Grant Number:	1R01CA299858-01A1 Interpret this number
Primary Investigator:	Lyons, Kathleen
Organization:	Mgh Institute Of Health Professions
Project Title:	Optimization of a Multicomponent Intervention to Foster Functional Recovery After Breast Cancer Treatment
Fiscal Year:	2026

PROJECT SUMMARY/ABSTRACT Almost one-third of breast cancer survivors report an inability to fully participate in vocational, social, physical, and instrumental activities of daily living. Breast cancer survivors who report lower participation in these activities report lower quality of life, greater depression, and are at risk for shortened survival. The long-term goal of this research is to address the absence of scalable, accessible, evidence-based interventions that improve cancer survivors' participation in life roles and activities. The objective of this R01 project is to systematically develop an intervention package ready for efficacy testing. We used the Multiphase Optimization Strategy (MOST) Framework to create a conceptual model of three remotely-delivered intervention components that have the potential to increase breast cancer survivors' engagement in role-relevant, valued activities: (1) priority elicitation, (2) education, and (3) guided application involving goal setting, problem-solving and action planning. The proposal will answer the research question: Which of the intervention components, alone or in combination, most effectively reduce participation restrictions? We will conduct a MOST optimization trial using a 23 factorial design, randomizing 352 breast cancer survivors to one of eight conditions that offers a unique combination of the three intervention components. Aim 1 will test the main effects and interactions among the three components. Aim 2 will evaluate the mechanisms of action by testing the effect of each component on its hypothesized proximal target that can catalyze participation in social roles and activities. We hypothesize that priority elicitation will have the strongest effect on engagement in meaningful activities, education will have the strongest effect on self- efficacy for managing health and activity, and guided application will have the strongest effect on adaptive coping. Aim 3 will provide the analysis to assemble an optimized intervention package by evaluating the main effects and interactions using the following optimization criterion: The largest effect on participation restrictions. The approach is innovative because it targets an area that reflects a priority of cancer survivors: helping them to find ways to fully and comfortably engage in the idiosyncratic activities that make life worth living. It uses the MOST framework to better understand the mechanisms of action that can reduce participation restrictions. The project reflects NOT-OD-22-203 which calls for “systematic development… of behavioral interventions and their components” using “innovative…designs for building… and optimizing… interventions.” The proposed research is significant because it helps breast cancer survivors develop strategies to enhance productivity at home, in the workplace, and in the community, and to create sustainable lifestyle changes that foster health, participation, and functional well-being. As such, the knowledge gained from this study has the potential to advance the mission of the Division of Cancer Control and Population Sciences of the National Cancer Institute by reducing disability and improving the quality of life of cancer survivors.