The EASE Study: Randomized Trial of a Novel Approach to Addressing Fear of Progression in Advanced Cancer (EASE)
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
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Colorado
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Aurora, Colorado, Stati Uniti, 80045
- Reclutamento
- University of Colorado Anschutz Medical Campus
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Contatto:
- Joanna Arch, PhD
- Numero di telefono: 720-897-1850
- Email: ease@colorado.edu
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Boulder, Colorado, Stati Uniti, 80309
- Reclutamento
- University of Colorado Boulder
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Investigatore principale:
- Joanna Arch, PhD
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Contatto:
- Sarah Genung
- Numero di telefono: 720-897-1850
- Email: ease@colorado.edu
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Contatto:
- Elliot Sandberg
- Numero di telefono: 720-897-1850
- Email: ease@colorado.edu
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Adults, age 18 or older
- Have been diagnosed with either (a) Stage IV metastatic cancer of any solid tumor type, (b) Stage III ovarian cancer that has recurred, (c) 'extensive stage' small cell lung cancer, or (d) glioblastomas of any staging
- Are capable at time of consent of understanding and voluntarily consenting themselves to the study, attending intervention sessions, and writing for 30 minutes, confirmed by an Eastern Cooperative Group Performance Status Scale of ≤2
- Report elevated FoP and cancer-related trauma symptoms on the screening measures: FoP-Q 12-item short version: mean score of 2.5 (or total score of 30), IES-R: mean of 1.5 (or total score of 33)
- Are fluent in English or Spanish and can read English proficiently (for the surveys, which are in English)
Exclusion Criteria:
- Patients who have a history of chronic untreated trauma unrelated to their cancer, psychiatric hospitalization or suicide attempt(s) in the past 2 years, or current high suicide risk, as identified in the screening.
- EMR-noted cognitive impairment (such as dementia) is an exclusion due to potential impairments in neural learning mechanisms that may affect the efficacy of exposure therapy.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Terapia di supporto
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Doppio
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
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Sperimentale: EASE (Written Exposure-Based Coping Intervention)
EASE intervention over 6 individual sessions.
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The EASE intervention includes 6-sessions of structured writing designed to reduce fear of progression (FoP) and cancer-related trauma symptoms in adults with advanced cancer.
Adapted from Written Exposure Therapy (WET), EASE will be delivered via telehealth by trained interventionists through 1:1 sessions.
Each session will last approximately 60 minutes.
The first session begins with an assessment, where participants identify their worst-case scenario related to their cancer.
In the next three sessions, participants engage in structured exposure writing about this imagined scenario, focusing on vivid, sensory-rich descriptions and thoughts and feelings.
The final two sessions involve coping writing, where participants re-evaluate the realism of their scenario.
If deemed unlikely, they write about a more realistic outcome and how to cope with it; if likely, they focus on coping strategies for the original scenario
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Altro: Control: Usual Care
Usual Care (UC) consists of access to supportive care providers available at treatment sites.
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Usual Care (UC) consists of access to a clinical social worker and nurse practitioners for supportive visits at patient request.
To account for individual and site differences in use/availability of UC resources, patients in both arms will report use of non-study cancer supportive care using piloted trackers.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Fear of Progression Questionnaire, Short Form (with cancer as the disease)
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Assesses fear of cancer progression.
Higher scores = higher fear of progression.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Impact of Events Scale-Revised (with cancer as the event)
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Cancer-related trauma symptoms.
Higher scores = higher symptom levels.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Concerns About Recurrence Scale (CARS overall fear scale)
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Fear of cancer recurrence/progression.
Higher scores = higher fear of recurrence/progression.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Generalized Anxiety Disorder-7
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Anxiety symptoms.
Higher scores = higher anxiety symptoms.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Patient Health Questionnaire-8
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Depression symptoms.
Higher scores = higher depression symptoms.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Hopelessness Assessment in Illness Questionnaire
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Hopelessness regarding one's illness.
Higher scores = higher hopelessness.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Functional Assessment of Cancer Therapy-General-7 item version (FACT-G7)
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Quality of life with cancer.
Higher scores = higher quality of life.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Valuing Questionnaire, Obstruction and Progress Scales
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Measures movement towards values and goals.
Higher scores = greater movement towards values and goals.
Theorized process variable.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Death Attitude Profile Revised (DAP-R), Death Avoidance and Fear of Death Scales
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Measures rigidly avoidance of all thinking about dying; fear of dying.
Higher scores = higher avoidance and fear.
Theorized process variable.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Coping Orientation to Problems Experienced Inventory (COPE) - Behavioral and Emotional Disengagement Scale and Emotion Approach Coping Scale
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Measures use of avoidance-based coping strategies.
Higher scores = higher use of coping strategies.
