Racial differences in treatment adherence and response to acupuncture and cognitive behavioral therapy for insomnia among Black and White cancer survivors Journal Article
| Authors: | Liou, K. T.; Garland, S. N.; Meghani, S. H.; Kaye, N. M.; Thompson, E.; Li, Q. S.; Mao, J. J. |
| Article Title: | Racial differences in treatment adherence and response to acupuncture and cognitive behavioral therapy for insomnia among Black and White cancer survivors |
| 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. © 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd. |
| Keywords: | adult; treatment outcome; treatment response; aged; middle aged; major clinical study; outcome assessment; neoplasm; neoplasms; quality of life; psychology; oncology; cancer therapy; cancer survivor; questionnaire; insomnia; survivorship; patient compliance; mental disease; acupuncture; anxiety; physical activity; lifestyle modification; sleep disorder; racial disparity; race difference; health care delivery; therapy; african american; health disparity; caucasian; ethnology; secondary analysis; racial disparities; cancer survivors; acupuncture therapy; comparative effectiveness; sleep; complication; cancer survivorship; procedures; sleep initiation and maintenance disorders; cognitive behavioral therapy; humans; human; male; female; article; polysomnography; malignant neoplasm; pain severity; sleep time; sleep latency; sleep hygiene; black or african american; white people; sleep health; treatment adherence and compliance |
| Journal Title: | Cancer Medicine |
| Volume: | 13 |
| Issue: | 16 |
| ISSN: | 2045-7634 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2024-08-01 |
| Start Page: | e7344 |
| Language: | English |
| DOI: | 10.1002/cam4.7344 |
| PUBMED: | 39161103 |
| PROVIDER: | scopus |
| PMCID: | PMC11333531 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Kevin Liou -- Source: Scopus |
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