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1. A Multi-step Approach to Adapting a Mind-Body Resiliency Intervention for Fear of Cancer Recurrence and Uncertainty in Survivorship (IN FOCUS)

Author

Daniel L. Hall PhD, Gloria Y. Yeh MD, MPH, Conall O'Cleirigh PhD, Jeffrey Peppercorn MD, MPH, Lynne I. Wagner PhD, John Denninger MD, PhD, Andrea J. Bullock MD, Helen R. Mizrach BS, Brett Goshe PhD, Tina Cheung BS, Raissa Li BS, Alexandros Markowitz BS, and Elyse R. Park PhD, MPH

Subjects
Medicine (General), R5-920, Public aspects of medicine, RA1-1270
Abstract

Background For cancer survivors, there is a paucity of fear of recurrence (FOR) interventions that integrate empirically supported mind-body and psychological skills for managing FOR and are delivered in scalable formats. Objective To adapt an evidence-based resiliency intervention to address FOR among cancer survivors. Methods A multidisciplinary team of researchers, clinicians, and patient stakeholders followed an iterative intervention adaptation process (ORBIT). In Step 1, we sought to define key FOR management skills through a literature review and feedback from stakeholders. In Step 2, we integrated findings into a treatment manual and refined procedures for in-person delivery to groups of cancer survivors, defined as adults who had completed primary cancer treatment for non-metastatic cancer. In Step 3, we conducted a single arm trial to assess initial acceptability and change in FOR severity with 23 cancer survivors (N=4 intervention groups). In Step 4, we conducted additional qualitative interviews with 28 cancer survivors (N=6 focus groups stratified by FOR severity, N=15 individual interviews) to define adaptive and maladaptive strategies for coping with FOR and to identify preferences for delivery. In Step 5, we refined the treatment manual and procedures for testing in a future pilot randomized feasibility trial. Results We identified critical feedback using a combination of qualitative and quantitative methods. The single arm trial suggested preliminary feasibility and sustained reductions in FOR severity, yet need for refinement (i.e., eligibility, delivery modality), prompting additional qualitative interviews for further targeting. The resulting intervention (IN FOCUS) is comprised of virtual, synchronous, group-delivered sessions that offer an integrated approach to FOR management by teaching cognitive-behavioral techniques, meditation, relaxation training, adaptive health behaviors, and positive psychology skills. Sessions are targeted by applying skills to FOR and associated healthcare engagement. Conclusions IN FOCUS is a targeted intervention for teaching mind-body resiliency skills to groups of cancer survivors with elevated FOR. Next steps are testing feasibility in a pilot randomized trial.

Published
2022
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2. Randomized Waitlist-Control Trial of a Web-Based Stress-Management and Resiliency Program for Adolescent and Young Adult Cancer Survivors: Protocol for the Bounce Back Study

Author

Helen Mizrach, Brett Goshe, Elyse R Park, Christopher Recklitis, Joseph A Greer, Yuchiao Chang, Natasha Frederick, Annah Abrams, Mary D Tower, Emily A Walsh, Mary Huang, Lisa Kenney, Alan Homans, Karen Miller, John Denninger, Ghazala Naheed Usmani, Jeffrey Peppercorn, and Giselle K Perez

