A Novel Prosocial Online Support Group for Distressed Breast Cancer Survivors

为痛苦的乳腺癌幸存者设立的新型亲社会在线支持小组

• 批准号: 8191793
• 负责人: STEPHEN J LEPORE
• 金额: $ 20.31万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8191793
• 关键词: Access to Information; Adopted; Affect; Anxiety; Attention; Cancer Center; Cancer Patient; Cancer Survivor; Clinical Trials Design; Code; Communities; Data; Disease; Distress; Dropout; Emotional; Estimation Techniques; Future; Helping Behavior; Intention; Internet; Intervention; Malignant Neoplasms; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Modeling; North America; Outcome; Participant; Patients; Population; Protocols documentation; Provider; Psychosocial Assessment and Care; Randomized Controlled Trials; Relative (related person); Scheme; Services; Social support; Structure; Support Groups; Survivors; Symptoms; Testing; Training; base; coping; efficacy testing; group intervention; improved; innovation; male; malignant breast neoplasm; novel; outreach; peer; physical conditioning; post intervention; primary outcome; psychologic; psychological distress; psychological outcomes; psychosocial; randomized trial; satisfaction; secondary outcome; self esteem; theories

DESCRIPTION (provided by applicant): Breast cancer (BC) survivors frequently use online support groups (OSGs) to help cope with their cancer, but evidence on the efficacy of OSGs for reducing psychological distress is weak. The proposed study assesses the potential efficacy (estimate effect sizes), acceptability, feasibility, and mediators of an innovative "prosocial" OSG (PRO-OSG) for distressed BC survivors. PRO-OSG provides structured helping opportunities (blogs, outreach) and coaching on how to recognize needs and give support to others in a BC OSG. The project is based on the "helper therapy principle," which emphasizes the psychological benefits of giving (vs. receiving) help. This is the first study to evaluate a prosocial intervention in the context of an OSG. In Aim 1, we propose using a randomized trial to assess the efficacy and effect sizes of PRO-OSG relative to a standard facilitated OSG (S-OSG). We will collect data from distressed BC survivors 1 month pre- and post-intervention using valid and reliable measures appropriate for the population. Intention-to-treat analyses will be used to compare the effects of the two interventions on levels of depression/anxiety symptoms (primary outcomes) and sense of purpose (secondary outcome) (n = 180; 90 per group). We hypothesize that relative to S-OSG, PRO-OSG will have a lower level of symptoms and a higher level of sense of purpose post-intervention. Accuracy in parameter estimation techniques (AIPE) will be used to assess effect sizes on outcomes. In Aim 2, we will explore: (a) if the benefits of PRO-OSG on psychological symptoms are mediated by greater increases in positive affect, self-esteem, and sense of belonging among participants in the PRO-OSG versus S-OSG group; (b) if the benefit of PRO-OSG on sense of purpose is mediated by a greater increase in sense of belonging in the PRO-OSG versus S-OSG; and (c) if sense of belonging indirectly improves psychological symptoms by increasing sense of purpose. AIPE will be used to assess effect sizes on mediators. In Aim 3, we will examine acceptability (e.g., retention, satisfaction) and feasibility (e.g., amount of helping) of the PRO- OSG. The significant outcome of this project will be an innovative, theory-based OSG intervention model that maximizes reductions in psychological distress and increases sense of purpose among distressed BC survivors. The intervention is sustainable, because it can be implemented by organizations such as the Cancer Support Community, a partner on this project and the largest provider of free psychosocial support services for cancer survivors in North America. The intervention also can be adopted by other organizations, such as cancer centers, which to date have mostly offered face-to-face support groups with limited patient reach. Future directions include developing a larger-scale trial to further evaluate PRO- OSG; evaluating PRO-OSG in other cancer populations; and developing and assessing the efficacy of PRO-OSG training protocols that will enable peer leaders (vs. helping professionals) to facilitate OSGs. PUBLIC HEALTH RELEVANCE: Depression and anxiety symptoms and disorder are highly prevalent among BC survivors and often undertreated. Depression is more prevalent among BC survivors than many other cancers populations, but existing interventions are not widely acceptable, accessible, or highly effective. The proposed study will develop and evaluate an innovative "prosocial" online support group that provides structured helping opportunities (blogs, outreach) and coaching on how to recognize needs and give support to others in an online support group for distressed BC survivors.

描述（由申请人提供）：乳腺癌（BC）幸存者经常使用在线支持团体（OSG）来帮助科普癌症，但OSG减少心理困扰的有效性的证据很弱。拟议的研究评估潜在的疗效（估计效应大小），可接受性，可行性，和调解人的创新“亲社会”的OSG（PRO-OSG）的痛苦BC幸存者。PRO-OSG提供结构化的帮助机会（博客、外展），并就如何识别需求和向BC OSG中的其他人提供支持进行辅导。该项目以“帮助者治疗原则”为基础，强调给予（与接受）帮助的心理益处。这是第一项研究，以评估亲社会干预的背景下，OSG。在目标1中，我们建议使用随机试验来评估PRO-OSG相对于标准易化OSG（S-OSG）的疗效和效应量。我们将使用适合人群的有效和可靠的措施，在干预前和干预后1个月收集来自困境BC幸存者的数据。意向治疗分析将用于比较两种干预措施对抑郁/焦虑症状（主要结局）和目的感（次要结局）水平的影响（n = 180;每组90例）。我们假设相对于S-OSG，PRO-OSG在干预后的症状水平较低，目标感水平较高。将使用参数估计技术的准确性（AIPE）评估结局的效应量。在目标2中，我们将探讨：（a）PRO-OSG组与S-OSG组相比，PRO-OSG对心理症状的益处是否由积极情感、自尊和归属感的更大增加介导;（B）PRO-OSG对目的感的益处是否由PRO-OSG与S-OSG组相比，归属感的更大增加介导;以及（c）归属感是否通过增加目标感而间接改善心理症状。AIPE将用于评估介质的效应量。在目标3中，我们将检查可接受性（例如，保留、满意度）和可行性（例如，帮助量）的PRO- OSG。该项目的重大成果将是一个创新的，以理论为基础的OSG干预模式，最大限度地减少心理困扰，并增加痛苦的BC幸存者的目的感。干预措施是可持续的，因为它可以由癌症支持社区等组织实施，该社区是该项目的合作伙伴，也是北美最大的癌症幸存者免费心理社会支持服务提供者。其他组织也可以采用这种干预措施，如癌症中心，迄今为止，这些中心主要提供面对面的支持小组，患者接触范围有限。未来的方向包括开发更大规模的试验，以进一步评估PRO-OSG;评估PRO-OSG在其他癌症人群中的作用;以及开发和评估PRO-OSG培训方案的有效性，使同行领导者（与帮助专业人员）能够促进OSG。 公共卫生相关性：抑郁和焦虑症状和障碍在不列颠哥伦比亚省幸存者中非常普遍，而且往往治疗不足。抑郁症在BC幸存者中比许多其他癌症人群更普遍，但现有的干预措施并不被广泛接受，可获得或高度有效。拟议的研究将开发和评估一个创新的“亲社会”在线支持小组，提供结构化的帮助机会（博客，外展）和辅导，如何认识到需要，并给予支持，以其他人在一个在线支持小组的痛苦BC幸存者。