Cancer Care


Participation Restrictions in Young-Middle Adult Rural Breast Cancer Survivors
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Study Number
This project will develop and preliminarily evaluate an intervention to assist young-middle
adult rural breast cancer survivors to overcome functional impairments related to their
cancer treatment. Younger breast cancer survivors (below age 60) have ongoing family, social
and vocational responsibilities and recreational interests and are at increased risk of
developing long-term difficulties performing these valued activities (participation
restrictions). Rural cancer survivors are medically underserved and due to distance and
geographic isolation face significant barriers to accessing traditional rehabilitation
services. Alternative rehabilitation approaches are sorely needed for this population. Based
on previous research with cancer and other medical populations a working draft of a
treatment manual using a telephone-delivered Behavioral Activation and Problem Solving
(BA/PS) intervention has been designed. Prior to testing the intervention in a randomized
clinical trial, additional work must be completed. The specific aims of this study are to a.
refine the BA/PS treatment manual, b. develop and apply treatment integrity measures for the
BA/PS manual, c. assess participation restrictions and associated outcomes, d. preliminarily
assess the immediate and maintenance effects of BA/PS, and e. examine mediators and
moderators of BA/PS effects based on our "Self Regulation" model of functional recovery. 188
young-middle adult breast cancer survivors will be screened for participation restrictions
following cancer treatment and 40 survivors with participation restrictions will receive
BA/PS delivered by phone. BA/PS participants will be assessed for treatment effectiveness
and interviewed regarding their experiences during treatment to provide information for
refining the manual. The long-term objective of this line of research is to develop
effective and feasible treatments for the medical and psychosocial consequences of cancer
and its treatment in medically underserved cancer survivors (e.g., rural populations).
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