Although considerable research attention has addressed the psychosocial concerns of breast cancer patients, little is known about the transition from active treatment to survivorship. Clinical experience and limited data suggest that this period can be particularly stressful. In this competing continuation, the investigators propose to develop and evaluate a relatively low-cost psycho-educational preparatory intervention to facilitate this transition. The proposed study builds on their prior research program in quality of life and breast cancer. In this multi-center study, the investigators will register 1260 newly-diagnosed breast cancer patients from Los Angeles, Washington, D.C., and Kansas City, Kansas, one month after definitive surgery, and prospectively recruit them for participation in a randomized controlled trial (RCT) designed to test and evaluate three different intervention approaches for improving post-treatment patient outcomes. The interventions will occur after the completion of primary/adjuvant therapy. They expect to consent and randomize at least 630 women to one of 3 groups: (A) CONTROL CONDITION: standard written information (NCI publication """"""""Facing Forward""""""""); (B) MINIMAL INTERVENTION: control + videotape that models coping and addresses the transition from patient to survivor; and HIGH INTENSITY INTERVENTION: minimal intervention + brief counseling (one in-person session with follow-up telephone call) + additional written materials. They hypothesize that a brief, preparatory intervention that includes counseling will be the most effective strategy for improving quality of life during the transition for patient to survivor.
The specific aims of this application are: (1) to measure the impact of the three preparatory interventions on subsequent cognitive adaptation, and emotional, physical and interpersonal functioning, 2 and 6 months after the intervention; (2) to evaluate a model derived from self-regulation and stress and coping theories which postulates that promotion of realistic expectancies regarding the treatment transition and of specific approach-oriented coping strategies will serve as mediators of the intervention's effectiveness on adaptive outcomes; (3) to conduct an economic evaluation of the RCT strategies, and to calculate the incremental costs per unit change in specific dimensions of quality of life.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA063028-08
Application #
6350155
Study Section
Behavioral Medicine Study Section (BEM)
Program Officer
O'Mara, Ann M
Project Start
1994-04-15
Project End
2002-07-31
Budget Start
2001-02-01
Budget End
2002-01-31
Support Year
8
Fiscal Year
2001
Total Cost
$571,791
Indirect Cost
Name
University of California Los Angeles
Department
Internal Medicine/Medicine
Type
Schools of Public Health
DUNS #
119132785
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Dupont, Alexandra; Bower, Julienne E; Stanton, Annette L et al. (2014) Cancer-related intrusive thoughts predict behavioral symptoms following breast cancer treatment. Health Psychol 33:155-63
Christie, Kysa M; Meyerowitz, Beth E; Stanton, Annette L et al. (2013) Characteristics of breast cancer survivors that predict partners' participation in research. Ann Behav Med 46:107-13
Moser, André; Stuck, Andreas E; Silliman, Rebecca A et al. (2012) The eight-item modified Medical Outcomes Study Social Support Survey: psychometric evaluation showed excellent performance. J Clin Epidemiol 65:1107-16
Kraemer, Lia M; Stanton, Annette L; Meyerowitz, Beth E et al. (2011) A longitudinal examination of couples' coping strategies as predictors of adjustment to breast cancer. J Fam Psychol 25:963-72
Ganz, Patricia A; Kwan, Lorna; Stanton, Annette L et al. (2011) Physical and psychosocial recovery in the year after primary treatment of breast cancer. J Clin Oncol 29:1101-9
Yanez, Betina; Edmondson, Donald; Stanton, Annette L et al. (2009) Facets of spirituality as predictors of adjustment to cancer: relative contributions of having faith and finding meaning. J Consult Clin Psychol 77:730-41
Rowland, Julia H; Meyerowitz, Beth E; Crespi, Catherine M et al. (2009) Addressing intimacy and partner communication after breast cancer: a randomized controlled group intervention. Breast Cancer Res Treat 118:99-111
Mandelblatt, Jeanne S; Cullen, Jennifer; Lawrence, William F et al. (2008) Economic evaluation alongside a clinical trial of psycho-educational interventions to improve adjustment to survivorship among patients with breast cancer. J Clin Oncol 26:1684-90
Low, Carissa A; Stanton, Annette L; Thompson, Nicole et al. (2006) Contextual life stress and coping strategies as predictors of adjustment to breast cancer survivorship. Ann Behav Med 32:235-44
Mandelblatt, Jeanne S; Lawrence, William F; Cullen, Jennifer et al. (2006) Patterns of care in early-stage breast cancer survivors in the first year after cessation of active treatment. J Clin Oncol 24:77-84

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