A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention

Daniel L. Hall; Beverly J. Levine; Elizabeth Jeter; Allison Chandler; Janet A. Tooze; Jenna Duffecy; David Victorson; William Gradishar; Joseph Leach; Thomas Saphner; Mary Lou Smith; Frank Penedo; David C. Mohr; David Cella; Lynne I. Wagner

doi:10.1007/s10865-022-00349-8

A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention

Daniel L. Hall^*, Beverly J. Levine, Elizabeth Jeter, Allison Chandler, Janet A. Tooze, Jenna Duffecy, David Victorson, William Gradishar, Joseph Leach, Thomas Saphner, Mary Lou Smith, Frank Penedo, David C. Mohr, David Cella, Lynne I. Wagner

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Fear of recurrence (FoR) is prevalent among breast cancer survivors (BCS) and may be exacerbated by avoidance coping. This study examined BCS with avoidance coping and their engagement in a FoR eHealth intervention (FoRtitude). Methods: BCS (N = 196) with elevated FoR participated in FoRtitude. Patient-reported measures assessed avoidance coping with FoR and baseline emotional and behavioral health. Intervention engagement was measured quantitatively (e.g., website logins, telecoaching attendance) and qualitatively (i.e., telecoaching notes). Results: 38 BCS (19%) endorsed avoidance coping, which was associated with more severe post-traumatic anxiety-related symptoms and worse global mental health (ps <.05), but not anxiety (p =.19), depression (p =.11), physical health (p =.12), alcohol consumption (p =.85), or physical activity (p =.39). Avoidance coping was not associated with engagement levels (ps >.05) but did characterize engagement-related motivators and barriers. Conclusions: Avoidance coping was not a barrier to FoRtitude engagement. eHealth delivery is a promising modality for engaging survivors with avoidance coping in FoR interventions.

Original language	English (US)
Pages (from-to)	771-781
Number of pages	11
Journal	Journal of Behavioral Medicine
Volume	45
Issue number	5
DOIs	https://doi.org/10.1007/s10865-022-00349-8
State	Published - Oct 2022

Funding

This work was supported by the National Cancer Institute at the National Institutes of Health (CA173193, 1UG1CA189828, 2U10CA37403) and by the ECOG-ACRIN Medical Research Foundation. DH was supported by NCCIH K23AT010157.

Keywords

Avoidance
Cancer
Fear of recurrence
Survivorship
eHealth

ASJC Scopus subject areas

General Psychology
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10865-022-00349-8

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Hall, D. L., Levine, B. J., Jeter, E., Chandler, A., Tooze, J. A., Duffecy, J., Victorson, D., Gradishar, W., Leach, J., Saphner, T., Smith, M. L., Penedo, F., Mohr, D. C., Cella, D., & Wagner, L. I. (2022). A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention. Journal of Behavioral Medicine, 45(5), 771-781. https://doi.org/10.1007/s10865-022-00349-8

@article{b6dacd19115b4a66892f4850560b5de8,

title = "A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention",

abstract = "Background: Fear of recurrence (FoR) is prevalent among breast cancer survivors (BCS) and may be exacerbated by avoidance coping. This study examined BCS with avoidance coping and their engagement in a FoR eHealth intervention (FoRtitude). Methods: BCS (N = 196) with elevated FoR participated in FoRtitude. Patient-reported measures assessed avoidance coping with FoR and baseline emotional and behavioral health. Intervention engagement was measured quantitatively (e.g., website logins, telecoaching attendance) and qualitatively (i.e., telecoaching notes). Results: 38 BCS (19%) endorsed avoidance coping, which was associated with more severe post-traumatic anxiety-related symptoms and worse global mental health (ps <.05), but not anxiety (p =.19), depression (p =.11), physical health (p =.12), alcohol consumption (p =.85), or physical activity (p =.39). Avoidance coping was not associated with engagement levels (ps >.05) but did characterize engagement-related motivators and barriers. Conclusions: Avoidance coping was not a barrier to FoRtitude engagement. eHealth delivery is a promising modality for engaging survivors with avoidance coping in FoR interventions.",

