Carolyn Lafferty

A Sexual Health Self-Management Intervention (Psychosexual Educational Partners Program) for Couples With a History of Breast and Gynecological Cancer: Mixed Methods Feasibility Study

Background Women with breast or gynecological cancer and their intimate partners often face sexual problems in their relationships. Accessing care for sexual health problems is challenging for several reasons (eg, limited trained health care providers and privacy concerns), making self-management approaches highly promising. Objective This study assessed the feasibility of the Psychosexual Educational Partners Program (PEPP), a 6-week sexual health self-management intervention for women treated for breast or gynecological cancer and their intimate partners. Methods A mixed methods single-arm, repeated measures design was used for this study. An attrition rate of ≤25% was considered feasible. Intervention experiences were assessed via interviews, and preliminary effects on the Dyadic Sexual Communication Scale, relationship quality measured by the Revised Dyadic Adjustment Scale, and sexual health measured by PROMIS Sexual Function and Satisfaction version 2.0 were explored quantitatively. Results In total, 7 (77%) of the 9 couples completed the study through week 6 and provided both pre- and poststudy data, resulting in an attrition rate of 22% (2/9), which met the feasibility benchmark for attrition of 25% or less. The following two themes emerged: (1) PEPP helped us start difficult conversations and impacted emotional and physical intimacy. The intervention adherence was 85%. Dyadic Sexual Communication Scale scores improved with a mean change score of 6.64 (SD 9.65) and a Cohen d of 0.69. Revised Dyadic Adjustment Scale scores declined slightly, with a mean change score of –0.93 (SD 3.41) and a Cohen d of 0.27. PROMIS Sexual Function and Satisfaction version 2.0 scores showed small improvements for women on desire, with a mean change score of 2.36 (SD 6.24) and a Cohen d of 0.38. Similarly, for women, the satisfaction mean change score was 2.20 (SD 8.22) and a Cohen d of 0.27. For intimate partners, a small effect was found for desire, but in this instance, desire decreased with a mean change score of –1.57 (SD 6.09) and a Cohen d of 0.26. Conclusions The findings support PEPP as a feasible intervention for improving sexual communication. If proven effective in a randomized controlled trial, it has the potential to address the critical gap in supportive care among female cancer survivors. Trial Registration ClinicalTrials.gov NCT05070299; https://clinicaltrials.gov/study/NCT05070299