Theorized process variable.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Intolerance of Uncertainty (IUS-4)
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Measures behavioral reactions to ambiguous or uncertain situations.
Higher scores = greater levels of intolerance of uncertainty.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Positive and Negative Affect Schedule (PANAS)
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Measures emotional state.
Higher scores = higher intensity of affect.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Positive and Negative Valence Systems Scale (PVSS)
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Measures reward sensitivity.
Higher scores = higher reward sensitivity.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Scale - Short Form Version 1.0
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Measures fatigue and lack of vitality.
Higher scores = higher levels of fatigue and higher lack of vitality.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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RAND Short Form Health Survey (RAND-SF 36), 2-items
Lasso di tempo: Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Measures perceived health.
Higher scores = lower perceived health.
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Assessed four times with parallel timing in the control group: prior to the intervention (Pre), following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Adverse Childhood Experience Questionnaire for Adults
Lasso di tempo: Assessed once with parallel timing in the control group: prior to the intervention (Pre).
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Measures childhood exposure to trauma.
Higher scores = higher levels of exposure to trauma.
Theorized moderator/predictor.
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Assessed once with parallel timing in the control group: prior to the intervention (Pre).
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Demographics, Short Cancer History Questionnaire, History of journaling/creative writing
Lasso di tempo: Assessed once with parallel timing in the control group: prior to the intervention (Pre).
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Demographics and cancer treatment history - Relevant cancer diagnostic and treatment history items will be confirmed via medical chart review, Single item about history of journaling or use of writing to process emotion
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Assessed once with parallel timing in the control group: prior to the intervention (Pre).
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Client Satisfaction Questionnaire-8
Lasso di tempo: Assessed twice in intervention group only: within one week after the end of the weekly intervention (Post), and at 3-month follow-up (FU).
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Measures client satisfaction with the intervention.
Higher scores = higher satisfaction.
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Assessed twice in intervention group only: within one week after the end of the weekly intervention (Post), and at 3-month follow-up (FU).
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Sharing of Scenario
Lasso di tempo: Assessed three times with parallel timing in the control group: following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Item assessing whether participant has discussed their scenario with anyone else.
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Assessed three times with parallel timing in the control group: following session 3 of the intervention (Mid), within one week after the end of the weekly intervention (Post), at 3-month follow-up (FU).
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Reflection Questions
Lasso di tempo: Assessed pre and post- each 30-minute writing block in EASE Sessions 1-5, in the intervention group only.
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Description of experience of writing.
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Assessed pre and post- each 30-minute writing block in EASE Sessions 1-5, in the intervention group only.
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Collaboratori e investigatori
Sponsor
Sponsor
Collaboratori
Collaboratori
Pubblicazioni e link utili
Pubblicazioni generali
- Arch JJ, Kirk MH, Finkelstein LB. Patient-Reported Worst-Case Scenarios in Advanced Cancer: Presence, Contents, and Predictors. Psychooncology. 2024 Dec;33(12):e70039. doi: 10.1002/pon.70039.
- Finkelstein LB, Wojdak CP, Studts JL, Arch JJ. Writing Content Predicts Outcomes in Written Exposure to Worst-Case Scenarios for Advanced Cancer. J Palliat Med. 2025 Dec;28(12):1648-1653. doi: 10.1089/jpm.2024.0463. Epub 2025 Jun 12.
- Arch JJ, Slivjak ET, Finkelstein LB. A Novel Intervention to Reduce Fear of Progression and Trauma Symptoms in Advanced Cancer Using Written Exposure to Worst-Case Scenarios. J Palliat Med. 2024 Aug;27(8):1009-1017. doi: 10.1089/jpm.2023.0658. Epub 2024 Apr 5.
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Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Malattie urogenitali
- Malattie genitali
- Malattie del sistema endocrino
- Neoplasie urogenitali
- Neoplasie per sede
- Malattie urogenitali femminili
- Malattie urogenitali femminili e complicanze della gravidanza
- Neoplasie per tipo istologico
- Malattie genitali, femmina
- Neoplasie delle ghiandole endocrine
- Neoplasie, ghiandolari ed epiteliali
- Malattie ovariche
- Malattie annessiali
- Neoplasie genitali, femmina
- Disturbi gonadici
- Astrocitoma
- Glioma
- Neoplasie, Neuroepiteliali
- Tumori neuroectodermici
- Neoplasie, cellule germinali ed embrionali
- Neoplasie, tessuto nervoso
- Neoplasie
- Neoplasie ovariche
- Glioblastoma
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- 25-0367
- 1R01CA300028 (Sovvenzione/contratto NIH degli Stati Uniti)
Piano per i dati dei singoli partecipanti (IPD)
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Tipo di informazioni di supporto alla condivisione IPD
- STUDIO_PROTOCOLLO
- ICF
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