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundThe emotional health of adolescent and young adult (AYA) cancer survivors is compromised both during and after cancer treatment. Targeted programs designed to support AYAs’ ability to cope with stress in the years following treatment completion are lacking. Mind-body programs may ameliorate the negative psychological and emotional effects of stress and assist AYAs with managing the psychosocial challenges of early survivorship. ObjectiveOur randomized waitlist-control trial aims to assess the feasibility, acceptability, and preliminary efficacy of a virtual group program (Bounce Back) to promote stress management and resiliency among posttreatment AYAs. MethodsBounce Back is a stress management and resiliency program delivered via videoconference by a trained mental health clinician. Sessions were adapted from an evidence-based mind-body program (Stress Management and Resiliency Training - Relaxation Response Resiliency Program [SMART-3RP]) grounded in relaxation response elicitation, mindfulness, cognitive behavioral therapy, and positive psychology. Seventy-two AYAs (diagnosed with cancer between ages 14 years and 29 years and had completed cancer treatment within the last 5 years) were randomly assigned to the Bounce Back program or waitlist-control group and completed assessments at baseline, 3 months postbaseline, and 6 months postbaseline. The primary aim of the study is to determine the feasibility and acceptability of the Bounce Back program. Descriptive statistics, including means, frequencies, and ranges supplemented by qualitative exit interview feedback will be used to characterize the sample and to summarize feasibility and acceptability. The exploratory aims are to evaluate the preliminary effects of the program on stress coping and psychosocial outcome measures (ie, anxiety, depression) collected across the 3 time points. ResultsThis study was funded by the National Cancer Institute in July 2017. Study procedures were approved by the Dana-Farber Harvard Cancer Center Institutional Review Board in October 2018 (Protocol 18-428). The randomized trial was conducted from July 2019 to March 2021. Quantitative data collection is complete, and qualitative exit interview data collection is ongoing. Results are expected to be published in peer-reviewed journals and presented at local, national, or international meetings in the coming years. ConclusionsFew evidence-based programs exist that tackle the key transitional issues faced by AYA cancer survivors. Future analyses will help us determine the feasibility and acceptability of the Bounce Back program and its impact on AYA stress coping and psychological well-being. Trial RegistrationClinicalTrials.gov NCT03768336; https://clinicaltrials.gov/ct2/show/NCT03768336 International Registered Report Identifier (IRRID)DERR1-10.2196/34033

Published
2022
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3. World Congress Integrative Medicine & Health 2017: Part one

