Randomized Study with Wait-list Control to Evaluate the Impact of a Stress Reduction Intervention Based on Mindfulness Offered Virtually to Reduce Anxiety Levels in Breast Cancer Survivors

This is a prospective, randomized clinical study, controlled by a wait-list group and blinded to the statistician, with the main objective of evaluating whether an MBSR intervention offered virtually allows reducing the levels of anxiety of BC survivors.

The randomized design will make it possible to compare participants' levels of anxiety, depression, fear of recurrence, and physical symptoms according to whether they participate in a virtual MBSR program or do not. In addition, the randomized design will reduce the possible impact of confounding variables, facilitating direct comparison between the two groups.

Invitation to the study will be made through social networks of Mexican civil associations and through the dissemination of the study by specialists in oncology. It will be done this way because the intervention through an online mindfulness program can be delivered to a considerable volume of BC survivors with internet access, regardless of their place of residence or medical care.

Participants will be assigned to the intervention group or the wait-list control group. Those randomized to the control group will not receive the MBSR intervention during the study period, while those randomized to the intervention group will participate in a virtual MBSR program, which is described below. A wait-list control group will be used with the aim that all participants have the opportunity to receive the MBSR intervention and at the same time allow comparison of the effect of the program with a group without intervention. Given that anxiety has a significant negative impact on people's well-being, it is appropriate to offer the control group the possibility of receiving an intervention if its effectiveness is demonstrated. The control group will be assessed with the study surveys at baseline, will not receive MBSR intervention for the following 8 weeks, and will subsequently be reassessed with the study surveys at the same time points as the intervention group. At the end of the recruitment and follow-up of all the participants, the study will end and the control group will be able to receive the MBSR intervention free of charge according to the preference of the participants.

BC survivors will be invited to participate through an electronic link with a selection questionnaire asking about the inclusion and exclusion criteria. In particular, the General Anxiety Disorder-7 (GAD-7) tool will allow for anxiety screening in order to determine if those interested in participating have the minimum level of anxiety required to be included in the study. Through that same electronic link, those who meet the eligibility criteria will be invited to read and sign the electronic informed consent. Those who accept will be randomly assigned to the intervention group or control group, in a 1:1 ratio considering a stratification according to the severity of anxiety measured by GAD-7 (moderate vs. severe) and menopausal status (pre- vs. post-menopause) in the questionnaire. of selection. Likewise, they will be asked for contact information (i.e., telephone and email) in order to send them the study surveys (participants in both groups) and the electronic links for the MBSR program sessions (participants in the intervention group). At this baseline time (T1), participants randomized to either group will answer the study surveys to assess symptoms of anxiety, depression, and fatigue.