Table 2.

Characteristics of studies included in the review (N = 17)

Study	Study design	Inclusion criteria	Sample	Group comparison	Intervention (modification specific to the needs of Black women)	Measures	Results	Limitations
Taylor et al. [25]	RCT. 12-month follow-up.	Black women with stages 0–IIIA BC who had undergone surgery within the past 10 months. No psychotic illness. No drug or alcohol abuse. No severe cognitive impairment or previous systemic cancer diagnosis.	N = 73. Black (100%). Stage 0 BC (4.1%); I (41%); II (50.5%); IIIA (4.1%). Hormonal therapy (39.7%). Mean age: 54 years (SD = 11). Education: ≥13 years (50%). Monthly income: ≥$2500 (43%). Married (44%). Consent (62.8%). Attrition (50%).	Support group intervention versus usual care control group.	Eight weekly, 2-h meetings: relaxation training, spirituality, recurrence fears, social support, cancer education, nutrition, treatment side effects, and breast prostheses. (Supportive cultural context and spirituality.)	Cancer-related QoL (CARES-SF); mood over past week (POMS); psychological distress (MHI); cancer-related distress (IES); breast cancer-related knowledge.	At 12 months, intervention improved mood and reduced intrusive thoughts among those with greater baseline distress. Low income women maintained baseline functioning.	High attrition rate may reduce generalizability of findings.
Gil et al. [26]	2 (intervention, control) × 2 (Black and White) randomized block. 20-month follow-up.	Recurrence-free women 5–9 years of posttreatment for BC. English speaking. Have telephone access. No major cognitive impairments.	N = 483. Black (29.2%); White (70.8%). Mean age: 64 years. Mean education: 13 years. Monthly income: ≥$2000 (61.2%). Married (58.6%). Consent (55%). Attrition (5%).	Intervention versus usual care control group.	Four weekly telephone sessions. Nurses guided participants in the use of audiotaped cognitive-behavioral strategies and a self-help manual. (None specified.)	Illness uncertainty (MUIS-S); cancer knowledge (Cancer Survivor Knowledge Scale); social support satisfaction (Social Support Questionnaire); patient–provider communication (Likert scale); cognitive reframing and problem solving (Self-control Schedule); coping strategies (CSQ); negative mood state (POMS-SF); positive life change due to serious illness (GTUS).	Intervention increased cognitive reframing and cancer knowledge and decreased illness uncertainty for Black and White women. Black women in the intervention showed stable personal growth and flexibility (versus decline in control group).	No control for nonspecific effects of attention by nurse and time spent in a structured activity.
Germino et al. [27]	2 (intervention, control) × 2 (Black and White) randomized block. 8- to 10-month follow-up.	Black and White women at least 1–4 years of posttreatment for stages I–IV BC.	N = 313. Black (37.4%); White (62.6%). Mean age: 44 years.	YS-UMI versus attention control.	CD of cognitive-behavioral strategies for uncertainty management and guidebook of young survivor topics plus four, 20-min phone calls by nurses to reinforce skill learning. (None specified.)	Cognitive reframing and problem solving (Self-control Schedule); knowledge (Cancer Survivor Knowledge Scale); uncertainty (Mishel Uncertainty in Illness Scale–Survivor Version); fears of recurrence (Concerns About Recurrence Scale); Intrusive thoughts (IES); Affect (PANAS).	Intervention group reported decreased uncertainty, improved knowledge, and increased cognitive coping strategies. Black women in intervention reported decreased negative affect at time of a cancer stress event.	Limited sample demographic information.
Heiney et al. [29]	Randomized trial design. 16-week follow-up.	US-born. English speaking. Black female. ≥21 years old. Diagnosed with invasive ductal cancer within the past 6 months and underwent lumpectomy. No metastatic disease. No psychosis or major cognitive impairment. No past or current diagnosis of cancer (except skin basal or squamous cell).	N = 185. Black (100%). Chemo (26.5%). Radiation (35.1%). Combined chemo and radiation (38.4%). Mean age: 56 years (SD = 11.06). Education: ≥high school (83.8%). Income: <$19,000 (30%). Married (37.8%). Consent (68.3%). Attrition (7%).	STORY intervention versus usual psychosocial care control.	Eight weekly, 90-min group teleconference sessions plus two biweekly sessions aimed to increase social connection and cancer knowledge and decrease fear and fatalism. (Use of oral story telling tradition and larger kin context to provide support.)	Social connection (SSQ and SWB subscale of FACT-B); breast cancer knowledge (Breast Cancer Knowledge Scale); fear (POMS-B); loneliness (UCLA Loneliness Scale); fatalism (Powe Fatalism Inventory Revised).	Intervention group reported increased social connection and decreased fear and fatalism.	Study only included participants who underwent lumpectomy.
