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Grant Details

Grant Number: 1R01CA126971-01A1 Interpret this number
Primary Investigator: Laudenslager, Mark
Organization: University Of Colorado Denver
Project Title: Psychoeducation for Bmt Caregivers: Biobehavioral Markers and Outcome
Fiscal Year: 2008


DESCRIPTION (provided by applicant): This resubmission is in response to PA-07-046, "Research on mind body interactions and health." The National Cancer Institute is particularly concerned about cancer survivorship in which the caregiver is viewed as an integral component of the patient's recovery process. The number of adult caregivers exceeded 5.9 million in 2000, affecting over 22.4 million households in the US. Although caregivers may reduce medical care costs of the patient, the impact on the caregiver is substantial leading to lost work, financial burden, and increased medical and mental health problems. There is an extensive literature on the impact of caregiving on psychological well being, immune regulation, and neuroendocrine balance. Perturbations in these basic homeostatic processes have long term health consequences for the caregivers. Caregivers of patients receiving allogeneic blood and marrow transplants (BMT) are faced with a stressful experience marked by uncertainly and the likelihood of iatrogenic illness in the patient such as graft versus host disease associated with BMT. Approval for an allogeneic BMT requires the presence of a 24 hour caregiver for at least 100 days and quite often longer. Although a number of interventions have targeted the cancer patient, there have been few that have focused on the caregiver cancer patients and even fewer that have followed biomarkers in association with these interventions. Stress management and psychoeducation has been demonstrated as useful when dependent variables include behavioral markers. However many intervention studies have used convenience samples, failed to randomize treatments, did not include control groups for comparison purposes, or omitted biomarkers. The present study proposes a randomized control trial with intent to treat of BMT patient caregivers assigned to either treatment as usual or individualized stress management psychoeducation that includes a biofeedback device for training paced respiration which also tracks compliance. Dependent measures include caregiver and patient health, immune and endocrine markers, sleep characteristics via actimetry, and behavioral assessments of stress, depression, anxiety, and burden. This unique stress management psychoeducation intervention is expected to have positive effects on biomarkers of caregiver physical and psychological health including sleep, immune markers (natural cytotoxicity and Type 1 and 2 cytokine balance), and endocrine markers (diurnal variations in salivary cortisol and DHEA) compared to treatment as usual. This intervention focuses on needs of caregivers raised by the Surgeon General's Rx for caregivers at fundamental levels by 1) addressing issues around depression and anxiety, 2) identifying sources of support within the community for the caregivers, 3) focusing on the role of the caregiver's own health in their care of the patient, 4) sensitizing the caregivers to their stress and its effects on them, 5) teaching the caregiver about the illness their loved one is experiencing, and 6) providing stress management tools. PUBLIC HEALTH RELEVENCE. In a nation where three out of every four American families will have at least one member diagnosed with cancer, "survivorship" according to the National Cancer Institute (NCI) includes both the patient and those who support them. Caregivers are a distressed group which has become the focus of the NCI as well as the Office of the Surgeon General. Caregivers of blood and marrow transplant (BMT) patients are a particularly distressed group since their care is required 24/7 for the first 100 days following transplantation. The present study will test using a randomized control design, the impact of a stress management psychoeducation program versus treatment as usual on the physical and mental health of BMT caregivers since caregiver health is crucial to the long term prognosis in BMT patients as well.


