Randomized controlled trial to test feasibility of a culturally adapted meditation-based support intervention for Black patients dealing with advanced cancer

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PROJECT SUMMARY/ABSTRACT Although mind-body interventions effectively improve psychological and physical symptoms among cancer patients, few studies have included Black cancer patients. In particular, none exists that targets Black cancer patients dealing with advanced cancer, who are vulnerable to unmanaged symptoms and report greater symptom severity and burden than their non-Hispanic White (NHW) counterparts. Prior to evaluating definitive efficacy in this population fundamental aspects regarding the feasibility and acceptability of a mind-body intervention, particularly in the area of intervention format, must be examined. For instance, while mind-body interventions are typically delivered in group-based settings, the palliative care literature has increasingly identified the need to include family caregivers in supportive care interventions as they play a central role in patients’ healthcare. This family-based approach may allow for patient-caregiver discussions pertaining to joint coping with the cancer diagnosis and also addressing caregivers’ psychological distress, which often reach clinical levels. However, such a family-based intervention may inadvertently decrease access to care, if many Black patients do not have family members who are consistent care providers or able/willing to participate jointly in the intervention. It is currently unknown whether a family-based mind-body practice is feasible and acceptable in Black patients with advanced cancer. To address these critical knowledge gaps, the objective of the proposed research is to determine the feasibility of implementing a culturally adapted mind-body intervention (Meditation- Based Support-Adapted; MBS-A) as a supportive care strategy in Black patients diagnosed with advanced cancer. The original MBS intervention includes four 60-minute sessions delivered over 4 weeks that integrates guided meditations (e.g., mindfulness, compassion, gratitude) with emotional processing techniques, which have previously been tested in predominantly NHW patient-caregiver dyads as well as in a patient group setting. To determine the intervention format for the MBS-A program (family- vs group-based) and solicit input on the original MBS intervention regarding content that needs adaptation, we will first conduct formative research that includes quantitative surveys and in-depth interviews of patients and their primary caregivers. Once the intervention format is determined and content adapted, we will conduct a randomized controlled trial (RCT) to examine the feasibility of the MBS-A intervention vs. a dose-matched attention control arm receiving a psychoeducation intervention. Participants will be assessed at baseline (prior to randomization) and 6 and 12 weeks later. Primary outcomes include indicators of feasibility regarding the overall RCT design and intervention-specific procedures. Results of this study will inform future research in which effects and mechanisms of the intervention will be tested using fully powered samples of Black advanced cancer patients to ultimately improve health in this underserved patient population.