keywords = "Avoidance, Cancer, Fear of recurrence, Survivorship, eHealth",

author = "Hall, {Daniel L.} and Levine, {Beverly J.} and Elizabeth Jeter and Allison Chandler and Tooze, {Janet A.} and Jenna Duffecy and David Victorson and William Gradishar and Joseph Leach and Thomas Saphner and Smith, {Mary Lou} and Frank Penedo and Mohr, {David C.} and David Cella and Wagner, {Lynne I.}",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2022",

month = oct,

doi = "10.1007/s10865-022-00349-8",

language = "English (US)",

volume = "45",

pages = "771--781",

journal = "Journal of Behavioral Medicine",

issn = "0160-7715",

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Hall, DL, Levine, BJ, Jeter, E, Chandler, A, Tooze, JA, Duffecy, J, Victorson, D , Gradishar, W, Leach, J, Saphner, T, Smith, ML, Penedo, F, Mohr, DC , Cella, D & Wagner, LI 2022, 'A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention', Journal of Behavioral Medicine, vol. 45, no. 5, pp. 771-781. https://doi.org/10.1007/s10865-022-00349-8

TY - JOUR

T1 - A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention

AU - Hall, Daniel L.

AU - Levine, Beverly J.

AU - Jeter, Elizabeth

AU - Chandler, Allison

AU - Tooze, Janet A.

AU - Duffecy, Jenna

AU - Victorson, David

AU - Gradishar, William

AU - Leach, Joseph

AU - Saphner, Thomas

AU - Smith, Mary Lou

AU - Penedo, Frank

AU - Mohr, David C.

AU - Cella, David

AU - Wagner, Lynne I.

PY - 2022/10

Y1 - 2022/10

N2 - Background: Fear of recurrence (FoR) is prevalent among breast cancer survivors (BCS) and may be exacerbated by avoidance coping. This study examined BCS with avoidance coping and their engagement in a FoR eHealth intervention (FoRtitude). Methods: BCS (N = 196) with elevated FoR participated in FoRtitude. Patient-reported measures assessed avoidance coping with FoR and baseline emotional and behavioral health. Intervention engagement was measured quantitatively (e.g., website logins, telecoaching attendance) and qualitatively (i.e., telecoaching notes). Results: 38 BCS (19%) endorsed avoidance coping, which was associated with more severe post-traumatic anxiety-related symptoms and worse global mental health (ps <.05), but not anxiety (p =.19), depression (p =.11), physical health (p =.12), alcohol consumption (p =.85), or physical activity (p =.39). Avoidance coping was not associated with engagement levels (ps >.05) but did characterize engagement-related motivators and barriers. Conclusions: Avoidance coping was not a barrier to FoRtitude engagement. eHealth delivery is a promising modality for engaging survivors with avoidance coping in FoR interventions.

AB - Background: Fear of recurrence (FoR) is prevalent among breast cancer survivors (BCS) and may be exacerbated by avoidance coping. This study examined BCS with avoidance coping and their engagement in a FoR eHealth intervention (FoRtitude). Methods: BCS (N = 196) with elevated FoR participated in FoRtitude. Patient-reported measures assessed avoidance coping with FoR and baseline emotional and behavioral health. Intervention engagement was measured quantitatively (e.g., website logins, telecoaching attendance) and qualitatively (i.e., telecoaching notes). Results: 38 BCS (19%) endorsed avoidance coping, which was associated with more severe post-traumatic anxiety-related symptoms and worse global mental health (ps <.05), but not anxiety (p =.19), depression (p =.11), physical health (p =.12), alcohol consumption (p =.85), or physical activity (p =.39). Avoidance coping was not associated with engagement levels (ps >.05) but did characterize engagement-related motivators and barriers. Conclusions: Avoidance coping was not a barrier to FoRtitude engagement. eHealth delivery is a promising modality for engaging survivors with avoidance coping in FoR interventions.

KW - Avoidance

KW - Cancer

KW - Fear of recurrence

KW - Survivorship

KW - eHealth

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SN - 0160-7715

VL - 45

SP - 771

EP - 781

JO - Journal of Behavioral Medicine

JF - Journal of Behavioral Medicine

IS - 5

ER -

A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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