Grant Number:	1R01CA303881-01A1 Interpret this number
Primary Investigator:	Ramos, Katherine
Organization:	Duke University
Project Title:	Randomized Controlled Trial of Self-System Therapy to Reduce Distress, Improve Emotion Regulation and Enhance Quality of Life in Older Adults with Advanced Cancer: a Telehealth Delivered Intervention
Fiscal Year:	2026

Older adults aged 60+ with advanced cancer represent a vulnerable population with a critical need for tailored psychosocial support. They face significant and multifaceted challenges posed by their diagnosis, such as complex treatments, serious adverse side effects, and age-related changes in physiology, cognition, and function, all of which complicate their care. These challenges contribute to psychological distress and may impair their emotion regulation, and quality of life. Despite the availability of cancer-focused psychosocial interventions, they often skew toward younger populations and overlook critical issues unique to older adults, such as fears of losing independence due to multiple chronic conditions, increased frailty, cognitive and functional impairments, and existential concerns. There is an urgent need for targeted supportive care interventions designed explicitly for geriatric oncology populations, accounting for their lived experiences with advanced cancer. The long-term goal is to accelerate the delivery and dissemination of psychosocial interventions for older adults with advanced cancer. The overall objectives of this application are to determine the efficacy, associated mechanisms, and sustainability of Self-System Therapy to reduce psychological distress among older patients with advanced cancer (SST-AC). The central hypothesis, based in part on preliminary data collected by the study team, is that patients who participate in SST-AC will experience decreased distress and improvements in emotion regulation and overall quality of life. The rationale for the proposed research is that rigorous scientific evidence supporting the efficacy of SST-AC at alleviating distress in older adults with advanced cancer would provide new opportunities for its continued development as a tailored psychosocial support approach. The central hypothesis will be tested by pursuing three specific aims: 1. Determine the efficacy of SST-AC compared to an education control on patient-reported outcomes of psychological distress symptoms (primary outcome), emotion regulation, and quality of life (secondary outcomes). 2. Identify the underlying mechanisms (i.e., self-discrepancies and self- efficacy) responsible for the effects of SST-AC. 3. Assess contextual and environmental factors that inform implementation strategies of SST-AC. The research proposed in this application is innovative, from the applicant’s perspective, as it addresses the lack of psychosocial interventions tailored to older adults with advanced cancer, and SST-AC teaches goal-relevant behavioral activation, self-evaluation, and goal-setting skills within an integrative, developmental, and adaptive framework. The proposed research is significant because it is expected to provide a strong justification for the continued development and future implementation of an evidence-based approach to improving the psychological well-being of older patients with advanced cancer, thereby improving patient outcomes. Ultimately, the knowledge gained from this proposal has the potential to create opportunities for developing innovative supportive care interventions that target distress and improve the quality of life in older adults with advanced cancer.




Connected care in a digital world: Engagement and telehealth use in older cancer survivors.
Authors: Odera J.O. , Osazuwa-Peters N. , Ramos K. .
Source: Journal Of Geriatric Oncology, 2026-09-12 00:00:00.0; 18(1), p. 104121.
EPub date: 2026-09-12 00:00:00.0.
PMID: 42731363
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