Expanding Rural Access: Distance Delivery of Support Groups (Main Study)

Inclusion Criteria:To be eligible to participate, a woman must meet all of the following
criteria:

   1. be a resident of one of nine rural counties in northeastern California (Modoc, Plumas,
   Siskiyou, Shasta, Lassen, Trinity, Sierra, Nevada, and Tehama),

   2. be able to travel to a rural health facility included in the Northern Sierra Rural
   Health Network to participate in videoconferencing meetings;

   3. be able to speak and read English well enough to be able to read, discuss, and
   comprehend the consent form;

   4. be 21 years of age or older;

   5. have been diagnosed with breast cancer by a physician; and

   6. who (in the judgment of the Local Coordinator) is not unduly distressed or otherwise
   not able to participate effectively in a support group.

Women will be included with any stage of breast cancer as our pilot study demonstrated that
in these rural communities, women wanted to include women with any stage of breast cancer
in their groups. Also, our pilot study results showed that it worked fine to include women
regardless of the period elapsing since they received their diagnosis, as our pilot study
results showed that some women with a long period of time elapsing since receiving their
diagnosis were still in need of a source of social support for coping with having had this
experience and felt that they had a lot of help to offer women who had more recently
received a breast cancer diagnosis. The 9 counties were selected because they are among the
most remote counties in California, yet they have strong primary care systems in place, and
most patients receive specialty care in-state, as opposed to out-of-state. Every effort
will be made to include women of ethnic minority groups.

The support group facilitator, community advisory board (CAB) members, and the local
community coordinators will also be recruited for the interviews, with informed consent,
identified by having played one of these roles for this study.

Exclusion Criteria:Potential participants who do not meet all of the inclusion criteria
listed above will be excluded.