Awards for 2021-2022:
Lydiah Maingi, PhD, Department of Psychology in Kenyatta University, Kenya; Joanna Arch, PhD, University of Colorado Boulder and University of Colorado Cancer Center
Gaps in Supportive Care for Cancer Patients in Kenya: Recommendations for Acceptance and Committment Therapy Intervention
Lay Summary
Throughout the world, a cancer diagnosis is often associated with distress for patients and their families. Greater social and emotional support for cancer patients and families is essential for improving patient quality of life. There is growing evidence supporting the efficacy of Acceptance and Commitment Therapy (ACT) interventions in coping with cancer-related distress. These studies, however, have generally been conducted in high income,majority white countries. Yet lower middle income countries in sub-Saharan Africa, including Kenya, have recently been experiencing high and growing prevalence rates of cancer, high cancer-related mortality, late stage at diagnosis, low cancer literacy, and high stigma, with concomitant widespread unmet oncology supportive care needs. Kenya’s National Cancer Control Strategy 2017-2022 (MOH Kenya, 2017) identifies psychosocial support care as a priority area in enhancing the quality of life for cancer patients yet there remains a severe dearth of supportive care interventions. Moreover, common cancer coping strategies among cancer patients in Kenya include viewing cancer as the result of a curse, witchcraft, or spiritual deficit. These challenges lead to high rates of depression, anxiety, and low quality of life among many cancer patients.
This study aims to establish the existing gaps in supportive care for cancer patients among the existing cancer care agencies in Kenya. The identified gaps will be used to inform how ACT could be adapted to meet the most important psychosocial and behavioral needs of cancer patients within a Kenyan context. This effort will include getting patient and provider input on potential ACT strategies and how to make them most effective for a Kenyan context. The ultimate goal is to develop a culturally-sensitive ACT-based intervention to support distressed Kenyan cancer patients. As Kenya is a regional leader, the impacts of this project have implications for the broader sub-Saharan region of Africa.
Amanda Muñoz-Martínez, Ph.D., Department of Psychology in the Universidad de Los Andes (Colombia); Clara Sophie Otto-Scheiber, M.S., Hospital Universitario de la Fundación Santa Fe de Bogotá (Colombia)
Exploring the Relationship of Perceived Social Connection and Value-Based Behaviors in Adherence to Cardiac Rehabilitation Recommendations: A Momentary Ecological Evaluation
Lay Summary
Cardiovascular diseases are the leading cause of death in the world. Adherence to cardiac rehabilitation recommendations (ACRR) is crucial for reducing mortality. Nonetheless, after patients are discharged from these programs, their engagement in healthy behaviors tend to decrease. Contextual behavioral factors such as social connection and psychological flexibility have shown positive results in improving healthy behaviors such as physical activity and diet in the general population. However, evidence on how those factors can aid cardiac rehab in a within- and between-person level is unclear. Based on it, we formulate four research questions: a) Are daily perceived social connection and engagement in valuebased behaviors related to participants adherence in cardiac rehabilitation recommendations? b) Are daily interactions in high-quality social contexts and engagement
in value-based behaviors related to higher involvement in cardiac rehabilitation recommendations? c) Does the average quality of relationships moderate the relationship between social connection and adherence to cardiac rehabilitation recommendations? and d) Does psychological flexibility moderate the relationship between value-based behavior and adherence to cardiac rehabilitation recommendation? A device-contingent diary study
will be conducted (including the pilot study-phase). Fifty-four patients discharged after a cardiovascular event and referred to the cardiac rehab program at a private hospital will be eligible to participate in this study. Ongoing data of perceived social connection (PSC), value-based behaviors (VB), and ACRR will be collected for 12-weeks.
At a between-person level, it is expected to observe higher engagement in cardiac rehab recommendations in participants reporting higher levels of social connection and engagement value-based behaviors. At an individual level, it is expected to find that on the days in which participants have higher rates of interaction in high-quality social contexts and higher engagement in value-based behaviors, there is higher engagement in cardiac rehab recommendations. Likewise, it is expected that the average quality of relationships moderates the relationship between social connection and adherence to cardiac rehabilitation recommendations and that psychological flexibility moderate the relationship between value-based behavior and adherence to cardiac rehabilitation recommendation. Results will provide information for optimizing cardiac rehabilitation programs by including
strategies to modify contextual behavioral variables within their programs.
Amanda Rhodes, PsyD, Health Psychology and Neurobehavioral Research Group (HPNRG) in the Center for Cancer Research of the National Cancer Institute (NCI)/National Institutes of Health (NIH); Staci Martin, PhD, HPNRG; Mary Anne Tamula, MA, HPNRG; Melissa Baker, BS, HPNRG
A Pilot Randomized Controlled Trial of Acceptance and Commitment Therapy for Sleep Disturbances in Sickle Cell Disease
Lay Summary
Many individuals with sickle cell disease (SCD) exhibit sleep disturbance. Sleep disturbance has shown to relate to anxiety, depression, and executive dysfunction in this population. Unfortunately, nonpharmacological interventions for sleep disturbance have not been studied in individuals with SCD. Acceptance and Commitment Therapy (ACT) is an emerging evidence-based approach for sleep problems. Preliminary research shows ACT to be effective as measured by subjective (i.e., self-report) data. Despite current recommendations to utilize both subjective and objective methods of obtaining sleep data, ACT studies have yet to measure sleep through objective measures (i.e., actigraphy, which measures sleep through a device worn on the wrist). Thus, there is a need to study ACT for Sleep in a SCD population using objective and subjective measurements. Moreover, due to some limitations of CBT sleep interventions (e.g., minimal improvements in quality of life), ACT may offer a feasible alternative approach. Thus, our study will evaluate the feasibility and acceptability of a remote ACT intervention for sleep disturbance in individuals with SCD.
Participants will be recruited from the National Heart Lung and Blood Institute (NHLBI) and randomized to the intervention immediately or after 8 weeks. Participants will complete baseline measures, a 1-week period to obtain preliminary actigraphy/sleep diary data, 8 weekly ACT sessions with a psychologist/psychology associate, and follow-up evaluations at mid-treatment, post-treatment and four weeks later. Based on preliminary data in cancer populations, we propose that this ACT for Sleep intervention will be feasible and acceptable in individuals with SCD. Further, we will explore whether the treatment significantly improves sleep and quality of life in these patients. The current study has the potential to support ACT as a non-pharmacological treatment for sleep disturbances in SCD while promoting accessibility and decreasing health disparities in underserved medical populations through a fully-remote intervention – an area of research sorely needed.