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CompletedNCT03465813Updated Sep 25, 2023

Reducing Distress and Depressive-symptoms in Rural Women

An interventional study of CaringGuidance After Breast Cancer Diagnosis in Breast Cancer and Psychological Adjustment, sponsored by University of Nebraska. Completed at 1 site in United States. Open to female participants aged 19 Years to 85 Years. Per ClinicalTrials.gov, last updated 2023-09-25.

Sponsored by University of Nebraska · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
33
Allocation
Randomized
Ages
19 Years to 85 Years
Sex
Female
01

Study summary

Approximately 30% of U.S. breast cancer survivors experience significant cancer-related distress ranging from adjustment disorders, depression-symptoms and major depression up to 20 years after diagnosis. For rural cancer survivors, lack of access to care, support and stigma associated with cancer and mental health, challenge rural women's ability to prevent cancer-related distress and its deleterious outcomes. However, these barriers may be overcome by a new Internet-based psychoeducational program designed for newly diagnosed women; CaringGuidance™- After Breast Cancer Diagnosis. This self-guided program provides information, cognitive-behavioral and supportive coping strategies in a text/audio/visual format accessed via Internet/mobile devices to increase understanding and provide supportive tools to prevent/manage distress and depressive-symptoms. This pilot study will determine preliminary efficacy of the CaringGuidance™ program on distress and depressive-symptoms monthly and over 3 months, for rural women newly diagnosed with breast cancer.

Read the detailed description

Of the 3.1 million U.S. breast cancer survivors, approximately 30% experience significant cancer-related distress ranging from sub-threshold to diagnosable adjustment disorders, depression-symptoms and major depression up to 20 years after diagnosis. Rural cancer survivors report poorer mental health than urban survivors. Lack of access to care, support and stigma associated with cancer and mental health, challenge rural women's ability to prevent cancer-related distress and its deleterious outcomes. These barriers may be overcome by a new Internet-based, psychoeducational program designed for newly diagnosed women; CaringGuidance™- After Breast Cancer Diagnosis. This self-guided program provides information, cognitive-behavioral and supportive coping strategies in a text/audio/visual format accessed via Internet/mobile devices to increase understanding, and provide supportive tools to prevent/manage distress and depressive-symptoms.

The aims of this pilot study are to determine preliminary efficacy of the CaringGuidance™ program on distress and depressive-symptoms monthly and over 3 months, for rural women newly diagnosed with breast cancer, and trial measures and methods, prior to a fully powered randomized controlled clinical trial.

Sixty rural women, will be randomized to 3 months of self-guided CaringGuidance™ program access with usual care or usual care alone. Both groups complete monthly standard psychosocial measures, daily activity/symptom logs and receive a monthly call. Program engagement/dose will be measured by the CaringGuidance™ internal data system. Descriptive and inferential statistics will characterize the sample and determine differences between groups at monthly intervals and overall. Variability of outcome variables will also be assessed to determine usefulness.

02

Conditions studied

  • Breast Cancer
  • Psychological Adjustment
03

Who can participate

Ages eligible
19 Years to 85 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • experiencing their first, stage 0 - IIIA breast cancer diagnosis (either clinical or definitive early stage at enrollment), and be 19 to 85 years of age,
  • enroll \< 3 months post-diagnosis (as soon as possible after diagnosis is desirable),
  • reside in a non-metro county of the United States according to the USDA Rural-Urban Continuum Codes (6 -9) (RUCC) or at a rural zip-code by the USDA Rural Urban Commuting Area (RUCA) codes (4.0, 4.2, 5.0, 5.2, 6.0, 6.1, 7.0, 7.2-4, 8.0, 8.2-4, 9.0-2, 10.0, 10.2-6)
  • be able to read and write in English since the CaringGuidance™ program is in English,
  • have regular access (e.g. home or work) to high speed/satellite broadband Internet on desk/laptop or wireless iPad, Android or iPhone throughout the 3 months of the study,*
  • have an email address at which to receive CaringGuidance™ prompts,
  • have a Baseline Distress Thermometer score of > 4, or an Impact of Events Scale score of > 9, or Center for Epidemiological Studies Depression Scale score of > 16 (i.e. clinically meaningful thresholds).
  • Able to comprehend and provide informed consent

Exclusion criteria

Exclusion Criteria:

  • Men and women with recurrent or advanced breast cancer
  • Those mentally or physically unable to read the consent form or other study materials and/or participate in the consent and engagement with the CaringGuidance program. Women who have been hospitalized for mental health issues or substance abuse in the past year are ineligible.
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
33 participants (actual)

Study arms

  • Experimental
    CaringGuidance Intervention

    Three months of web-based CaringGuidance psychoeducational program use, independently on home computer in addition to usual care.

    Behavioral: CaringGuidance After Breast Cancer Diagnosis

  • No intervention
    Usual Care

    Three months of care as usual from subjects' clinics and community as the subject chooses.

Interventions

  • BehavioralCaringGuidance After Breast Cancer Diagnosis

    CaringGuidance After Breast Cancer Diagnosis, psychoeducational, Internet-accessible program

05

What researchers measure

Primary outcomes

  1. change from baseline in distress at 1, 2, and 3 months

    self-report of psychological distress

    Time frame: at baseline and months 1, 2, and 3

  2. change from baseline in depressive-symptoms at 1, 2, and 3 months

    self-report of depressive-symptoms

    Time frame: at baseline and months 1, 2, and 3

06

Study locations

1 site
  • University of Nebraska Medical Center, Oncology Clinics
    Omaha, Nebraska 68131, United States
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03465813
Lead sponsor
University of Nebraska
Collaborators
University of Kansas Medical Center
Responsible party
Sponsor
First posted
Mar 14, 2018
Start date
Jul 19, 2017
Primary completion
May 11, 2019
Completion
May 30, 2019
Last update
Sep 25, 2023

Study contacts

Robin M Lally, PhD
principal investigator · University of Nebraska

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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