Sheppard et al. [30]	QE. Single group. Pre-post.	Female. Self-identified Black. Current patients had histologically confirmed BC of any stage. >21 years old. No recurrent cancer. No secondary cancers.	N = 76. Black (100%). Mean age: 51.9 years (SD = 10.60). BC stage I (39.6%); stages II and III (60.4%). >High-school education (71.6%). Full-time employment (45.1%). Currently single (65.8%).	—	One-on-one, in-person session with a BC survivor coach using a patient guidebook and TALK Back!© model incorporating sharing stories, decision support, and communication skills training. (Health literacy and patient empowerment.)	Self-efficacy in communication with providers; self-efficacy in shared decision-making; self-efficacy in treatment knowledge; patient-centered communication PICS.	Post-intervention, patients reported 77% increase in decision-making self-efficacy.	No control group (although pilot study).
Wilson et al. [31]	QE. Single group. Pre-post.	Female. Black. Prior BC diagnosis. Completed BC treatment ≥3 months ago. Physically mobile. Less than 70 years old.	N = 24. Black (100%). Diagnosis: <1 year ago (14%); 1–3 years (32%); 4–6 years (18%); ≥7 years (37%). Chemo and radiation (46%). Taking tamoxifen (23%). Mean age: 55 years (range 47–66 years). Married (50%). Education: ≥high school (96%).	—	Eight, 75-min weekly sessions held at a local church. Curriculum on health benefits of exercise and problem-solving barriers to exercise. (Access through community-based locations.)	BMI, steps per day (measured by pedometer); body fat percentage (measured using Futrex); attitudes toward exercise (exercise decisional balance instrument).	Post-intervention, significant increase in mean daily steps; significant BMI and body weight decrease; significant body fat decrease; significantly increased positive perception of exercise.	No control group. Small sample size (although pilot study).
Stolley et al. [32]	QE. Single group. Pre–post.	Self-identified Black. Age: ≥ 18 years old. Stages I–III BC. BMI: ≥25 kg/m2. Completed BC treatment (except endocrine treatment) ≥6 months earlier. Physician cleared to engage in moderate physical activity. No prescription weight-loss medications. Not in organized weight-loss program.	N = 23. Black (100%). Mean age: 51.4 years (SD = 8.9). Education: >high school (87.0%). Income: ≥$50,000 (47.83%). Married (34.78%). Full-time employment (69.57%). Consent (unknown). Attrition (13%).	—	Moving forward: culturally relevant weight-loss program for Black BC survivors. Two weekly classes: one, 2-h class with 1 h devoted to information on diet, exercise, and weight and 1 h for an exercise class. The second weekly meeting was an exercise class. (Food preference, kin networks, and spirituality.)	Food intake (FFQ); physical activity (long IPAQ); friend and family support for eating and dietary changes (Social Support for Eating and Exercise Questionnaire); QoL (FACT-B).	At 6-month post-intervention, significant increase in vegetable and fiber consumption; significant decrease in weight and BMI; significant increase in social support for healthy eating and exercise.	No control group. Small sample size (although pilot study).
Greenlee et al. [33]	RCT. 12-month follow-up.	Female. 21–70 years old. Self-identified Black/Hispanic. Stages 0–IIIA BC. Completed treatment ≥6 months ago. BMI >25 kg/m2. <20 min of weekly vigorous physical activity. No weight-loss program. Nonsmoker. A1c: <8%. BP: <140/90. LDL: <150 mg/dl.	N = 42. Black (21%). Hispanic (79%). Mean age: 50.7 years (SD = 8.9). Postmenopausal (81%). Average BMI: 33.2 (SD = 5.9) kg/m2. Mean VO2 max 18.4 ml/kg/min (SD = 3.6 ml/kg/min). Consent (55.36%). Attrition (9.5%).	Commercial curves weight-loss program versus waitlist control.	Six months of Curves Weight Management Program: encouragement to use Curves fitness centers five times weekly and attend six, 1-h nutrition sessions at Curves. (None specified.)	Height; weight; body composition (measured by densitometer); VO2 max; serum metabolic markers; physical activity (self-administered Kaiser Physical Activity Survey); diet (Block questionnaire).	At 6 months, intervention group lost significantly more weight than control group. Intervention group regained most of lost weight during 12-month follow-up but weighed significantly less than at baseline.	Small sample size (although pilot study).
