Evaluation of Pillars4life: a virtual coping skills program for cancer survivors

Abstract

Objective Pillars4Life is an educational program that teaches coping skills to cancer patients in a virtual group setting; it was recently implemented at 17 hospitals across the USA. The cost-effective, scalable, and assessable Pillars4Life curriculum targets psychosocial resources (e.g., self-efficacy and coping skills) as a means to reduce symptoms (e.g., depression, anxiety, and posttraumatic stress) and enhance quality of life. Methods Cancer patients were recruited from hospitals that received the LIVESTRONG Community Impact Project Award to enroll in a pilot study of Pillars4Life. Consenting participants met with a certified instructor weekly for 10 weeks in a virtual environment; the manualized intervention trained participants in personal coping skills. Longitudinal assessments over 6 months were assessed using validated instruments to determine changes in Pillars4Life targeted resources and outcomes. Multiple linear regression models examined the relationship between changes in targeted resources and changes in outcome from baseline to 3 months post-intervention. Results Participants (n = 130) had the following characteristics: mean age of 56 ± 11 years, 87% women, 11% non-Caucasian, and 77% with college degree. At 3- and 6-month follow-up, mean scores improved on all key outcome measures such as depression (Patient Health Questionnaire), anxiety (Generalized Anxiety Disorder), posttraumatic stress (Posttraumatic Stress Disorder Checklist), fatigue (Functional Assessment of Chronic Illness Therapy—Fatigue), and well-being (Functional Assessment of Cancer Therapy—General) from baseline (all p<0.01); results were most pronounced among participants who reported ≥4/10 on the Distress Thermometer at baseline (all p<0.001). Changes in each targeted resource were associated with 3-month improvements in at least one outcome. Conclusions Participation in the Pillars4Life program was associated with statistically and clinically significant improvements in scores on pre-specified outcomes and targeted resources.

An online randomized controlled trial, with or without problem-solving treatment, for long-term cancer survivors after hematopoietic cell transplantation

“…High attrition rates are major reasons for reduced effect sizes of online interventions compared with face-to-face treatments [72]. Our attrition rate of 32% is consistent with other oncology online studies that include one for fatigue that had a 38% dropout and another for coping skills in cancer survivors that had a 32% attrition rate [29, 73]. It is also worth noting that a meta-analysis of dropouts from in-person psychotherapy for anxiety is 17%, with no definable modifiers based on patient, therapist, or treatment variables and can range up to at least 38% for some in-person treatments [74, 75].…”

A Bio-Psychosocial Intervention Program for Improving Quality of Life in Breast Cancer Survivors - Final Outcome of a Prospective Randomized Trial

“…A cross‐sectional survey on association between mental health and communication among families of breast cancer survivors found that open and productive communication among breast cancer survivors and their families was associated with better mental health . The only other report we found on a coping skills program focusing on self‐efficacy and control that assessed the impact on QoL is the Pilars4life program ; this program involved virtual meetings with a certified instructor weekly over a 10 week period. At 3‐ and 6‐month follow‐up, mean scores improved on measures of depression (Patient Health Questionnaire), anxiety (Generalized Anxiety Disorder), posttraumatic stress (Posttraumatic Stress Disorder Checklist), fatigue (Functional Assessment of Chronic Illness Therapy‐Fatigue), and well‐being (FACT‐General) from baseline (all p < 0.01).…”

Elementos-chave de uma intervenção educacional em enfermagem promotora da adaptação dos sobreviventes de cancro

“…Estes autores afirmam ainda que a educação e a informação são essenciais para reduzir os níveis de ansiedade, uma vez que geralmente os medos se baseiam em informações incorretas. Smith et al (2015) desenvolveram um programa com vista ao ensino e treino de habilidades de coping para os sobreviventes de cancro e concluíram que a participação no programa foi associada a melhorias estatísticas e clinicamente significativas, quer para a redução da ansiedade, depressão, stress pós-traumático e fadiga, quer para o aumento do bem-estar. Também Towsley et al (2007) exploraram as experiências de coping durante o processo de transição para a sobrevivência do adulto com cancro e desenvolveram um modelo denominado Learning to live with it, demonstrando como os sobreviventes recorrem a várias estratégias, atitudes e experiências de vida anterior para integrar a doença oncológica nas suas vidas.…”