Feasibility, acceptability, and preliminary efficacy of a technology-assisted psychosocial intervention for racially diverse men with advanced prostate cancer.
BACKGROUND
The utility of psychosocial interventions in reducing symptom burden and improving health-related quality of life (HRQOL) for men with localized prostate cancer has been demonstrated. However, studies have yet to demonstrate the efficacy of interventions in advanced prostate cancer (APC). This study examined the feasibility, acceptability, and preliminary efficacy of a technology-assisted, 10-week, group-based psychosocial intervention for diverse men with APC.


METHODS
The participants were 74 men (mean age, 68.84 years; non-Hispanic white, 57%; black, 40.5%) who were randomized to a cognitive-behavioral stress management (CBSM) treatment or health promotion (HP) attention-control condition. The participants were assessed at the baseline, weekly throughout the 10-week program, and 6 months after the baseline. Outcomes were assessed with the Patient-Reported Outcomes Measurement Information System along with established measures of HRQOL, CBSM intervention targets (eg, relaxation skills), and patient-reported acceptability.


RESULTS
Feasibility was demonstrated through good retention rates (>85%) and acceptable average attendance rates (>70%), and acceptability was demonstrated through very favorable weekly session evaluations (mean score, 4/5) and exit surveys (mean score, 3.6/4). Men randomized to the CBSM condition reported significant reductions (P < .05) in depressive symptoms and improvements in relaxation self-efficacy (P < .05) at the 6-month follow-up. CBSM participants reported trends for improvement in distress and functional well-being (P < .08) in comparison with those in the HP condition. Effect sizes ranged from medium (0.54) to large (1.87) and, in some instances, were clinically meaningful.


CONCLUSIONS
Technology-based CBSM interventions among diverse men with APC may be feasible, acceptable, and efficacious.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Betina
B
Yanez
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Heather L
HL
McGinty
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
David C
DC
Mohr
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Mark J
MJ
Begale
Mental Health and Behavioral Sciences Service, Miami Veterans Affairs Healthcare System, Miami, Florida.
Jason R
JR
Dahn
Department of Urology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Sarah C
SC
Flury
Department of Urology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Kent T
KT
Perry
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Frank J
FJ
Penedo
D001741:Black or African American / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology*; D011788:Quality of Life; D020377:Self Efficacy; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D044465:White People / Q000523:psychology
eHealth; prostate cancer; psychosocial aspects; quality of life; randomized trial