Association between employment status change and depression and anxiety in allogeneic stem cell transplant caregivers.
Authors: Natvig C. , Mikulich-Gilbertson S.K. , Laudenslager M.L. , Bradley C.J. .
Source: Journal of cancer survivorship : research and practice, 2022 Oct; 16(5), p. 1090-1095.
EPub date: 2021-08-21.
PMID: 34417708
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An evidence-based stress management intervention for allogeneic hematopoietic stem cell transplant caregivers: development, feasibility and acceptability.
Authors: Simoneau T.L. , Kilbourn K. , Spradley J. , Laudenslager M.L. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2017 Aug; 25(8), p. 2515-2523.
EPub date: 2017-03-10.
PMID: 28283805
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A randomized controlled pilot study of inflammatory gene expression in response to a stress management intervention for stem cell transplant caregivers.
Authors: Laudenslager M.L. , Simoneau T.L. , Philips S. , Benitez P. , Natvig C. , Cole S. .
Source: Journal of behavioral medicine, 2016 Apr; 39(2), p. 346-54.
EPub date: 2016-01-05.
PMID: 26733011
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Sleep Moderates and Mediates the Relationship Between Acculturation and Depressive Symptoms in Pregnant Mexican-American Women.
Authors: D'Anna-Hernandez K.L. , Garcia E. , Coussons-Read M. , Laudenslager M.L. , Ross R.G. .
Source: Maternal and child health journal, 2016 Feb; 20(2), p. 422-33.
PMID: 26728897
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Intraindividual Cortisol Variability and Psychological Functioning in Caregivers of Hematopoietic Stem Cell Transplant Patients.
Authors: Sannes T.S. , Mikulich-Gilbertson S.K. , Natvig C.L. , Laudenslager M.L. .
Source: Psychosomatic medicine, 2016 Feb-Mar; 78(2), p. 242-7.
PMID: 26569536
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Cardiovascular responses to an acute psychological stressor are associated with the cortisol awakening response in individuals with chronic neck pain.
Authors: Shahidi B. , Sannes T. , Laudenslager M. , Maluf K.S. .
Source: Physiology & behavior, 2015-10-15; 150, p. 93-8.
EPub date: 2015-02-07.
PMID: 25662023
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A randomized control trial of a psychosocial intervention for caregivers of allogeneic hematopoietic stem cell transplant patients: effects on distress.
Authors: Laudenslager M.L. , Simoneau T.L. , Kilbourn K. , Natvig C. , Philips S. , Spradley J. , Benitez P. , McSweeney P. , Mikulich-Gilbertson S.K. .
Source: Bone marrow transplantation, 2015 Aug; 50(8), p. 1110-8.
EPub date: 2015-05-11.
PMID: 25961767
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Distress among caregivers of phase I trial participants: a cross-sectional study.
Authors: Kessler E.R. , Moss A. , Eckhardt S.G. , Laudenslager M.L. , Kilbourn K. , Mauss I.B. , Bowles D.W. , Hecker S. , Fairclough D.L. , Kutner J.S. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2014 Dec; 22(12), p. 3331-40.
EPub date: 2014-08-15.
PMID: 25120010
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Chemical processing and shampooing impact cortisol measured in human hair.
Authors: Hoffman M.C. , Karban L.V. , Benitez P. , Goodteacher A. , Laudenslager M.L. .
Source: Clinical and investigative medicine. Medecine clinique et experimentale, 2014-08-01; 37(4), p. E252-7.
EPub date: 2014-08-01.
PMID: 25090265
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Self-compassion training modulates alpha-amylase, heart rate variability, and subjective responses to social evaluative threat in women.
Authors: Arch J.J. , Brown K.W. , Dean D.J. , Landy L.N. , Brown K.D. , Laudenslager M.L. .
Source: Psychoneuroendocrinology, 2014 Apr; 42, p. 49-58.
EPub date: 2014-01-07.
PMID: 24636501
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Decreased mental health care utilization following a psychosocial intervention in caregivers of hematopoietic stem cell transplant patients.
Authors: Ouseph R. , Croy C. , Natvig C. , Simoneau T. , Laudenslager M.L. .
Source: Mental illness, 2014-03-04; 6(1), p. 5120.
EPub date: 2014-03-25.
PMID: 25478136
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Anxiety, depression, stress, and cortisol levels in mothers of children undergoing maintenance therapy for childhood acute lymphoblastic leukemia.
Authors: Neu M. , Matthews E. , King N.A. , Cook P.F. , Laudenslager M.L. .
Source: Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses, 2014 Mar-Apr; 31(2), p. 104-13.
PMID: 24608702
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"Anatomy of an Illness": control from a caregiver's perspective.
Authors: Laudenslager M.L. .
Source: Brain, behavior, and immunity, 2014 Feb; 36, p. 1-8.
EPub date: 2013-09-06.
PMID: 24012646
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Diurnal patterns of salivary cortisol and DHEA using a novel collection device: electronic monitoring confirms accurate recording of collection time using this device.
Authors: Laudenslager M.L. , Calderone J. , Philips S. , Natvig C. , Carlson N.E. .
Source: Psychoneuroendocrinology, 2013 Sep; 38(9), p. 1596-606.
EPub date: 2013-03-13.
PMID: 23490073
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Elevated peri-transplant distress in caregivers of allogeneic blood or marrow transplant patients.
Authors: Simoneau T.L. , Mikulich-Gilbertson S.K. , Natvig C. , Kilbourn K. , Spradley J. , Grzywa-Cobb R. , Philips S. , McSweeney P. , Laudenslager M.L. .
Source: Psycho-oncology, 2013 Sep; 22(9), p. 2064-70.
EPub date: 2013-02-25.
PMID: 23440998
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Developmental patterns of hair cortisol in male and female nonhuman primates: lower hair cortisol levels in vervet males emerge at puberty.
Authors: Laudenslager M.L. , Jorgensen M.J. , Fairbanks L.A. .
Source: Psychoneuroendocrinology, 2012 Oct; 37(10), p. 1736-9.
EPub date: 2012-04-10.
PMID: 22497987
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Acculturation, maternal cortisol, and birth outcomes in women of Mexican descent.
Authors: D'Anna-Hernandez K.L. , Hoffman M.C. , Zerbe G.O. , Coussons-Read M. , Ross R.G. , Laudenslager M.L. .
Source: Psychosomatic medicine, 2012 Apr; 74(3), p. 296-304.
EPub date: 2012-02-24.
PMID: 22366584
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Hair cortisol levels as a retrospective marker of hypothalamic-pituitary axis activity throughout pregnancy: comparison to salivary cortisol.
Authors: D'Anna-Hernandez K.L. , Ross R.G. , Natvig C.L. , Laudenslager M.L. .
Source: Physiology & behavior, 2011-08-03; 104(2), p. 348-53.
EPub date: 2011-03-21.
PMID: 21397617
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Environmental stress alters genetic regulation of novelty seeking in vervet monkeys.
Authors: Fairbanks L.A. , Bailey J.N. , Breidenthal S.E. , Laudenslager M.L. , Kaplan J.R. , Jorgensen M.J. .
Source: Genes, brain, and behavior, 2011 Aug; 10(6), p. 683-8.
EPub date: 2011-07-01.
PMID: 21631727
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Care of the caregiver: stress and dysregulation of inflammatory control in cancer caregivers.
Authors: Lutgendorf S.K. , Laudenslager M.L. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-06-20; 27(18), p. 2894-5.
EPub date: 2009-05-11.
PMID: 19433678
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Caregiver Sleep and Patient Neutrophil Engraftment in Allogeneic Hematopoietic Stem Cell Transplant: A Secondary Analysis.
Authors: Sannes T.S. , Mikulich-Gilbertson S.K. , Natvig C.L. , Brewer B.W. , Simoneau T.L. , Laudenslager M.L. .
Source: Cancer nursing, 2018 Jan/Feb; 41(1), p. 77-85.
PMID: 27922914
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