acupuncture
sleep health
cancer survivorship
oncology
insomnia
Language English
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SSID ssj0000702671
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Snippet Background Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer populations....
Racial disparities in sleep are well-documented. However, evidence-based options for addressing these disparities are lacking in cancer populations. To inform...
Background Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer populations....
Abstract Background Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer...
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pubmedcentral
proquest
crossref
pubmed
wiley
SourceType Open Website
Open Access Repository
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StartPage e7344
SubjectTerms Acupuncture
Acupuncture Therapy
Adult
Aged
Anxiety
Behavior modification
Black or African American - psychology
Cancer
Cancer Survivors - psychology
cancer survivorship
Cancer therapies
Cognitive behavioral therapy
Cognitive Behavioral Therapy - methods
Fatigue
Female
Humans
Inequality
Insomnia
Intervention
Latency
Male
Medical diagnosis
Mental depression
Mental disorders
Middle Aged
Neoplasms - complications
Neoplasms - ethnology
Neoplasms - psychology
Neoplasms - therapy
oncology
Pain
Patients
Population studies
Quality of life
Race
Racial differences
racial disparities
Sleep
Sleep disorders
sleep health
Sleep Initiation and Maintenance Disorders - therapy
Treatment Adherence and Compliance - psychology
Treatment Adherence and Compliance - statistics & numerical data
Treatment Outcome
White People - psychology
White People - statistics & numerical data
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Title Racial differences in treatment adherence and response to acupuncture and cognitive behavioral therapy for insomnia among Black and White cancer survivors
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fcam4.7344
https://www.ncbi.nlm.nih.gov/pubmed/39161103
https://www.proquest.com/docview/3099365763
https://www.proquest.com/docview/3094820820
https://pubmed.ncbi.nlm.nih.gov/PMC11333531
https://doaj.org/article/c20216d723a24416a3affa9196b7a325
Volume 13
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