Symptom Management for YA Cancer Survivors
Improving Symptom Management for Survivors of Young Adult Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke Cancer Institute
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Young Adult Cancer Survivors Participating in Intervention Development Interviews
Eligibility Criteria
- Diagnosed with hematologic, breast, gastrointestinal, or endocrine cancers, melanoma, or germ cell tumors
- Diagnosed with cancer as a young adult
- Under the care of a medical provider at the Duke Cancer Institute
- Completed curative treatment involving multimodal therapy within the last five years
- Able to speak and read English
- Able to give informed consent
Exclusion Criteria
- Nonambulatory
- Major mental illness, i.e., schizophrenia
- Untreated or uncontrolled mental illness, i.e., bipolar
- Residence greater than 100 miles from the research site
Medical Providers Participating in Intervention Development Interviews Eligibility criteria
o Provide care to young adult cancer survivors at the Duke Cancer Institute
Young Adult Cancer Survivor User Testers
Eligibility Criteria
- Diagnosed with hematologic, breast, gastrointestinal cancers, or endocrine cancers, melanoma, or germ cell tumors
- Diagnosed with cancer as a young adult
- Under the care of a medical provider at the Duke Cancer Institute
- Completed curative treatment involving multimodal therapy within the last five years
- Able to speak and read English
- Able to give informed consent
Exclusion Criteria
- Nonambulatory
- Major mental illness, i.e., schizophrenia
- Untreated or uncontrolled mental illness, i.e., bipolar
- Residence great than 100 miles from the research site
RCT Participants
Eligibility Criteria:
- diagnosed with cancer as a YA (aged 18-39)
- diagnosis of hematologic, breast, endocrine or gastrointestinal cancer, melanoma, or germ cell tumor
- receiving care at the Duke Cancer Institute
- completed curative treatment involving multimodal therapy within the last 2 years
- able to speak/read English; and able to give informed consent.
Exclusion Criteria:
- non-ambulatory
- major mental illness (i.e., schizophrenia)
- untreated or uncontrolled mental illness (i.e., bipolar disorder)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Behavioral Symptom Management for Young Adult Cancer Survivors
The intervention provides systematic training in cognitive and behavioral coping skills (e.g., activity-rest cycling, cognitive defusion, relaxation training) delivered over the course of 8 sessions (12 therapy hours).
By employing these strategies, participants learn to adjust their behaviors and emotions as well as interact differently with their thoughts in the service of better managing symptoms.
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The intervention includes group sessions held over Zoom along with an integrated mobile application to provide participants with instruction in cognitive and behavioral strategies for managing symptoms (i.e., pain, fatigue, distress).
The developed intervention includes 8 face-to-face group sessions (12 therapy hours).
Sessions are delivered using a faded contact approach (i.e., sessions 1-6: weekly, sessions 7-8: biweekly).
Participants receive secure access to a study-specific mobile application that includes: 1) audio and video files and brief text-based educational content reviewing strategies discussed during the groups; 2) the ability to self-monitor symptom severity; 3) the ability to connect with group members via a social networking platform; and 4) activity tracking synchronization.
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Active Comparator: Waitlist Control
Waitlist control participants will receive the intervention and receive systematic training in cognitive and behavioral coping skills approximately 6 months into their participation in the study.
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The intervention includes group sessions held over Zoom along with an integrated mobile application to provide participants with instruction in cognitive and behavioral strategies for managing symptoms (i.e., pain, fatigue, distress).
The developed intervention includes 8 face-to-face group sessions (12 therapy hours).
Sessions are delivered using a faded contact approach (i.e., sessions 1-6: weekly, sessions 7-8: biweekly).
Participants receive secure access to a study-specific mobile application that includes: 1) audio and video files and brief text-based educational content reviewing strategies discussed during the groups; 2) the ability to self-monitor symptom severity; 3) the ability to connect with group members via a social networking platform; and 4) activity tracking synchronization.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Use of Intervention Strategies
Time Frame: Following completion of the intervention, up to 12 months
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Participants' use of intervention strategies will be assessed using a measure developed specific to components of the proposed intervention.
Participants will be asked about how frequently treatment strategies discussed in session have been used outside of session since the previous session or last assessment depending on the timing of the questionnaire.
A scale ranging from 0 "not at all" to 5 "every day" will be used.
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Following completion of the intervention, up to 12 months
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Intervention Satisfaction: Satisfaction With Therapy and Therapist Scale-Revised (STTS-R)
Time Frame: Following completion of the intervention, up to 12 months
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Intervention satisfaction will be assessed using the Satisfaction witth Therapy and Therapist Scale-Revised, a 13-item measure with the first 12-items on a five-point scale ranging from 1 "strongly disagree" to 5 "strongly agree."
