Project Grant R37CA288557

POSITIVE PSYCHOLOGY INTERVENTION FOR HEMATOPOIETIC STEM CELL TRANSPLANTATION SURVIVORS - PROJECT SUMMARY/ABSTRACT OVERVIEW: THE GOAL OF THIS PROJECT IS TO ASSESS THE EFFICACY OF A TAILORED PHONE-DELIVERED POSITIVE PSYCHOLOGICAL INTERVENTION (PATH) FOR IMPROVING ANXIETY AND DEPRESSION SYMPTOMS, AND QUALITY OF LIFE (QOL) IN HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT) SURVIVORS. BACKGROUND: ALLOGENEIC HSCT SURVIVORS EXPERIENCE HIGH RATES OF TREATMENT-RELATED TOXICITIES, A PROLONGED RECOVERY, SUBSTANTIAL RISK OF LIFE-THREATENING COMPLICATIONS, AND LONG-TERM MORBIDITY AND MORTALITY. HENCE, HSCT SURVIVORS EXPERIENCE TREMENDOUS PSYCHOLOGICAL SYMPTOMS (E.G., ANXIETY, DEPRESSION) AND LOW LEVELS OF POSITIVE PSYCHOLOGICAL WELL-BEING (E.G., FLOURISHING, GRATITUDE), WHICH UNDERMINES VARIOUS HEALTH-RELATED OUTCOMES SUCH AS QUALITY OF LIFE (QOL). HOWEVER, MOST EXISTING PSYCHOSOCIAL INTERVENTIONS ARE NOT ACCESSIBLE TO THE MAJORITY OF HSCT SURVIVORS BECAUSE THEY ARE 1) DELIVERED IN-PERSON, 2) ENTAIL LONG 60-90-MINUTE SESSIONS, 3) REQUIRE DELIVERY BY PALLIATIVE CARE CLINICIANS OR PSYCHOLOGISTS WITH EXTENSIVE AND COSTLY TRAINING, AND 4) NOT FOCUSED ON POSITIVE PSYCHOLOGICAL WELL-BEING. TO ADDRESS THESE GAPS, WE DEVELOPED PATH, AN ACCESSIBLE, PHONE-DELIVERED POSITIVE PSYCHOLOGICAL INTERVENTION WITH DELIBERATE AND SYSTEMATIC ACTIVITIES TO CULTIVATE GRATITUDE, STRENGTHS, AND MEANING. INTERVENTIONS LIKE PATH CAN BUFFER AGAINST DISTRESS TO IMPROVE ANXIETY AND DEPRESSION SYMPTOMS, AND QOL IN HSCT SURVIVORS AND ENTAILS 15-20-MINUTE SESSIONS DELIVERED BY INTERVENTIONISTS FROM DIVERSE BACKGROUNDS, INCLUDING NURSING, SOCIAL WORK, OR PSYCHOLOGY. WITH A SINGLE SITE RANDOMIZED CONTROLLED TRIAL (RCT) OF PATH, WE SHOWED IT WAS FEASIBLE AND PRELIMINARILY LED TO CLINICALLY SIGNIFICANT IMPROVEMENT IN PATIENTS' ANXIETY SYMPTOMS. AS THE FIRST RCT TO SHOW THE FEASIBILITY AND PRELIMINARY EFFICACY OF A TAILORED HSCT POSITIVE PSYCHOLOGY INTERVENTION, THE NEXT STEP IS TO ASSESS THE EFFICACY OF PATH ON ANXIETY AND DEPRESSION SYMPTOMS, AND QOL. RESEARCH PLAN: WE WILL CONDUCT AN RCT IN 400 HSCT SURVIVORS TO TEST THE EFFICACY OF PATH FOR IMPROVING ANXIETY AND DEPRESSION SYMPTOMS, AND QOL (AIM #1). WE WILL ALSO ASSESS THE IMPACT OF PATH ON POSITIVE WELL- BEING (E.G., GRATITUDE, FLOURISHING) AND SELF-MANAGEMENT TARGETS (E.G., COPING, PHYSICAL ACTIVITY) (AIM #2). FINALLY, WE WILL ASSESS MEDIATORS AND MODERATORS OF THE EFFECT OF PATH ON ANXIETY SYMPTOMS AND QOL (AIM #3). ENVIRONMENT: THIS PROJECT WILL BE CONDUCTED AT THE MASS GENERAL BRIGHAM/DANA-FARBER CANCER INSTITUTE (MGB/DFCI), DUKE CANCER INSTITUTE, AND MOFFITT CANCER CENTER, WHICH INDIVIDUALLY CONDUCT 200-250 ALLOGENEIC HSCTS PER YEAR. DR. AMONOO AND THE RESEARCH TEAM AT MGB/DFCI, DUKE, AND MOFFITT HAVE EXTENSIVE PROFICIENCY IN DEVELOPING AND CONDUCTING MULTI-SITE PSYCHOSOCIAL INTERVENTIONS FOR PATIENTS WITH HEMATOLOGIC MALIGNANCIES WHO ARE HSCT SURVIVORS TO ENSURE THE SUCCESSFUL EXECUTION OF THE PROPOSED RCT ACROSS STUDY SITES. RELEVANCE OF RESEARCH: IF EFFICACIOUS AT IMPROVING ANXIETY AND DEPRESSION SYMPTOMS AND QOL, PATH CAN POTENTIALLY CHANGE THE PARADIGM OF PSYCHOSOCIAL CARE FOR HSCT SURVIVORS AND VULNERABLE CANCER POPULATIONS.