Research and observations confirm that cancer survivors experience significant stress throughout cancer treatment and especially during transition back to normal life. Their stressors, which are particularly severe for disadvantaged patient groups and those with medical comorbidities, can interfere with the patient ability to make reasoned and timely decisions about survivorship care. As survival rates have increased, it has become evident that decisions made in the early stages of survivorship can have profound long-term health consequences, for both patients and their caregivers. The ultimate goal is to help cancer survivors cope more effectively with decision making and distress and effectively use survivorship care plans (SCP) provided by their oncologists. Over the past 20 years, Dr. Sahler, one of the study MPIs, and colleagues have developed and tested problem-solving skills training (PSST) interventions for mothers of children diagnosed with cancer. Their findings clearly show that PSST significantly increases problem-solving skills and decreases negative affectivity in mothers from a variety of racial, ethnic, and socioeconomic backgrounds. A large body of literature also demonstrates that negative affectivity and poor problem-solving skills are associated with poor SCP adherence as well as poor quality of life, low physical and social functioning and poor prognosis in patients with cancer. In this 2-year study, the team will first adapt the Bright IDEAS PSST intervention and supportive materials to maximize learning potential for adult cancer survivors and their caregivers (SA1). The acceptability (SA2) and feasibility (SA3) of offering an 8-week PSST to distressed cancer survivors and their caregivers will then be assessed. The patient-reported outcomes evaluations will be collected at randomization and at 3 and 6 months later. The four acceptability objectives of the Bright IDEAS-AC Study will assess: (1) burden of patient- reported data collection; (2) compliance with 8-session SCP-specific PSST intervention; (3) barriers to consistent participation of supportive others (SO) in PSST; and (4) recruitment rates for a future trial. The team will also collect patient healthcare utilization data to test whether patients in the PSST arm will have fewer hospital and ED admissions than care-as-usual (CAU) patients. Finally, the outside consultant will interview patients, caregivers and providers about any threats to the intervention sustainability and organizational barriers to its adaptation. The evidence from this pilot study will help guide development of a future multi-site randomized clinical trial of the effect of PSST on cancer survivorship care. To account for regional variation in care delivery, the study will be conducted in three oncology clinics from different regions which have collaborated before on a PCORI Engagement Project that developed a regional virtual oncology network (contract #2481-Rochester).
The goal of this study is to assess feasibility and acceptability of problem solving skills training among colorectal cancer survivors. These results will be used to develop and test a novel intervention (Bright IDEAS- AC) to help improve health and function of cancer survivors by increasing utilization of cancer survivorship plans in a multi-site randomized pragmatic trial.
