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Principal Investigator: LAURA S PORTER
Organization: DUKE UNIVERSITY
Fiscal Year: 2024
Award: $478,506
Funding agency: National Cancer Institute
For patients and their intimate partners, advanced cancer poses significant physical and
emotional challenges that can negatively impact both the individuals and the couple. Couples’
ability to communicate openly and effectively with each other about cancer-related concerns can
improve their psychological adjustment and the quality of their relationship. It may also lead to
better symptom management and goal-concordant care for the patient. However, many couples
report difficulties communicating about cancer, even in the context of overall satisfying
relationships. Prior research has found that couple-based interventions that target
communication lead to positive outcomes for cancer patients and their partners. However, most
have been limited by an in-person treatment delivery format that precludes many couples from
participating; they have also not targeted interventions to couples most at risk for poor
outcomes. To address these limitations, the proposed study will conduct an RCT to test the
efficacy of a Couples Communication Skills Training (CCST) intervention delivered via
videoconference for couples facing advanced cancer. The intervention will be targeted to
couples who report high levels of holding back from discussing cancer-related concerns, a
variable associated with poorer psychological and relationship functioning. The CCST
intervention includes components to assist couples communicate effectively, decrease
avoidance of important cancer-related issues, and provide each other with support. In the
proposed study, 230 patients with advanced GI, GU, breast, or lung cancer and their partners
will be randomly assigned to one of two conditions: 1) CCST, or 2) Education. All participants
will be provided with tablet computers with internet access for videoconferencing. Assessments,
including self-report measures and audio recorded couple conversations, will be conducted with
patients and partners at baseline, mid-treatment, and post-treatment. Self-report measures will
also be collected at 3 months follow up. The primary hypothesis to be tested is that patients and
partners in the CCST intervention will report significantly higher levels of relationship satisfaction
and intimacy relative to those in the education condition. Secondary aims will focus on (a)
improvements in patient and partner psychological adjustment; (b) improvements in patient
health and health care outcomes; and (c) whether improvements in individual and relationship
functioning are mediated by improvements in self-reported and objective measures of
communication. Exploratory analyses include (a) examination of moderators of intervention
effects, and (b) an implementation-related process evaluation of the intervention guided by the
RE-AIM framework to expedite translation of the intervention into clinical practice.
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