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Principal Investigator: Ashley M. Henneghan
Organization: UNIVERSITY OF TEXAS AT AUSTIN
Fiscal Year: 2024
Award: $193,768
Funding agency: National Institute of Nursing Research
PROJECT SUMMARY/ABSTRACT
Cancer-related cognitive impairments (CRCI) are some of the most distressing and burdensome effects of
breast cancer and its treatment. When patient reported outcomes (PROs) are used, up to 75% of survivors
report CRCI. Cognitive PROs are accessible, brief, and represent everyday cognitive functioning and quality of
life (QOL). Yet, cognitive PROs have been overlooked as primary outcomes in CRCI research, and there are
no best practices for measurement. To move the science forward, we have to determine which cognitive PRO
best reflects and predicts everyday functioning and QOL. We also need to assess CRCI within the context of
survivors’ real life where competing demands are high and functioning poor. This will facilitate a better
understanding of the individual variations and phenotypes of CRCI that traditional retrospective assessments
may not capture. Doing so will enhance our ability to detect and quantify clinical CRCI, and better measure
intervention effects aimed at improving CRCI. The proposed prospective study will collect data from 124 breast
cancer survivors (BCS, ages 21+) within 1 year of completing chemotherapy (baseline) and again 2 months
later (follow up). Between baseline and follow up data collection, ecological momentary assessments (EMAs)
will be administered daily for 56 days (5 total: current daily activity, self-ratings of anxiety, feelings of
depression, fatigue, cognitive functioning), and mobile cognitive tests (MCTs) for working memory, executive
functioning, processing speed, and memory (4 total) administered every other day. We aim to 1) compare
cognitive PRO predictors of everyday functioning (social function, QOL) across time and 2) determine
longitudinal relationships among real life contextual factors measured by EMAs, MCTs, and cognitive PROs (at
follow up). Considering the importance of PROs in healthcare research and the shift towards precision health
approaches to care, the gaps in knowledge and weaknesses of research using cognitive PROs in CRCI
research to date are critical. The proposed study is innovative in several ways: we will directly compare and
evaluate cognitive PROs based on their ability to predict everyday functioning and QOL which has not been
done before; and we will use a new methodology, intensive longitudinal assessments, to define CRCI and
capture day-to-day within person variability inherent to cognitive processes. Findings from Aim 1 will provide
data to inform instrument choices in CRCI practice and research. Findings from Aim 2 will establish the validity
and reliability of EMAs and MCTs in BCS with CRCI and facilitate accurate and precise measurement of the
lived experience. Both will facilitate rigorous observational and interventional research on CRCI in the future.
Our preliminary studies and previous work strongly support our ability to carry out the proposed study. This
study addresses the health promotion and prevention priority of the National Institute of Nursing Research—
specifically, tertiary prevention to reduce symptoms, severity, and progression of chronic diseases like cancer.
Terms: <Active Follow-up><Activities of Daily Living><Activities of everyday life><Address><After Care><After-Treatment><Aftercare><Age><Anxiety><Application Context><Attention><Breast Cancer><Breast Cancer survivor><Cancer Survivor><Cancers><Caring><Chronic Disease><Chronic Illness><Clinical><Cognition><Cognition Disorders><Cognitive><Consensus><Coupling><Data><Data Collection><Data Systems><Diagnosis><Disabling><Distress><EORTC><Ecological momentary assessment><Emotional Depression><Enrollment><European Organization for Research and Treatment of Cancer><Fatigue><Feeling><Foundations><Future><Goals><Health Care Research><Health Promotion><IT Systems><Immediate Memory><Information Systems><Information Technology Systems><Intervention Studies><Investigators><Knowledge><Lack of Energy><Life><Literature><Lived experience><Lived experiences><Malignant Breast Neoplasm><Malignant Neoplasms><Malignant Tumor><Measurement><Measures><Memory><Mental Depression><Methodology><Methods><Monitor><National Institute of Nursing Research><Nature><Observation research><Observation study><Observational Study><Observational research><Occupational><Outcome><Outcome Measure><Patient Outcomes Assessments><Patient Reported Measures><Patient Reported Outcomes><Persons><Phenotype><Precision Health><Prevention><Prospective Studies><Psychometrics><QOL><Quality of life><Recommendation><Reporting><Research><Research Personnel><Researchers><Salutogenesis><Sampling><Science><Self Assessment><Severities><Short-Term Memory><Shortterm Memory><Social Functioning><Survivors><Symptoms><Time><Validity and Reliability><Work><active followup><ages><alleviate symptom><ameliorating symptom><cancer related cognitive decline><cancer related cognitive dysfunction><cancer-related cognitive impairment><chemotherapy><chronic disorder><clinical practice><clinical significance><clinically significant><cognitive assessment><cognitive disease><cognitive disorder><cognitive function><cognitive process><cognitive syndrome><cognitive testing><contextual factors><daily living function><daily living functionality><decrease symptom><depression><depression symptom><depressive><depressive symptoms><develop therapy><enroll><executive control><executive function><experience><feelings><fewer symptoms><follow up><follow-up><followed up><followup><function socially><functional ability><functional capacity><functioning social><health care management><health management><healthcare management><healthcare research><improved><individual heterogeneity><individual variability><individual variation><innovate><innovation><innovative><insight><instrument><interest><intervention development><intervention effect><intervention research><interventional research><interventional study><interventions research><malignancy><malignant breast tumor><measurable outcome><neoplasm/cancer><outcome measurement><outcome prediction><performance tests><post treatment><primary outcome><processing speed><promoting health><prospective><reduce symptoms><relieves symptoms><social><symptom alleviation><symptom reduction><symptom relief><tertiary prevention><therapy development><treatment development><treatment planning><working memory>