||1R37CA255875-01 Interpret this number
||Northwestern University At Chicago
||Technology Facilitated Behavioral Intervention for Depression Among Diverse Patients in Ambulatory Oncology
Depressionis one of the most common psychological comorbidities experienced throughout the cancercontinuum. Elevated depressive symptoms in oncology patients is a major concern as unmanaged depressive
symptoms in cancer patients is associated with poor health-related quality of life (HRQoL), poor adherence to
cancer treatments, delayed return to work and baseline function, greater emergency department visits, greater
risk of suicide, and higher all-cause mortality. Behavioral interventions for the management of depression are
efficacious, but scalability and implementation of these evidence-based interventions in oncology is limited.
information technologies (HIT) provide an ideal opportunity t o expedite the administration, scoring, and
of depression screening with well-validated, brief and precise measurement tools that can
actionable data to screen for depression, and deliver pragmatic and scalable evidence-based
interventions that are proven to reduce depressive symptomatology across various other
Despite the benefits of these HITs,use of technology-based models to screen and deliver
evidence-based behavioral treatments that address the depressive symptoms in cancer remains
underdeveloped and poorly implemented.
evaluate the effectiveness and the implementation of an
evidence-based HIT behavioral treatment for cancer patients with elevated depressive symptoms. This HIT
treatment combines systematic, electronic health record-integrated screening for depressive symptoms with an
individually-tailored HIT interventions to address gaps in the treatment of depression among cancer patients.
The study takes place across two distinct health systems in two major metropolitan areas—Chicago and Miami
(Northwestern Medicine and University of Miami Health System). We aim to conduct a pragmatic Type I
effectiveness-implementation hybrid trial of My Cancer Support—an evidence-based, tailored behavioral HIT
program for the management of elevated depressive symptoms—in ambulatory oncology care settings within
two large health systems. We will establish the effectiveness of My Cancer Support on depressive
symptoms(i.e., primary outcome) and anxiety, HRQoL, and health services use (i.e. secondary outcomes)
compared to usual care. We will evaluate the process of implementing My Cancer Support and its impact on
patient and system-level outcomes, including reach, adoption, maintenance, and acceptability. Next, we will
identify facilitators and barriers to wide-scale implementation of My Cancer Support beyond Northwestern
Medicine and University of Miami Health System. Finally, we will explore whether the effects of My Cancer
Support vary across SES, language, disease severity, severity of depressive symptoms, recruitment sites, and
other patient and clinical characteristics.