Randomized Controlled Trial of a Positive Psychology Based Intervention (PATH-C) for Caregivers of Hematopoietic Stem Cell Transplant Survivors
Overview
- Phase
- Not Applicable
- Intervention
- PATH-C
- Conditions
- Hematologic Malignancy
- Sponsor
- Brigham and Women's Hospital
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- PATH-C Intervention Feasibility
- Status
- Active, not recruiting
- Last Updated
- 2 months ago
Overview
Brief Summary
The goal of this randomized clinical trial is to evaluate whether a positive psychology intervention (PATH-C) can improve psychological well-being, quality of life, and physical activity in caregivers of patients undergoing hematopoietic stem cell transplantation (HSCT).
Detailed Description
Family and friend caregivers are vital care providers throughout the entire care continuum for patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT). These caregivers must manage multiple time-consuming responsibilities, including monitoring vital signs and side effects of treatment, administering medications, and coordinating transportation to and from medical appointments. The substantial caregiving burden among caregivers of patients undergoing HSCT is associated with increased symptoms of depression, anxiety, and fatigue. Symptoms such as fatigue and depression in HSCT caregivers may undermine attempts to maintain regular physical activity routines, which may impact essential health outcomes such as cardiovascular health. With persistent shortages in the mental health workforce needed to address these psychological needs of HSCT caregivers adequately, remotely-delivered psychosocial interventions offer an innovative approach to overcome the unmet psychological needs of this population. Hence, the investigators developed a remotely-delivered positive psychology intervention, Positive Affect in the Transplantation of Hematopoietic Stem Cells for Caregivers (PATH-C), tailored to the unique psychological needs of HSCT caregivers. With this study, the investigators will establish the impact of PATH-C on participant-reported outcomes compared to usual care. The study will use validated questionnaires to measure caregivers' quality of life, caregiver burden, psychological distress symptoms, positive psychological well-being (e.g., positive affect, gratitude), and self-management targets (e.g., coping, self-efficacy). The study will also use the validated ActiGraph GT3X+ accelerometer to measure minutes/day of moderate-to-vigorous physical activity, light activity, and sedentary leisure time.
Investigators
Hermioni L.Amonoo, MD, MPP, MPH
Director, Well-Being and Cancer Research Program
Brigham and Women's Hospital
Eligibility Criteria
Inclusion Criteria
- •Adult caregivers (aged 18 years and older) of patients undergoing allogeneic or autologous HSCT at Dana-Farber Cancer Institute for a hematologic malignancy.
- •A relative or a friend who either lives with the patient or has in-person contact with them at least twice per week and is identified as the primary caregiver for HSCT.
- •Ability to speak English and able to complete questionnaires with minimal assistance of an interpreter as this is a feasibility trial of the PATH-C intervention which is currently only available in English.
Exclusion Criteria
- •Caregivers of patients undergoing HSCT for benign hematologic conditions.
- •Caregivers with acute or unstable psychiatric conditions which the treating transplant clinician believes prohibits informed consent or compliance with study procedures.
- •Cognitive deficits impeding a caregiver's ability to provide informed consent or participate adequately in the study assessed via a commonly used 6-item cognitive assessment with the Brief Interview for Mental Status (BIMS) screening tool that is sensitive and specific for screening for cognitive impairment in research participants.
Arms & Interventions
PATH-C
Participants will be recruited from the Dana-Farber Cancer Institute and randomized in a 1:1 fashion, stratified by transplant type (autologous versus allogeneic), to PATH-C versus usual care. Caregivers of patients undergoing HSCT will receive the PATH-C intervention to learn to reflect on their positive emotions and consistently use and incorporate positive psychology exercises in their daily routine, as well as learn how to set goals and track their physical activity (i.e., with an activity tracker) daily while caring for a loved one undergoing HSCT. Participants will complete questionnaires (in person, over the computer or telephone, or by mail) at predetermined days per protocol.
Intervention: PATH-C
Usual Care
Participants will be recruited from the Dana-Farber Cancer Institute and randomized in a 1:1 fashion, stratified by transplant type (autologous versus allogeneic), to PATH-C versus usual care. Participants will complete questionnaires (in person, over the computer or telephone, or by mail) at predetermined days per protocol. Participants in the usual care arm will receive their usual support from the HSCT team as caregivers of patients undergoing HSCT, including all routine supportive care resources (e.g., support from social work) offered by the HSCT team. Patients in the usual care and PATH-C groups will be permitted to use all supportive care services per standard care. The investigators will track referrals to supportive care services in both groups by reviewing the Electronic Health Record (EHR).
Outcomes
Primary Outcomes
PATH-C Intervention Feasibility
Time Frame: Up to 10 weeks
PATH-C Intervention Feasibility is defined as \>60% of eligible participants enrolling in the study and \>60% of enrolled participants who start the intervention completing at least 6/9 intervention sessions.
Secondary Outcomes
- Caregiver Quality of Life based on the CarGOQOL(Up to 20 weeks (+/- 28 days))
- Depression Symptoms based on the HADS-Depression Subscale(Up to 20 weeks (+/- 28 days))
- Caregiving Burden based not the Caregiver Reaction Assessment (CRA)(Up to 20 weeks (+/- 28 days))
- PATH-C Intervention Acceptability(Up to 10 weeks)
- Anxiety Symptoms based on the HADS-Anxiety Subscale(Up to 20 weeks (+/- 28 days))
- Physical activity longitudinally based on ActiGraph GT3X+ accelerometer(Up to 20 weeks (+/- 28 days))