Schover et al. [34]	Randomized trial. 3-month follow-up.	Female. Self-identified Black. ≥1 year of post-diagnosis of stages 0–IIIA BC. Completed BC treatment except hormonal therapy. Not currently undergoing breast reconstruction.	N = 48. Mean age: 49.29 years (SD = 8.39). Mean time since BC diagnosis: 4.52 years (SD = 3.84). Married (50%). Education: ≥high school (92%). Annual income: ≤$25,000 (19%). Tamoxifen currently (25%). Consent (65%). Attrition (10% of intervention group; 29% of control group).	SPIRIT peer-counseled group versus waitlist control.	SPIRIT. An informational workbook on survivor sexual health concerns. Peer counselors met individually three times over 6 weeks for 60–90 min focusing on a workbook chapter. (Supportive cultural context.)	Spirituality (Spiritual Well Being Scale of FACIT-Sp); emotional distress (BSI-18); sexual dysfunction (FSFI); menopausal symptoms (Breast Cancer Prevention Trial Symptom Checklist).	Knowledge of reproductive issues, distress, and menopausal symptoms significantly improved baseline to 3 months.	Small sample size.
Schover et al. [35]	Comparative effectiveness. 12-month follow-up.	Female. Self-identified Black. ≥1 year post-BC diagnosis. English speaking.	N = 300. Black (100%). Mean age: 54 years (SD = 9.8). Married (40.11%). Education: ≥high school (94.92%). Family income: ≤$25,000 (15.49%). Regular menses (7.6%). Postmenopausal (44.7%). Irregular menses (7.6%). Hysterectomy (38.1%). Consent (unknown). Attrition (38%).	SPIRIT peer-counseled group versus SPIRIT telephone-counseling group.	SPIRIT. informational workbook on survivor sexual health concerns. Peer counselors met individually three times over 6 weeks for 60–90 min focusing on one workbook chapter. Telephone-counseling participants received counselor’s contact information and calling card and were encouraged to call counselor to discuss workbook. (Supportive cultural context.)	Spirituality (Spiritual Well Being Scale of FACIT-Sp); emotional distress (BSI-18); sexual dysfunction (FSFI); menopausal symptoms (Breast Cancer Prevention Trial Symptom Checklist).	Both in-person peer counseling and telephone peer counseling improved reproductive knowledge and reported decreased distress and hot flashes. No significant differences between groups.	High attrition rate, high educational attainment, and high income may reduce generalizability of the findings.
Germino et al. [36]	Descriptive. Recruitment and retention strategies.	Black and White women at least 1–4 years of posttreatment for stages I–IV BC.	N = 104. Attrition (13%) for both Black and White women.	Younger Breast Cancer Survivors: Managing Uncertainty Intervention versus control.	CD of cognitive-behavioral strategies for uncertainty management and guidebook of young survivor topics plus four, 20-min phone calls by nurses to reinforce skill learning. (Community engagement through churches)	—	Implementation of culturally relevant recruitment and retention strategies increased enrollment by 373% in 11 months.	Lack of participant demographic information.
Sheppard et al. [37]	Qualitative design. Intervention development.	Female. Self-identified Black. Current patients had histologically confirmed BC of any stage. >21 years old.	N = 34. Cancer patients, survivors, and cancer providers. Aged 38–69 years. Attrition (38%).	Semistructured, individual interviews.	TALK Back!© communication and decision-making intervention.	—	Themes of interviews: importance of patient–provider relationship, cultural values of collectivism, religious faith, and oral tradition.
Chung et al. [38]	Qualitative design.	Self-identified Black. ≥25 years old. Confirmed BC diagnosis. Completed primary treatment 2–12 months earlier.	N = 13. Aged 41–72 years. Consent (86. 7%).	Focus groups.	Taking CHARGE self-management program aimed to improve prevention and resolution of problems related to life after BC treatment.	Relevance of program to Black BC survivors.	Three content areas identified as needing enhancement: spirituality, strength, and body image.	No quantitative measures.
Lechner et al. [39]	Descriptive. Intervention development, recruitment, and retention.	Female. English speaking. Self-identified Black. Any stage of BC diagnosis. Received ≥1 medical BC treatment. No previous cancer history. Self-reported life expectancy: ≥12 months. No inpatient psychiatric treatment or substance dependence within the past year. No active suicidality.	N = 55. Black (100%). Mean age: 49.45 years (SD = 8.82). Stage 0 BC (9.1%); I (23.6%); II (41.8%); III (23.6%); IV (1.8%). Mean time since BC diagnosis: 14 months. Employed full time or part time (49%). Mean educational attainment: 13 years. Mean income: $31,000. Married (30.9%). Christian affiliation (100%). Consent (62.5%). Attrition (9.5%).	CBSM intervention versus enhanced breast cancer education control.	Ten-week CBSM intervention delivered in group format: cognitive-behavioral skills and relaxation training. (Use of kin context, spiritual coping, and supportive cultural context.)	—	High program acceptability ranging from 81% to 94% for those in the intervention condition and from 71% to 90% for the control condition.	High educational attainment of sample may reduce generalizability of the findings.
