The proposed study extends a successful nursing intervention for breast cancer patients to Caucasian and African-American men with Stage B prostate cancer and to their family care provider (FCP). This investigation provides a further test of the efficacy of the intervention with a different population and, including subset the family care provider, enables a test of two different structures for receiving the intervention: direct receipt or direct plus supplemented receipt via the FCP. The purposes of this study are: 1) to determine the effectiveness of an uncertainty management intervention delivered by a nurse via, telephone using two different structures for treatment delivery: directly to the patient, or directly to the patient plus supplemented through a family care provider in increasing compliance with treatment and enhancing quality of life; 2) to identify the characteristics of patients most in need of the intervention by examining, prior to the intervention, which person factors, disease factors and contextual factors are predictors of uncertainty, and life quality among Caucasian and African-American men diagnosed with stage B prostate cancer; 3) to determine the characteristics of patients with most benefit from the intervention by a) identifying whether the treatment is more effective for men predicted as needing the intervention based on person, disease and contextual factors associated with uncertainty at baseline; b) identifying,the effects of person, disease, and contextual factors plus time as mediators and moderators of treatment effectiveness on compliance with treatment, uncertainty, and life quality among experimental subjects; 4) to determine characteristics of the content and structure of the uncertainty management intervention that predict successful treatment outcomes; 5) to evaluate the dissemination procedure and utilization of the uncertainty management intervention by oncology nurses in community practice; 6) to estimate the cost effectiveness of the utilization of the uncertainty management protocol in practice. The design is a 3 X 2 repeated measures design with three levels of treatment (uncertainty management direct, uncertainty management direct plus supplemented and natural control condition) crossed with two levels of ethnicity (Caucasian and African-American). The measures are taken at baseline and 4 and 7 months post baseline. The intervention runs for 10 weeks and is delivered via weekly telephone calls. Multivariate models will be used to test for intervention effects, treatment need and benefit. During the final year of the study, efforts will be focused on disseminating the intervention protocol to oncology nurses in North Carolina through workshops conducted via the AHEC system. The utilization of the intervention and the costs associated with its adoption into practice will be estimated.
