This K01 application will provide the applicant, Dr. Milbury, with protected time, resources, and training to help her transition into the role of an independent researcher in the field of cancer prevention and control. Dr. Milbury's primary research interest focuses on how cancer patients and their spouses/partners cope together with the debilitating physical and psychological sequelae associated with the cancer diagnosis and treatment. Little is known about a couple-based approach to improving quality of life (QOL). A mind-body program (e.g., yoga, tai chi) that uses a couple-based approach may be particularly effective in reducing psychological and physiological symptom burden in lung cancer patients and their partners. Thus, Dr. Milbury's career goal is relevant to public health and to the scope of the National Center for Complementary and Alternative Medicine (NCCAM) because this investigation will examine the role a mind-body intervention in improving the health of cancer patients and their partners using a scientifically rigorous, multi-method assessment strategy. To help Dr. Milbury become an independent researcher, we propose a plan that will provide training and research experience under the mentorship of established, independent scientists. Training will focus on three areas: 1) complimentary and integrative medicine (CIM); 2) randomized controlled trials (RCTs); and 3) biological measurement and mechanisms. With respect to each of these areas, the applicant will complete formal coursework and other educational programs, receive hands-on training and publish research findings. Research experience will include the completion of a project that addresses two Specific Aims: 1) to develop and test the acceptability of a couple-based mind-body (CBMB) program and 2) to establish feasibility and initial efficacy of the CBMB program on subjective and objective measures of health in lung cancer patients undergoing radiotherapy and their partners. This project does not only represent a major step towards managing QOL in lung cancer patients and their partners but also towards advancing the science of mind-body medicine. To achieve these Aims, we will first conduct formative research including quantitative and qualitative methods to evaluate the experiences of 18 couples with three different mind-body practices (Hatha Yoga, Tibetan Yoga and Tai Chi) to select the most appropriate practice as the foundation of the CBMB program. We will develop content of the CBMB program based on these findings and then implement a pilot RCT of the CBMB program to examine subjective (e.g., self-report) and objective health outcomes (e.g., biological assessments, pulmonary function tests) in 50 couples coping with lung cancer and its treatment. Dr. Milbury will use the obtained pilot data to inform her applications for future grant support that will formally test the efficacy of the CBMB program. The training and research activities proposed in this application will help her become an independent researcher capable of obtaining such grant support.
This project may demonstrate the effectiveness of using a behavioral intervention to improve quality of life and symptom burden in lung cancer patients, which may even have implications for their prolonged survival. Because informal caregiving has been demonstrated to increase the risk of disease and mortality, this intervention includes patients' spouses/partners attempting to reduce emotional and physical strain associated with caregiving and to improve partners' quality of life.
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