The 13th item (Global Improvement) asks, "How much did the intervention help with your symptoms?"
with 5 answer choices ranging from "made things a lot better" (1) to "made things a lot worse" (5).
Each of the subscales (Satisfaction With Therapy and Satisfaction With Therapist) range from 6 to 30, with higher scores indicating greater overall satisfaction.
A total score is calculated as the sum of the first twelve items, with possible scores from 12 to 60, with higher scores indicating greater overall satisfaction.
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Following completion of the intervention, up to 12 months
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Number of Participants Who Completed Open-Ended Questions About the Program
Time Frame: Following completion of the intervention, up to 12 months
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Intervention will be evaluated using 3 open-ended questions, including the following: "1) What was the most helpful part of the program?," "2) What was the least helpful part of the program?", and "3) What suggestions do you have for us to help improve the program?"
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Following completion of the intervention, up to 12 months
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Percentage of Sessions Attended by Each Participant
Time Frame: Following completion of the intervention, up to 12 months
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Treatment feasibility will be assessed by measuring the session attendance rate for each participant.
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Following completion of the intervention, up to 12 months
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Treatment Acceptability Questionnaire
Time Frame: Following completion of the intervention, up to 12 months
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The Treatment Acceptability Questionnaire is a six-item scale assessing participants' views of an intervention as acceptable, ethical, and effective.
Items are rated on a 7-point Likert scale (e.g., 1 "very unacceptable" to 7 "very acceptable") and averaged.
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Following completion of the intervention, up to 12 months
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Self-reported Use of the Mobile Application
Time Frame: Following completion of the intervention, up to 12 months
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Participants' use of the mobile application will be assessed using a measure developed specific to components of the proposed mobile application.
Participants will be asked about how frequently they have used components of the mobile application outside of session since the previous session or last assessment depending on the timing of the questionnaire.
A scale ranging from 0 "not at all" to 5 "2 or more times a day" will be used.
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Following completion of the intervention, up to 12 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change in Depressive Symptoms: PROMIS Depression Short Form
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment, pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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Depressive Symptoms will be assessed using the Patient Reported Outcomes Measurement Information System Depression Short Form-8a, an 8-item measure assessing symptoms of depression in the last week.
Participants are asked to respond to items (e.g., "I felt sad," "I felt helpless") using a five-point scale ranging from 1 "never" to 5 "always."
Items are summed and converted to standardized t-scores with a mean of 50 and standard deviation of 10.
Higher T-scores indicate higher levels of depression.
T-scores of 55 to 60 indicate mild levels of depression, 60 to 70 indicates moderate levels of depression, and greater than 70 indicate severe levels of depression.
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment, pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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Change in Anxiety: PROMIS Anxiety Short Form
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment, pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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Symptoms of Anxiety will be assessed using the Patient Reported Outcomes Measurement Information System Anxiety Short Form-8a, an 8-item measure assessing symptoms of anxiety in the last week.
Participants are asked to respond to items (e.g., "I felt nervous," "I felt tense") using a five-point scale ranging from 1 "never" to 5 "always".
Total scores are then converted to T-scores.
Items are summed and converted to standardized t-scores with a mean of 50 and standard deviation of 10.
Higher T-scores indicate higher levels of anxiety.
T-scores of 55 to 60 indicate mild levels of anxiety, 60 to 70 indicates moderate levels of anxiety, and greater than 70 indicate severe levels of anxiety.
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment, pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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Change in Symptom Interference: Illness Intrusiveness Rating Scale
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment, pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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Symptom interference will be assessed using the Illness Intrusiveness Rating Scale (IIRS).
The IIRS assesses the extent to which an illness and/ or its treatments interfere with 13 quality of life domains (e.g., health, diet, work, sex life, active recreation).
Items are rated on a 7-point scale from 1 "not very much" to 7 "very much."
The total score ranges from 7 to 91, where a higher score indicates greater interference.
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment, pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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Change in Pain: Brief Pain Inventory
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment; pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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The Brief Pain Inventory is a 9-item, self-report measure assessing pain severity and interference from pain across important life domains (e.g., general activity, work, relations with others).
Participants rate their pain on a scale from 0 "no pain" to 10 "pain as bad as you can imagine."
Pain severity is calculated as the average of four items assessing participants' worst, least, current, and average (in the last week) pain on a scale from 0 "no pain" to 10 "worst pain."
Pain interference is computed as the average of seven items, which ask about the interference of pain across different life domains (e.g., general activity, mood, relations with other people).
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment; pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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Change in Fatigue: PROMIS Fatigue Short Form
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment, pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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Fatigue will be assessed using the Patient Reported Outcomes Measurement Information System Fatigue Scale, a 6-item self-report measure of fatigue.