Author

Benno Brinkhaus, Torkel Falkenberg, Aviad Haramati, Stefan N. Willich, Josephine P. Briggs, Merlin Willcox, Klaus Linde, Töres Theorell, Lisa M. Wong, Jeffrey Dusek, Darong Wu, David Eisenberg, Bettina Berger, Kathi Kemper, Beate Stock-Schröer, Hedda Sützl-Klein, Rosaria Ferreri, Gary Kaplan, Harald Matthes, Gabriele Rotter, Elad Schiff, Zahi Arnon, Eckhard Hahn, Christina M. Luberto, David Martin, Silke Schwarz, Diethard Tauschel, Andrew Flower, Harsha Gramminger, Hedwig H. Gupta, S. N. Gupta, Annette Kerckhoff, Christian S. Kessler, Andreas Michalsen, Eun S. Kim, Eun H. Jang, Rana Kim, Sae B. Jan, Martin Mittwede, Wiebke Mohme, Eran Ben-Arye, Massimo Bonucci, Bashar Saad, Thomas Breitkreuz, Elio Rossi, Rejin Kebudi, Michel Daher, Samaher Razaq, Nahla Gafer, Omar Nimri, Mohamed Hablas, Gunver Sophia Kienle, Noah Samuels, Michael Silbermann, Lena Bandelin, Anna-Lena Lang, Eva Wartner, Christoph Holtermann, Maxwell Binstock, Robert Riebau, Edin Mujkanovic, Holger Cramer, Romy Lauche, Andres Michalsen, Lesley Ward, Dominik Irnich, Wolfram Stör, Geoffrey Burnstock, Hans-Georg Schaible, Thomas Ots, Jost Langhorst, Tobias Sundberg, Catherina Amarell, Melanie Anheyer, Marion Eckert, Mercedes Ogal, Annette Schönauer, Birgit Reisenberger, Bernhard Brand, Dennis Anheyer, Gustav Dobos, Matthias Kroez, Aldo Ammendola, Jun J. Mao, Claudia Witt, Yufei Yang, Miriam Oritz, Markus Horneber, Petra Voiß, Alexandra von Rosenstiel, Catharina Amarell, Friedemann Schad, Marc Schläppi, Matthias Kröz, Arndt Büssing, Gil Bar-Sela, David Avshalomov, Samuel Attias, Sian Cotton, Miek Jong, Mats Jong, Christian Scheffer, Friedrich Edelhäuser, Abdullah AlBedah, Myeong Soo Lee, Mohamed Khalil, Keiko Ogawa, Yoshiharu Motoo, Junsuke Arimitsu, Masao Ogawa, Genki Shimizu, Rainer Stange, Karin Kraft, Kenny Kuchta, Kenji Watanabe, D Bonin, Harald Gruber, Sabine Koch, Urs Pohlmann, Christine Caldwell, Barbara Krantz, Ria Kortum, Lily Martin, Lisa S. Wieland, Ben Kligler, Susan Gould-Fogerite, Yuqing Zhang, John J. Riva, Michael Lumpkin, Emily Ratner, Liu Ping, Pei Jian, Gesa-Meyer Hamme, Xiaosong Mao, Han Chouping, Sven Schröder, Josef Hummelsberger, Michael Wullinger, Marc Brodzky, Christoff Zalpour, Julia Langley, Wendy Weber, Lanay M. Mudd, Peter Wayne, Clauda Witt, Wolfgang Weidenhammer, Vinjar Fønnebø, Heather Boon, Amie Steel, Andrea Bugarcic, Melisa Rangitakatu, Jon Adams, David Sibbritt, Jon Wardle, Matthew Leach, Janet Schloss, Helene Dieze, Nadine Ijaz, Michael Heinrich, George Lewith, Bertrand Graz, Daniela Adam, Linus Grabenhenrich, Miriam Ortiz, Sylvia Binting, Thomas Reinhold, Susanne Andermo, Johanna Hök Nordberg, Maria Arman, Manoj Bhasin, Xueyi Fan, Towia Libermann, Gregory Fricchione, John Denninger, Herbert Benson, David D. Martin, Inge Boers, Arine Vlieger, Michael Teut, Alexander Ullmann, Fabian Lotz, Stephanie Roll, Claudia Canella, Michael Mikolasek, Matthias Rostock, Jörg Beyer, Matthias Guckenberger, Josef Jenewein, Esther Linka, Claudia Six, Sarah Stoll, Roger Stupp, Claudia M. Witt, Elisabeth Chuang, Melissa D. McKee, Petra Klose, Silke Lange, Vincent C. H. Chung, Hoi L. C. Wong, Xin Y. Wu, Grace