title: Evaluation of Pillars4life: a virtual coping skills program for cancer survivors.
abstract: OBJECTIVE
  Pillars4Life is an educational program that teaches coping skills to cancer patients in a virtual group setting; it was recently implemented at 17 hospitals across the USA. The cost-effective, scalable, and assessable Pillars4Life curriculum targets psychosocial resources (e.g., self-efficacy and coping skills) as a means to reduce symptoms (e.g., depression, anxiety, and posttraumatic stress) and enhance quality of life.
  
  
  METHODS
  Cancer patients were recruited from hospitals that received the LIVESTRONG Community Impact Project Award to enroll in a pilot study of Pillars4Life. Consenting participants met with a certified instructor weekly for 10 weeks in a virtual environment; the manualized intervention trained participants in personal coping skills. Longitudinal assessments over 6 months were assessed using validated instruments to determine changes in Pillars4Life targeted resources and outcomes. Multiple linear regression models examined the relationship between changes in targeted resources and changes in outcome from baseline to 3 months post-intervention.
  
  
  RESULTS
  Participants (n = 130) had the following characteristics: mean age of 56 ± 11 years, 87% women, 11% non-Caucasian, and 77% with college degree. At 3- and 6-month follow-up, mean scores improved on all key outcome measures such as depression (Patient Health Questionnaire), anxiety (Generalized Anxiety Disorder), posttraumatic stress (Posttraumatic Stress Disorder Checklist), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), and well-being (Functional Assessment of Cancer Therapy-General) from baseline (all p < 0.01); results were most pronounced among participants who reported ≥4/10 on the Distress Thermometer at baseline (all p < 0.001). Changes in each targeted resource were associated with 3-month improvements in at least one outcome.
  
  
  CONCLUSIONS
  Participation in the Pillars4Life program was associated with statistically and clinically significant improvements in scores on pre-specified outcomes and targeted resources.
authors: Duke University School of Nursing, Durham, NC, USA.|Duke Clinical Research Institute, Durham, NC, USA.|Duke Cancer Institute, Durham, NC, USA.
authors: Sophia K
authors: SK
authors: Smith
authors: Duke Clinical Research Institute, Durham, NC, USA.|Duke University School of Medicine, Durham, NC, USA.
authors: Jonathan D
authors: JD
authors: O'Donnell
authors: Duke University School of Nursing, Durham, NC, USA.|Duke Clinical Research Institute, Durham, NC, USA.|Duke Cancer Institute, Durham, NC, USA.|Duke University School of Medicine, Durham, NC, USA.|Duke Department of Medicine, Division of Medical Oncology, Durham, NC, USA.
authors: Amy P
authors: AP
authors: Abernethy
authors: Pillars4Life Inc., Los Angeles, CA, USA.
authors: Kristin
authors: K
authors: MacDermott
authors: Pillars4Life Inc., Los Angeles, CA, USA.
authors: Tina
authors: T
authors: Staley
authors: Duke Clinical Research Institute, Durham, NC, USA.|Duke University School of Medicine, Durham, NC, USA.|Duke Department of Biostatistics and Bioinformatics, Durham, NC, USA.
authors: Gregory P
authors: GP
authors: Samsa
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000517:prevention & control; D003863:Depression / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010865:Pilot Projects; D015397:Program Evaluation; D011788:Quality of Life; D020377:Self Efficacy; D013313:Stress Disorders, Post-Traumatic / Q000517:prevention & control; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D014584:User-Computer Interface
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