Interventions for fear of cancer recurrence: examining effects of skill practice

The National Cancer Institute awarded Indiana University Indianapolis $100,228 under the Cancer Research Manpower program (CFDA 93.398) on December 1, 2026, to support Stella Snyder's F31 research training fellowship examining the relationship between between-session coping skills practice and fear of cancer recurrence (FCR) outcomes in breast cancer survivors.

The funded work is a secondary analysis of data from a completed three-arm randomized controlled trial (R01 CA255480) that enrolled 390 breast cancer survivors and compared acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), and enhanced usual care for FCR. Snyder's analysis will evaluate engagement with ACT and CBT skills over 12 months and explore three specific aims: the relationship between coping skills practice and FCR outcomes following ACT; the relationship between coping skills practice and FCR outcomes following CBT; and the degree to which survivor characteristics such as age, education, and income moderate the impact of ACT and CBT on FCR outcomes. The award will provide research training necessary for Snyder to establish an independent research career focused on optimizing psychosocial interventions for distress and symptoms in cancer survivors.

Performance occurs at Indiana University Indianapolis in Indianapolis, Indiana. The period of performance runs from December 1, 2026, through June 30, 2028. The assistance type is a Project Grant, which under the Cancer Research Manpower program provides research training support to individuals interested in careers in cancer-related research.

Abstract

This F31 award will provide stella snyder (PI) with the research training necessary for an independent research career with a focus on optimizing psychosocial interventions for distress and symptoms in cancer survivors. Fear of cancer recurrence (FCR) is one of the most prevalent and distressing concerns among cancer survivors, particularly breast cancer survivors, and is associated with general anxiety and depressive symptoms and reduced quality of life. Psychosocial interventions such as acceptance and commitment therapy (act) and cognitive behavioral therapy (CBT) have shown promising effects on FCR, yet little is known about the therapeutic components that contribute to intervention success. Additionally, research has yet to examine whether intervention engagement-such as home practice of specific skills-predicts reductions in FCR over time, or whether survivor characteristics moderate intervention effects. This information is critical for refining interventions to improve effectiveness for cancer survivors. This study leverages data from a recently completed three-arm randomized controlled trial (R01 CA255480) comparing act, CBT, and enhanced usual care for FCR in 390 breast cancer survivors. The proposed secondary analysis will evaluate between-session engagement with act and CBT skills and its impact on FCR outcomes over 12 months. Specifically, the following F31 aims will be addressed: aim 1: to examine the relationship between breast cancer survivors' between-session coping skills practice and FCR following act. Aim 2: to examine the relationship between breast cancer survivors' between-session coping skills practice and FCR following CBT. Aim 3: to explore the degree to which survivor characteristics (e.g., age, education, income) moderate the impact of act and CBT on FCR outcomes. IT is hypothesized that greater engagement in act practices (mindfulness and valuesbased actions) and CBT practices (cognitive and behavioral skills) will predict reductions in FCR over time. Findings will provide valuable insights into which skill practices are associated with reductions in FCR, contributing to more effective psychosocial care for cancer survivors. In addition to research training, this F31 award will provide PI snyder with structured mentorship and coursework in cancer symptom science, intervention research, and advanced statistical methods, including longitudinal structural equation modeling and multilevel modeling. The training environment at indiana university indianapolis includes mentorship by R01-funded investigators affiliated with an interdisciplinary T32 program in cancer prevention and control. The training activities will lay the foundation for a future independent research career in psychosocial oncology, leading to a postdoctoral grant application (e.g., F32 or K99/R00) and ultimately an R01 focused on optimizing psychosocial interventions for cancer survivors.