Y. G. Wen, Robin S. T. Ho, Jessica Y. L. Ching, Justin C. Y. Wu, Amanda Coakley, Jane Flanagan, Christine Annese, Joanne Empoliti, Zishan Gao, Xugang Liu, Shuguang Yu, Xianzhong Yan, Fanrong Liang, Christoph D. Hohmann, Nico Steckhan, Thomas Ostermann, Arion Paetow, Evelyn Hoff, Xiao-Yang Hu, Ruo-Han Wu, Martin Logue, Clara Blonde, Lily Y. Lai, Beth Stuart, Yu-Tong Fei, Michael Moore, Jian-Ping Liu, Michael Jeitler, Hannah Zillgen, Manuel Högl, Barbara Stöckigt, Georg Seifert, Christian Kessler, Talat Khadivzadeh, Maryam Hassanzadeh Bashtian, Shapour Badiee Aval, Habibollah Esmaily, Jihye Kim, Keun H. Kim, Carina Klocke, Stefanie Joos, Abdulrahman Koshak, Li Wie, Emad Koshak, Siraj Wali, Omer Alamoudi, Abdulrahman Demerdash, Majdy Qutub, Peter Pushparaj, Sigrid Kruse, Isabell Fischer, Nadine Tremel, Joseph Rosenecker, Brenda Leung, Wendy Takeda, Ning Liang, Xue Feng, Jian-ping Liu, Hui-juan Cao, Nina Shinday, Lisa Philpotts, Elyse Park, Gregory L. Fricchione, Gloria Yeh, Niki Munk, Arash Zakeresfahani, Trevor R. Foote, Rick Ralston, Karen Boulanger, Dominik Özbe, Elmar Gräßel, Katharina Luttenberger, Anna Pendergrass, Daniel Pach, Judit Bellmann-Strobl, Yinhui Chang, Laura Pasura, Bin Liu, Sven F. Jäger, Ronny Loerch, Li Jin, Katja Icke, Xuemin Shi, Friedemann Paul, Michaela Rütz, Andreas Lynen, Meike Schömitz, Maik Vahle, Nir Salomon, Alon Lang, Adi Lahat, Uri Kopylov, Shomron Ben-Horin, Ofir Har-Noi, Benjamin Avidan, Rami Elyakim, Dorit Gamus, Siew NG, Jessica Chang, Justin Wu, John Kaimiklotis, Dania Schumann, Ludovica Buttó, Dirk Haller, Caroline Smith, Sheryl de Lacey, Michael Chapman, Julie Ratcliffe, Neil Johnson, Jane Lyttleton, Clare Boothroyd, Paul Fahey, Bram Tjaden, Marja van Vliet, Herman van Wietmarschen, Wilfried Tröger, Pia Vuolanto, Paulina Aarva, Minna Sorsa, Kaija Helin, Claudia Wenzel, Iris Zoderer, Patricia Pammer, Patrick Simon, Gerhard Tucek, Kathrin Wode, Roger Henriksson, Lena Sharp, Anna Stoltenberg, Yang Xiao-ying, Li-qiong Wang, Jin-gen Li, Ying Wang, Lynda Balneaves, Rielle Capler, Chiara Bocci, Marta Guffi, Marina Paolini, Ilaria Meaglia, Patrizia Porcu, Giovanni B. Ivaldi, Simona Dragan, Petru Bucuras, Ana M. Pah, Marius Badalica-Petrescu, Florina Buleu, Gheorghe Hogea-Stoichescu, Ruxandra Christodorescu, Lan Kao, Yumin Cho, Nadja Klafke, Cornelia Mahler, Cornelia von Hagens, Lorenz Uhlmann, Martina Bentner, Andreas Schneeweiss, Andreas Mueller, Joachim Szecsenyi, Isabella Neri, Katharina Schnabel, Margit Cree, Ralf Suhr, Sonia Baccetti, Fabio Firenzuoli, Maria V. Monechi, Mariella Di Stefano, Gianni Amunni, Wendy Wong, Bingzhong Chen, Hakima Amri, Lucy Kotlyanskaya, Belinda Anderson, Roni Evans, Paul Marantz, Ryan Bradley, Cathryn Booth-LaForce, Heather Zwickey, Benjamin Kligler, Audrey Brooks, Mary J. Kreitzer, Patricia Lebensohn, Elisabeth Goldblatt, Neus Esmel-Esmel, Maria Jiménez-Herrera, Alexandra Jocham, Pascal O. Berberat, Antonius Schneider, Morgana Masetti, Henriette Murakozy, Marja Van Vliet, Rita Agdal, Fatemeh Atarzadeh, Amir M. Jaladat, Leila Hoseini, Fatemeh Amini, Chen Bai, Tiegang Liu, Zian Zheng, Yuxiang Wan, Jingnan Xu, Xuan Wang, He Yu, Xiaohong