Assessment, Development and Application of Positive Psychology Science for Cancer

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Abstract: This career development application proposes a mentored training and research experience to develop John Salsman, Ph.D., as an independent investigator in the development of innovative positive psychological outcome measures for cancer prevention and control. Patient-reported outcomes (PROs) capture the patient's unique perspective on the impact of chronic diseases such as cancer and assess subjective experience in ways distinct from physiological outcomes. The Patient-Reported Outcomes Measurement Information System (PROMIS) is an NIH Roadmap initiative designed to improve and standardize PROs for patients with a wide range of chronic diseases and demographic characteristics using state-of-the-art psychometric methods. It is an ambitious and comprehensive PRO measurement system that applies item response theory (IRT) modeling to health status assessment. PROMIS has developed and calibrated item banks assessing emotional distress, sleep-wake function, physical function, pain, fatigue, and social health. There remains a gap in the PROMIS domain framework, with no current banks assessing positive psychological functioning (PPF). As more people survive and even thrive with cancer, understanding positive adjustment and growth in cancer is an important complement to understanding impairment, disability and psychosocial morbidity in cancer prevention and control research. Dr. Salsman proposes (1) to develop new item banks for positive psychological functioning (PPF) to augment and expand the existing PROMIS item banks, (2) to explore the utility of the PPF banks across the cancer care continuum using multiple assessments with a heterogeneous group of cancer patients and survivors, and (3) to adapt and pilot test an intervention to promote well-being among young adult cancer patients and survivors to determine feasibility and acceptability. Results will lead to further refinement of innovative measures of PPF and guide development of future interventions to minimize the adverse impact of cancer and enhance adaptive functioning. The proposed research is supported by a training plan that involves interactions with multidisciplinary colleagues and formal coursework in clinical trials, qualitative methodologies, biostatistics, psychometrics, and positive psychology.