Participants are asked to think about the last week when responding to each item (e.g., "In the past 7 days, how run-down did you feel, on average?").
Items are summed and converted to standardized t-scores with a mean of 50 and standard deviation of 10.
A higher score indicates greater fatigue.
T-scores of 55 to 60 indicate mild levels of fatigue, 60 to 70 indicates moderate levels of fatigue, and greater than 70 indicate severe levels of fatigue.
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment, pre-intervention (baseline for Intervention, 6 months for Waitlist Control) and post-intervention (3 months for Intervention, 9 months for Waitlist Control) reported
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Group Therapy Experiences Scale
Time Frame: Following completion of the intervention, up to 12 months
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The 17-item Group Therapy Experiences Scale will be used to assess the level of cohesion among group members (e.g., development of positive relationships, comfort level with other group members).
Items 1-16 are rated on a 5-point scale with 1 = "strongly agree" to 5 = "strongly disagree."
Item 17 is an open-ended question, "was there something in the group today that helped or hindered you?"relationships, comfort level with other group members).
Items are rated on a 4-point scale with 1= "strongly disagree" to 4= "strongly agree."
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Following completion of the intervention, up to 12 months
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Change in Social Isolation: PROMIS Social Isolation Scale
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The PROMIS Social Isolation Scale is a 6-item measure is used to assess social isolation.
Participants are asked to rate each item (e.g., "I felt left out," "I feel that people avoid talking to me") on a scale from 1= "never" to 5= "always."
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Change in Self-Efficacy: The Self-Efficacy for Managing Chronic Disease Scale
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The Self-Efficacy for Managing Chronic Disease Scale is a 6-item scale.
Participants rate their confidence in keeping pain, fatigue, emotional distress, and other symptoms from interfering with things they want to do on a scale from 1 "not at all confident" to 10 "totally confident."
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Change in Self-Efficacy: PROMIS Self-Efficacy for Managing Chronic Conditions - Managing Symptoms - Short Form 4a
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The PROMIS Self-Efficacy for Managing Chronic Conditions - Managing Symptoms - Short Form 4a is a 4-item scale.
Participants rate their confidence in managing their symptoms during daily activities, with relationships with friends and family, in a public place, and working with their doctor to manage these symptoms on a scale from 1 = "I am not at all confident" to 5 "I am very confident."
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Change in Emotional Support: PROMIS Emotional Support-Short Form
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The PROMIS Emotional Support Short Form is a 6-item measure used to assess emotional support.
Participants are asked to rate each item ("I have someone who will listen to me when I need to talk," "I have someone to talk with when I have a bad day") on a scale from 1= "never" to 5= "always."
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Change in Instrumental Support: PROMIS Instrumental Support-Short Form
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The PROMIS Instrumental Support Short Form is a 6-item measure used to assess instrumental support.
Participants are asked to rate each item (e.g., "Do you have someone to take you to the doctor if you needed it?,"
"Do you have someone to prepare your meals if you are unable to do it yourself?")
on a scale from 1= "never" to 5= "always."
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Change in Informational Support: PROMIS Informational Support-Short Form
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The PROMIS Informational Support Short Form is a 6-item measure used to assess informational support.
Participants are asked to rate each item (e.g., "I have someone to turn to for suggestions about how to deal with a problem," "I have someone to give me information if I need it") on a scale from 1= "never" to 5= "always."
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Change in Activity: International Physical Activity Questionnaire
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The International Physical Activity Questionnaire is a seven-item questionnaire that assesses the amount of time participants have spent doing physical activity (e.g., moderate physical activities, vigorous physical activities, walking) in the last seven
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Change in Spritual Well-Being: Functional Assessment of Chronic Illness Therapy (FACIT)
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The FACIT assesses the spiritual wellbeing of participants with 12-item questionnaire on a scale from 0 = "not at all" to 4 = "very much."
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Changes in Cancer Experience: Acceptance and Action Questionnaires for Cancer (AAQ)
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The AAQ is a 7-item questionnaire to track psychological flexibility related to coping with cancer and cancer treatment.
The scale ranges from 1 = "never true" to 7 "always true."
Item is scored by adding all of the responses together.
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Change in Activity: Stanford Leisure-Time Activity Categorical Item (LCAT)
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The Stanford LCAT is a categorical item that assesses the type of physical activities participants do.
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Changes in Living in Alignment With Values: The Valuing Questionnaire (VQ)
Time Frame: Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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The VQ is a 10-item self-report questionnaire with a scale 0 = "not true at all" to 6 "completely true."
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Baseline and again 3, 6, 9, and 12 months following the baseline assessment
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Caroline S Dorfman, Duke University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Pro00103249
- 1K08CA245107-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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