DEVELOPMENT, FEASIBILITY, AND ACCEPTABILITY OF A BEHAVIORAL WEIGHT AND SYMPTOM MANAGEMENT INTERVENTION FOR BREAST CANCER SURVIVORS AND INTIMATE PARTNERS.
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BackgroundWeight gain is common for breast cancer survivors and associated with disease progression, recurrence, and mortality. Traditional behavioral programs fail to address symptoms (i.e., pain, fatigue, distress) experienced by breast cancer survivors that may interfere with weight loss and fail to capitalize on the concordance in weight-related health behaviors of couples. This study aimed to develop and examine the feasibility and acceptability of a behavioral weight and symptom management intervention for breast cancer survivors and their intimate partners.
Materials and methodsInterviews were conducted with N=14 couples with overweight/obesity to develop the intervention. Intervention feasibility and acceptability were examined through a single-arm pilot trial (N=12 couples). Patterns of change in intervention targets were examined for survivors and partners.
ResultsThemes derived from interviews were used to develop the 12-session couple-based intervention, which included components from traditional behavioral weight management interventions, appetite awareness training, and cognitive and behavioral symptom management protocols. Couples also worked together to set goals, create plans for health behavior change, and adjust systemic and relationship barriers to weight loss. Examples were tailored to the experiences and symptom management needs of breast cancer survivors and partners. The intervention demonstrated feasibility (attrition: 8%; session completion: 88%) and acceptability (satisfaction). Survivors and partners experienced reductions in weight and improvements in physical activity, eating behaviors, emotional distress, and self-efficacy. Survivors evidenced improvements in fatigue and pain.
ConclusionsA behavioral weight and symptom management intervention for breast cancer survivors and partners is feasible, acceptable, and is potentially efficacious.
Published Version (Please cite this version)
Dorfman, Caroline S, Tamara J Somers, Rebecca A Shelby, Joseph G Winger, Michele L Patel, Gretchen Kimmick, Linda Craighead, Francis J Keefe, et al. (2022). DEVELOPMENT, FEASIBILITY, AND ACCEPTABILITY OF A BEHAVIORAL WEIGHT AND SYMPTOM MANAGEMENT INTERVENTION FOR BREAST CANCER SURVIVORS AND INTIMATE PARTNERS. Journal of cancer rehabilitation, 5. pp. 7–16. 10.48252/jcr57 Retrieved from https://hdl.handle.net/10161/27275.
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Caroline Dorfman, Ph.D. is an Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Duke University. Dr. Dorfman is a member of the Pain Prevention and Treatment Research Program and the Cancer Symptom Management and Support Program within the Duke Department of Psychiatry and Behavioral Sciences. She is also a member of the Duke Cancer Institute where she serves as the Director of Research and Behavioral Medicine for the Duke Teen and Young Adult Oncology Program. Dr. Dorfman completed her graduate training in clinical psychology at the Ohio State University and her clinical internship at Duke University Medical Center. Her research focuses on developing, implementing, and evaluating psychosocial and behavioral interventions designed to meet the needs of cancer survivors and their partners/families. She is particularly interested in conducting research to address the unique needs of adolescent and young adult cancer survivors.
Tamara J. Somers, PhD, is a Clinical Psychologist and Faculty Member in the Department of Psychiatry and Behavioral Sciences. Dr. Somers conducts research developing, testing, and implementing behavioral interventions for pain and other symptoms in patients with chronic disease (e.g., cancer, arthritis). She is particularly interested in developing behavioral interventions that are personalized to the needs of individual patients and using innovative delivery methods to deliver the interventions. Grant awards from the NIH, American Cancer Society, and other funding agencies support her research. Dr. Somers also co-directs a clinical psychology training program at the Duke Cancer Institute (DCI) that trains graduate students, clinical psychology interns, and post-doctoral fellows in psychosocial and behavioral symptom management interventions.
Rebecca Shelby, Ph.D. is an Associate Professor with Tenure in the Department of Psychiatry and Behavioral Sciences at Duke University and the Director of Education and Training for the Duke Cancer Patient Support Program. Dr. Shelby is a member of the Duke Pain Prevention and Treatment Research Program and the Duke Cancer Control and Population Sciences Program. Dr. Shelby completed her graduate training in clinical psychology at the Ohio State University and her clinical internship and postdoctoral fellowship at Duke University Medical Center. Her research focuses on developing and evaluating behavioral interventions for cancer patients, management of cancer pain and treatment side effects, and improving adherence to recommended care. Dr. Shelby serves on the Duke clinical psychology internship faculty and supervises clinical psychology fellows, interns, and clinical psychology graduate practicum students completing clinical rotations as part of the Duke Cancer Patient Support Program.
Joseph G. Winger, PhD, is a licensed clinical psychologist and an Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. Dr. Winger's research focuses on developing and testing novel psychosocial interventions for patients facing life-limiting illnesses. His work emphasizes addressing spiritual and existential aspects of coping with debilitating symptoms, particularly maintaining a sense of meaning and purpose in life. Grants from the American Cancer Society and National Palliative Care Research Center have supported his research. Dr. Winger also serves as co-director of the Cognitive Behaviorally Informed Skills Training (CBIST) Program for Physical and Occupational Therapists. The CBIST program trains non-behavioral health specialists, specifically PTs and OTs, to integrate evidence-based cognitive and behavioral skills into their clinical practice to improve quality of care and patient outcomes. To date, more than 300 PTs and OTs have completed the CBIST program.
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