Gil et al. [40]	Descriptive. Intervention development and dismantling.	Recurrence-free women 5–9 years of posttreatment for BC. English speaking. Have telephone access. No major cognitive impairments.	N = 509. Black (29.27%); White (70.73%). Stage I/II BC (84%). Tamoxifen currently (36.3%). Mean age: 64 years. Monthly income: ≥$2000 (61.2%). Married (58%); Widowed (21%). Living alone (34%). Consent (55%). Attrition (5%).	Uncertainty management intervention versus usual care control.	Four weekly telephone sessions. Nurses guided participants in the use of audiotaped cognitive-behavioral strategies and a self-help manual. (None specified.)	Use and helpfulness of intervention components to deal with potential triggers of fear of recurrence (e.g., pain).	Calming self-talk was most commonly used strategy, followed by distraction. Black women used skills less frequently than White women and found them less helpful.	No control for nonspecific effects of attention by nurse and time spent in a structured activity.
Mishel et al. [41]	2 (intervention, control) × 2 (Black and White) randomized block. 10-month follow-up.	Recurrence-free women 5–9 years of posttreatment for BC. English speaking. Have telephone access. No major cognitive impairments.	N = 509. Black (29.27%); White (70.73%). Stage I/II BC (84%). Tamoxifen currently (36.3%). Mean age: 64 years (SD = 8.9). Monthly income: ≥$2000 (61.2%). Married (58%). Widowed (21%). Living alone (34%). Consent (55%). Attrition (5%).	Uncertainty management intervention versus usual care control.	Four weekly telephone sessions. Nurses guided participants in the use of audiotaped cognitive-behavioral strategies and a self-help manual. (None specified.)	Cancer knowledge (Cancer Survivor Knowledge Scale); social support satisfaction (Social Support Questionnaire); patient–provider communication; cognitive reframing and problem solving (Self-control Schedule); coping strategies (CSQ); negative mood state (POMS-SF).	Among Black women at 10-month follow-up, the intervention improved cognitive reframing, increased communication with providers, and decreased catastrophizing.	No control for nonspecific effects of attention by nurse and time spent in a structured activity.
Griffith et al. [43]	QE. Single group. Pre-post.	Self-identified Black. Aged Between 30 and 70 years. Stages 0–IIIA BC and completed surgery, chemotherapy, and radiation 3–8 months prior.	N = 8. Black (100%). Mean age: 61.1 years (SD = 3.1). Stage 0 BC (25%); I (12.5%); II (50%). Annual income: <$20,000 (37.5%). Current/previous hormonal therapy (75%). Married (37.5%). Mean BMI: 30.7 kg/m2. Consent (40.9%). Attrition (11.2%).	—	Eight, 45- to 60-min individual nutritional counseling sessions: education, review of food records, goal setting, problem solving, and cognitive strategies. (Food preference.)	Fasting insulin and glucose levels; daily consumption of: fat, calcium, vitamin D, vegetables, and fruit.	High adherence (100%). Intervention significantly reduced triglycerides and daily fat consumption and increased mean daily fruit and vegetable consumption.	No control group. Small sample size (although pilot study).

BC, breast cancer; BMI, Body mass index; BP, Blood pressure; BSI-18, Brief Symptom Inventory-18; CARES–SF, Cancer Rehabilitation Evaluation System – Short Form; CD, compact disc; Chemo, chemotherapy; CSQ, Cognitive Coping Strategies Questionnaire; FACIT, Functional Assessment of Chronic Illness Therapy; FACIT-Sp, Functional Assessment of Chronic Illness Therapy Spiritual Well Being subscale; FACT-B, Functional Assessment of Cancer Therapy – Breast; FFQ, Food Frequency Questionnaire; FSFI, Female Sexual Functioning Inventory; GTUS, Growth Through Uncertainty Scale; IES, Impact of Events Scale; long IPAQ; International Physical Activity Scale, Long Format; LDL, Low-density lipoprotein cholesterol; MHI, Mental Health Inventory; MUIS-S, Mishel Uncertainty in Illness Scale-Survivor; PANAS, Positive and Negative Affect Scale; PICS, Patient Perceived Involvement in Care; POMS, Profile of Mood States; POMS-B, Profile of Mood States Brief; POMS-SF, Profile of Mood States Short Form; QE, quasi-experimental; QoL, quality of life; SSQ, Northouse Social Support Questionnaire; SWB, Social Well Being subscale; UCLA, University of California Los Angeles.