title: Protocol for a cluster randomised trial of a communication skills intervention for physicians to facilitate survivorship transition in patients with lymphoma.
abstract: Survivors of cancer often describe a sense of abandonment post-treatment, with heightened worry, uncertainty, fear of recurrence and limited understanding of what lies ahead. This study examines the efficacy of a communication skills training (CST) intervention to help physicians address survivorship issues and introduce a new consultation focused on the use of a survivorship care plan for patients with Hodgkin's lymphoma and diffuse large B-cell lymphoma.
  
  
  
  Specifically, this randomised, 4-site trial will test the efficacy of a survivorship planning consultation (physicians receive CST and apply these skills in a new survivorship-focused office visit using a survivorship plan) with patients who have achieved complete remission after completion of first-line therapy versus a control arm in which physicians are trained to subsequently provide a time-controlled, manualised wellness rehabilitation consultation focused only on discussion of healthy nutrition and exercise as rehabilitation postchemotherapy. The primary outcome for physicians will be uptake and usage of communication skills and maintenance of these skills over time. The primary outcome for patients is changes in knowledge about lymphoma and adherence to physicians' recommendations (eg, pneumococcus and influenza vaccinations); secondary outcomes will include perceptions of the doctor-patient relationship, decreased levels of cancer worry and depression, quality of life changes, satisfaction with care and usage of healthcare. This study will also examine the moderators and mediators of change within our theoretical model derived from Leventhal's Common-Sense Model of health beliefs.
  
  
  
  This study was approved by the Institutional Review Boards at Memorial Sloan Kettering Cancer Centers and all other participating sites. This work is funded by the National Cancer Institute (R01 CA 151899 awarded to DWK and SH as coprincipal investigators). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute (NCI) or the National Institutes of Health (NIH). The study findings will be disseminated to the research and medical communities through publication in peer-reviewed journals and through presentations at local, national and international conferences.
  
  
  
  NCT01483664.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Parker
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Smita C
authors.initials: SC
authors.lastname: Banerjee
authors.affiliation: Department of Medicine, Weill Cornell Medical College, New York, New York, USA Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Matasar
authors.affiliation: Department of Communication Studies, Hamad Medical Corporation, Doha, Qatar Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Carma L
authors.initials: CL
authors.lastname: Bylund
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Kara
authors.initials: K
authors.lastname: Franco
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Yuelin
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Tomer T
authors.initials: TT
authors.lastname: Levin
authors.affiliation: Divison of Population Science, Moffitt Cancer Center, Tampa, Florida, USA.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.affiliation: Department of Medicine, Mamonides Cancer Center, New York, New York, USA.
authors.forename: Alan B
authors.initials: AB
authors.lastname: Astrow
authors.affiliation: Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Leventhal
authors.affiliation: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Horwitz
authors.affiliation: Department of Psychiatry, Monash University, Clayton, Victoria, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Kissane
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000073116:Cancer Survivors / Q000523:psychology*; D002983:Clinical Competence; D003142:Communication; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010817:Physician-Patient Relations; D010820:Physicians / Q000592:standards; D011788:Quality of Life; D012107:Research Design; D000073859:Survivorship; D014481:United States; D055815:Young Adult
keywords: communication; survivorship