Internet-Based Cancer Symptom Management: WRITE Symptoms

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DESCRIPTION (provided by applicant): Many individuals with cancer experience multiple, co-occurring symptoms that drastically impair functioning and quality of life. The process of trying to manage multiple symptoms can be overwhelming to patients. An innovative approach to patient education has recently been developed that should facilitate the process of managing multiple symptoms9. This proposal represents the first phase in the process of applying the representational approach to a new delivery mode (from in-person interviews to correspondence via secure internet messaging services) and to a more complex patient care situation (from management of a single, pre-determined symptom to multiple, patient-selected symptoms). We refer to this as a Written Representational intervention To Ease Symptoms, or WRITE symptoms. The specific aims of this pilot study, conducted in collaboration with the National Ovarian Cancer Coalition (NOCC), are to conduct preliminary evaluations (feasibility, acceptability, and initial efficacy) of WRITE symptoms with a sample of women with recurrent ovarian cancer. Subjects will be 90 women experiencing two or more bothersome symptoms associated with ovarian cancer recruited via mailed invitations and advertisements on the NOCC website. Women will be randomly assigned to one of 2 conditions: 1) a full baseline assessment, WRITE symptoms intervention group; and 2) a full baseline assessment, modified wait-list control group. WRITE symptoms will be delivered via secure messaging services situated on the NOCC website. Measures of symptom representations, symptom interference with life activities and quality of life will be completed by all subjects at baseline and 5 and 9 weeks later. Assessment of feasibility and acceptability will be conducted during recruitment, throughout the study period, and after subjects have completed the study. Should WRITE symptoms pass initial evaluations of feasibility, acceptability, and efficacy, knowledge gained from this pilot study will be used to plan a randomized controlled trial grant application (R01) to determine the efficacy of the intervention and the potential mechanism(s) through which the intervention has its effect.