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E-health Intervention for Cancer Survivors (Onward)

18 mars 2014 mis à jour par: David Mohr, Northwestern University

Project Onward: an Innovative E-health Intervention for Cancer Survivors

This study will develop and examine the effectiveness of an intervention that utilizes multiple telecommunications technologies to improve cancer survivors' access to mental health care and increase their ability to manage the high risk transition time from active cancer treatment to survivorship. The intervention, referred to as Project Onward, uses an interactive website, e-mail, telephone, and an online social network. The purpose of this study is to pilot a novel intervention that can reduce costs, examine methods to improve adherence to internet based treatment and overcome numerous barriers to treatment for mental health concerns.

Aperçu de l'étude

Description détaillée

Nearly 65% of those with cancer diagnoses will survive for at least 5 years, with approximately 10.5 million cancer survivors in the United States. The time of transition for cancer patients, from active treatment to survivorship, has been identified as a time of high risk for depression and anxiety. Cancer survivors experience higher rates of anxiety and depression than those without a cancer history. Research has identified fear of recurrence, perceived loss of support, and social pressure to resume a "normal" life, among other phenomena, as sources for this emotional distress. However, only about 20% of all patients referred for psychotherapy ever enter treatment and of those who initiate treatment, nearly half drop out before completion. This suggests that there are significant barriers to receiving care. These barriers may be even higher for cancer survivors struggling with issues related to re-entry, such as returning to work, resuming household responsibilities and managing residual symptoms such as fatigue or pain.

The internet promises to provide inexpensive access to treatment at any time of the day or night. Unfortunately, the potential for internet delivered services has not been realized. Studies examining treatments that simply provide access to an internet site commonly result in very high dropout after the first site visit, and typically little or no improvement target symptoms. A variety of methods to improve responses to internet interventions have been examined. In general, e-mail support improves adherence and telephone support can improve adherence even more. Another type of support that has only begun to be investigated is the use of social networks to help maintain adherence.

This intervention will combine a variety of outreach methods, including telephone, email and an online social network, to increase adherence and promote the use of the website and the skills it teaches.

Type d'étude

Interventionnel

Inscription (Réel)

31

Phase

  • La phase 1

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Illinois
      • Chicago, Illinois, États-Unis, 60611
        • Northwestern University

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

19 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Any cancer diagnosis
  2. Has completed treatment for cancer and is currently in full remission.
  3. ECOG performance Status of < 3.
  4. No history of hospitalization for psychiatric reasons with in the past 5 years.
  5. Has a telephone, e-mail account, computer, and broadband access to the Internet.
  6. Has familiarity with using the Internet that allows for adequate navigation of website.
  7. Is able to speak and read English.
  8. Is at least 19 years of age.
  9. Is able to give informed consent.

Exclusion Criteria:

  1. Has hearing or voice impairment that would prevent participation in assessments or coach treatment arm
  2. Has visual impairment that would prevent use of the website and completion of assessment materials.
  3. Diagnosis of basal or squamous cell skin cancers

3) Has physical impairments that would limit use of the computer. 4) Meets criteria for dementia by scoring < 25 on the Telephone Interview for Cognitive Status (TICS).

5) Is diagnosed with a psychotic disorder, bipolar disorder, dissociative disorder, current post-traumatic stress disorder (PTSD), current substance abuse, or other diagnosis for which participation in a clinical trial of an internet intervention may be either inappropriate or dangerous, or has been hospitalized for psychiatric reasons within the past 5 years. Patients with substance abuse diagnoses who have been abstinent for 3 months will be admitted if otherwise eligible.

6) Is currently receiving individual psychotherapy or planning to receive psychotherapy during the 8-week treatment phase of the study.

7) Is planning to be out of town or unavailable for treatment for 2 weeks or more during the scheduled treatment time.

8) Exhibits severe suicidality, including ideation, plan, and intent. 9) Has initiated treatment with an antidepressant in past 10 days. Once patients have been on a stable dose for 10 days and do not have an appointment with a physician or psychiatrist to change this dose, the patient will be eligible based on this criterion.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Project Onward website + social network
This arm has the website which includes 8 weeks of Internet-based cognitive behavioral therapy combined with discussion and support from a group of up to 8 other cancer survivors.
The website will include 8 weeks of Internet-based cognitive behavioral therapy combined with discussion and support from a group of up to 8 other cancer survivors.
Comparateur actif: Project Onward website
This arm has the website which includes 8 weeks of Internet-based cognitive behavioral therapy.
Access to an interactive website that provides 8 weeks of Internet-based cognitive behavioral therapy.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Délai
Dépression, telle que mesurée par l'échelle d'anxiété et de dépression hospitalière (HADS)
Délai: Mesuré au départ, 4 semaines, 8 semaines et 12 semaines
Mesuré au départ, 4 semaines, 8 semaines et 12 semaines

Mesures de résultats secondaires

Mesure des résultats
Délai
Utilisation du site Web (par exemple, nombre de connexions, durée moyenne des visites, temps total passé sur le site, nombre d'exercices terminés)
Délai: De la ligne de base à 12 semaines
De la ligne de base à 12 semaines

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: David C. Mohr, Ph.D., Northwestern University

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 avril 2010

Achèvement primaire (Réel)

1 avril 2011

Achèvement de l'étude (Réel)

1 juin 2011

Dates d'inscription aux études

Première soumission

29 avril 2010

Première soumission répondant aux critères de contrôle qualité

30 avril 2010

Première publication (Estimation)

3 mai 2010

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

19 mars 2014

Dernière mise à jour soumise répondant aux critères de contrôle qualité

18 mars 2014

Dernière vérification

1 juin 2013

Plus d'information

Termes liés à cette étude

Autres numéros d'identification d'étude

  • STU00026896

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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