Gu, Babak Daneshfard, Majid Nimrouzi, Vahid Tafazoli, Seyed M. Emami Alorizi, Seyed A. Saghebi, Mohammad R. Fattahi, Alireza Salehi, Hossein Rezaeizadeh, Mohammad M. Zarshenas, Kealoha Fox, John Hughes, Nenad Kostanjsek, Stéphane Espinosa, Peter Fisher, Abdul Latif, Donald Lefeber, William Paske, Ali Ö. Öztürk, Gizemnur Öztürk, Wim Tissing, Marianne Naafs, Martine Busch, Mohammad R. Sanaye, Kilian Dräger, Brent Leininger, Kate Shafto, Jenny Breen, Ana P. Simões-Wüst, Carolina Moltó-Puigmartí, Martien van Dongen, Pieter Dagnelie, Carel Thijs, Shelley White, Solveig Wiesener, Anita Salamonsen, Trine Stub, Sergio Abanades, Mar Blanco, Laia Masllorens, Roser Sala, Shafekah Al-Ahnoumy, Dongwoon Han, Luzhu He, Ha Yun Kim, Da In Choi, Terje Alræk, Agnete Kristoffersen, Christel von Sceidt, Stig Bruset, Frauke Musial, Felix J. Saha, Heidemarie Haller, Hoda Azizi, Nayereh Khadem, Malihe Hassanzadeh, Nazanin Estiri, Hamideh Azizi, Fatemeh Tavassoli, Marzieh Lotfalizadeh, Reza Zabihi, Mahmoud Mohammadzadeh Shabestari, Reza Paeizi, Masoumeh Alvandi Azari, Hamidreza Bahrami-Taghanaki, Erik Baars, Anja De Bruin, Anne Ponstein, Sergio Segantini, Maria Valeria Monechi, Fabio Voller, Jürgen Barth, Alexandra Kern, Sebastian Lüthi, Anja Zieger, Fabius Otto, Ariel Beccia, Corina Dunlap, Brendan Courneene, Paula Bedregal, Alvaro Passi, Alfredo Rodríguez, Mayling Chang, Soledad Gutiérrez, Florian Beissner, Christine Preibisch, Annemarie Schweizer-Arau, Roxana Popovici, Karin Meissner, Sylvie Beljanski, Laura Belland, Laura Rivera-Reyes, Ula Hwang, Dominik Sethe, Dörte Hilgard, Peter Heusser, Felicity Bishop, Miznah Al-Abbadey, Katherine Bradbury, Dawn Carnes, Borislav Dimitrov, Carol Fawkes, Jo Foster, Hugh MacPherson, Lisa Roberts, Lucy Yardley, Michelle Holmes, Paul Little, Cyrus Cooper, Patrizia Bogani, Valentina Maggini, Eugenia Gallo, Elisangela Miceli, Sauro Biffi, Alessio Mengoni, Renato Fani, Nadine Brands-Guendling, Peter W. Guendling, Gert Bronfort, Mitch Haas, Craig Schulz, Xiangwei Bu, J. Wang, T. Fang, Z. Shen, Y. He, X. Zhang, Zhengju Zhang, Dali Wang, Fengxian Meng, Klaus Baumann, Eckhard Frick, Christoph Jacobs, Ralph-Achim Grünther, Désirée Lötzke, Sonny Jung, Daniela R. Recchia, Sibylle Robens, Josephin Stankewitz, Mika Jeitler, Chunhoo Cheon, Bo H. Jang, Seong G. Ko, Ching W. Huang, Yui Sasaki, Youme Ko, Anna Cheshire, Damien Ridge, David Peters, Maria Panagioti, Chantal Simon, Hyun J. Cho, Soo J. Choi, Young S. Jung, Hyea B Im, Kieran Cooley, Laura Tummon-Simmons, Rachel Wasson, Kristen Kraemer, Richard Sears, Carly Hueber, Gwendolyn Derk, JR Lill, Ruopeng An, Lois Steinberg, Lourdes Diaz Rodriguez, Francisca García-de la Fuente, Miguel De la Vega, Keyla Vargas-Román, Jonatan Fernández-Ruiz, Irene Cantarero-Villanueva, Francisca García-De la Fuente, Fanny Jiménez-Guerrero, Noelia Galiano-Castillo, Gualberto Diaz-Saez, José I. Torres-Jimenez, Olga Garcia-Gomez, Luis Hortal-Muñoz, Camino Diaz-Diez, Demijon Dicen, Helene Diezel, Jane Frawley, Alex Broom, Fei Dong, Xueyan Ma, Liyi Yan, Liqun Wu, Jiaju Ma, Jianhua Zhen, Julie Dubois, Pierre-Yves Rodondi, Sophia Schwartze, Barbara Trapp, and Dirk Cysarz

