Grant Number:	2R01CA201179-06A1 Interpret this number
Primary Investigator:	Langer, Shelby
Organization:	Arizona State University-Tempe Campus
Project Title:	Couple Communication in Cancer: a Multi-Method Examination - Renewal - 1
Fiscal Year:	2024

PROJECT SUMMARY For persons with cancer and their intimate partners, the ability to communicate effectively about cancer-related issues impacts the adjustment of both individuals and their relationships. However, the vast majority of research on couple communication in cancer has been limited by reliance on global self-report measures of communication that focus on a single dimension of communication behavior (e.g., disclosure versus avoidance) without consideration of other potentially important processes such as emotional arousal, the quality of emotions expressed, and sequences and trajectories of communication behaviors. This narrow focus has prohibited advancements in our understanding of communication processes which, in turn, limits efforts to develop efficacious interventions and target them to couples most at risk of poor adjustment. The proposed study will address these limitations by leveraging a large longitudinal, multi-method dataset we collected among 353 couples coping with stage II-IV breast, colon, rectal, and lung cancer (R01 CA201179). Participants completed global self-report measures of communication four times over a one-year period; twice-daily ecological momentary assessments (EMA) over two weeks; and audio- and video-recorded couple conversations of cancer-related topics from which we coded affective expressions and communicative behaviors and obtained data on fundamental frequency, a novel objective indicator of vocally expressed emotional arousal. Preliminary results provided support for two theories of couple communication in cancer (Social Cognitive Processing and Relationship Intimacy) and underscored the utility of different indicators of communication in predicting adjustment. While these findings are promising, our original aims and methods relied on single indicators of communication in isolation, and thus did not fully capitalize on the integrative potential of the dataset. Recent advances in relationship science suggest that the integration of self-report, behavioral, and fundamental frequency data can provide a richer and more sophisticated picture of communication processes and their impacts on intra- and interpersonal outcomes. This in turn can inform the development of more targeted and efficacious interventions. Specific aims of this proposal are: (1) To identify communication profiles of couples based on EMA and observational data. (2) To examine the predictive relationship of these communication profiles to outcomes including patient and partner psychological adjustment, relational functioning, and physical and functional well-being collected at the 12-month follow up. (3a) To develop, using machine learning, a brief self-report screening tool that will identify couples most at risk for poor outcomes based on the communication profiles developed and tested in Aims 1-2. (3b) To concurrently and prospectively validate this brief screening tool in a new sample of 270 couples (patients with stage II-IV breast, colorectal, or lung cancer and their partners). (3c) To identify facilitators and barriers to implementation of the screener in a clinical setting. The goal is development of an efficient, empirically-derived measure that can be administered to patients and partners in real-world clinical settings.





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