This project will develop and preliminarily evaluate an intervention to assist young-middle adult rural breast cancer survivors to overcome functional impairments related to their cancer treatment. Younger breast cancer survivors (below age 60) have ongoing family, social and vocational responsibilities and recreational interests and are at increased risk of developing long-term difficulties performing these valued activities (participation restrictions). Rural cancer survivors are medically underserved and due to distance and geographic isolation face significant barriers to accessing traditional rehabilitation services. Alternative rehabilitation approaches are sorely needed for this population. Based on previous research with cancer and other medical populations a working draft of a treatment manual using a telephone-delivered Behavioral Activation and Problem Solving (BA/PS) intervention has been designed. Prior to testing the intervention in a randomized clinical trial, additional work must be completed.
The specific aims of this study are to a. refine the BA/PS treatment manual, b. develop and apply treatment integrity measures for the BA/PS manual, c. assess participation restrictions and associated outcomes, d. preliminarily assess the immediate and maintenance effects of BA/PS, and e. examine mediators and moderators of BA/PS effects based on our """"""""Self Regulation"""""""" model of functional recovery. 188 young-middle adult breast cancer survivors will be screened for persistent participation restrictions at 3-6 months following cancer treatment and 40 survivors with persistent participation restrictions will receive BA/PS delivered by phone. BA/PS participants will be assessed for treatment effectiveness and interviewed regarding their experiences during treatment to provide information for refining the manual. The long-term objective of this line of research is to develop effective and feasible treatments for the medical and psychosocial consequences of cancer and its treatment in medically underserved cancer survivors (e.g., rural populations).

Public Health Relevance

Narrative Breast cancer treatment can lead to functional interference in cancer survivors over both the short and long-term. This adversely affects quality of life and economic productivity. Alternative rehabilitation approaches are sorely needed for medically underserved populations (e.g., rural).

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21CA140849-02
Application #
8073129
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Alfano, Catherine M
Project Start
2010-05-17
Project End
2013-04-30
Budget Start
2011-05-01
Budget End
2013-04-30
Support Year
2
Fiscal Year
2011
Total Cost
$200,004
Indirect Cost
Name
Dartmouth College
Department
Psychiatry
Type
Schools of Medicine
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
03755
Lyons, Kathleen D; Hull, Jay G; Kaufman, Peter A et al. (2015) Development and initial evaluation of a telephone-delivered, behavioral activation, and problem-solving treatment program to address functional goals of breast cancer survivors. J Psychosoc Oncol 33:199-218
Lyons, Kathleen D; Svensborn, Ingrid A; Kornblith, Alice B et al. (2015) A Content Analysis of Functional Recovery Strategies of Breast Cancer Survivors. OTJR (Thorofare N J) 35:73-80