Targeted eHealth Intervention to Reduce Breast Cancer Survivors’ Fear of Recurrence: Results From the FoRtitude Randomized Trial

作者：Lynne I. Wagner, Janet Austin Tooze, Daniel L. Hall, Beverly J. Levine, Jennifer L. Beaumont, Jennifer L. Duffecy, David E. Victorson, William John Gradishar, Joseph W. Leach, Thomas James Saphner, Keren B. Sturtz, Mary Lou Smith, Frank J. Penedo, David Curtis Mohr, David F Cella · 发表于：JNCI Journal of the National Cancer Institute · 年份：2021 · DOI：10.1093/jnci/djab100 · 被引用次数：71 · 研究领域：Cancer-related cognitive impairment studies、Cancer survivorship and care、Advanced Breast Cancer Therapies

BACKGROUND: Fear of recurrence (FoR) is a prevalent concern among breast cancer survivors (BCS), yet few accessible interventions exist. This study evaluated a targeted eHealth intervention, "FoRtitude," to reduce FoR using cognitive behavioral skills training and telecoaching. METHODS: BCS (N = 196) were recruited from an academic medical center and 3 National Cancer Institute Community Oncology Research Program community sites, had stage 0-III breast cancer, were 1-10 years postprimary treatment, with moderate to high FoR and familiarity with the internet. Using the Multiphase Optimization Strategy, participants were independently randomly assigned to 3 cognitive behavioral skills (relaxation, cognitive restructuring, worry practice) vs an attention control condition (health management content [HMC]) and to telecoaching (motivational interviewing) vs no telecoaching. Website content was released across 4 weeks and included didactic lessons, interactive tools, and a text-messaging feature. BCS completed the Fear of Cancer Recurrence Inventory at baseline and at 4 and 8 weeks. Fear of Cancer Recurrence Inventory scores over time were compared using mixed-effects models. All statistical tests were 2-sided. RESULTS: FCRI scores [SD] decreased statistically significantly from baseline to postintervention (T0 = 53.1 [17.4], T2 = 41.9 [16.2], P < .001). The magnitude of reduction in FCRI scores was comparable across cognitive behavior therapy (CBT) and attention control HMC condit...