Subjects
Other systems of medicine, RZ201-999
Published
2017
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4. An Online Resilience Intervention for Military Personnel

Author

Rachel A. Millstein, Megan D. McCarthy, Rana Chudnofsky, Stacie Fredriksson, Jacqueline Francona, Tricia Winklosky, Brianne Sampson, Ariel Mulzoff, Ronald E. Hirschberg, Elyse R. Park, Gregory Fricchione, Darshan H. Mehta, John Denninger, and Louisa G. Sylvia

Subjects
Psychiatry and Mental health
Abstract

Mind-body programs can improve mental health and well-being in military populations. This pilot study of a virtual synchronous resilience intervention was conducted from 2018 to 2020 among 26 military personnel. Participants completed self-report psychosocial questionnaires before and after the 6-week program, including measures of posttraumatic stress disorder, depression, stress, resilience, and mindfulness. The intervention included eliciting the relaxation response, adaptive coping strategies, and healthy behaviors. Pre-post changes were calculated using paired t tests and effect sizes ( d ). Significant improvements were found for depression (Patient Health Questionnaire-8), stress reactivity (Measure of Current Status-Abbreviated Scale), and mindfulness (Cognitive Affective Mindfulness Scale-Revised). A 6-week resilience intervention can help military personnel improve mental health, coping, and stress management. [ Psychiatr Ann . 2022;52(5):186–190.]

Published
2022

5. Randomized Waitlist-Control Trial of a Web-Based Stress-Management and Resiliency Program for Adolescent and Young Adult Cancer Survivors: Protocol for the Bounce Back Study (Preprint)

Author

Helen Mizrach, Brett Goshe, Elyse R Park, Christopher Recklitis, Joseph A Greer, Yuchiao Chang, Natasha Frederick, Annah Abrams, Mary D Tower, Emily A Walsh, Mary Huang, Lisa Kenney, Alan Homans, Karen Miller, John Denninger, Ghazala Naheed Usmani, Jeffrey Peppercorn, and Giselle K Perez

Abstract

BACKGROUND The emotional health of adolescent and young adult (AYA) cancer survivors is compromised both during and after cancer treatment. Targeted programs designed to support AYAs’ ability to cope with stress in the years following treatment completion are lacking. Mind-body programs may ameliorate the negative psychological and emotional effects of stress and assist AYAs with managing the psychosocial challenges of early survivorship. OBJECTIVE Our randomized waitlist-control trial aims to assess the feasibility, acceptability, and preliminary efficacy of a virtual group program (Bounce Back) to promote stress management and resiliency among posttreatment AYAs. METHODS Bounce Back is a stress management and resiliency program delivered via videoconference by a trained mental health clinician. Sessions were adapted from an evidence-based mind-body program (Stress Management and Resiliency Training - Relaxation Response Resiliency Program [SMART-3RP]) grounded in relaxation response elicitation, mindfulness, cognitive behavioral therapy, and positive psychology. Seventy-two AYAs (diagnosed with cancer between ages 14 years and 29 years and had completed cancer treatment within the last 5 years) were randomly assigned to the Bounce Back program or waitlist-control group and completed assessments at baseline, 3 months postbaseline, and 6 months postbaseline. The primary aim of the study is to determine the feasibility and acceptability of the Bounce Back program. Descriptive statistics, including means, frequencies, and ranges supplemented by qualitative exit interview feedback will be used to characterize the sample and to summarize feasibility and acceptability. The exploratory aims are to evaluate the preliminary effects of the program on stress coping and psychosocial outcome measures (ie, anxiety, depression) collected across the 3 time points. RESULTS This study was funded by the National Cancer Institute in July 2017. Study procedures were approved by the Dana-Farber Harvard Cancer Center Institutional Review Board in October 2018 (Protocol 18-428). The randomized trial was conducted from July 2019 to March 2021. Quantitative data collection is complete, and qualitative exit interview data collection is ongoing. Results are expected to be published in peer-reviewed journals and presented at local, national, or international meetings in the coming years. CONCLUSIONS Few evidence-based programs exist that tackle the key transitional issues faced by AYA cancer survivors. Future analyses will help us determine the feasibility and acceptability of the Bounce Back program and its impact on AYA stress coping and psychological well-being. CLINICALTRIAL ClinicalTrials.gov NCT03768336; https://clinicaltrials.gov/ct2/show/NCT03768336 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/34033

Published
2021

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