Research and observations confirm that cancer survivors experience significant stress throughout cancer
treatment and especially during transition back to normal life. Their stressors, which are particularly severe for
disadvantaged patient groups and those with medical comorbidities, can interfere with the patient ability to
make reasoned and timely decisions about survivorship care. As survival rates have increased, it has become
evident that decisions made in the early stages of survivorship can have profound long-term health
consequences, for both patients and their caregivers. The ultimate goal is to help cancer survivors cope more
effectively with decision making and distress and effectively use survivorship care plans (SCP) provided by
their oncologists. Over the past 20 years, Dr. Sahler, one of the study MPIs, and colleagues have developed
and tested problem-solving skills training (PSST) interventions for mothers of children diagnosed with cancer.
Their findings clearly show that PSST significantly increases problem-solving skills and decreases negative
affectivity in mothers from a variety of racial, ethnic, and socioeconomic backgrounds. A large body of literature
also demonstrates that negative affectivity and poor problem-solving skills are associated with poor SCP
adherence as well as poor quality of life, low physical and social functioning and poor prognosis in patients
with cancer. In this 2-year study, the team will first adapt the Bright IDEAS PSST intervention and supportive
materials to maximize learning potential for adult cancer survivors and their caregivers (SA1). The acceptability
(SA2) and feasibility (SA3) of offering an 8-week PSST to distressed cancer survivors and their caregivers will
then be assessed. The patient-reported outcomes evaluations will be collected at randomization and at 3 and 6
months later. The four acceptability objectives of the Bright IDEAS-AC Study will assess: (1) burden of patient-
reported data collection; (2) compliance with 8-session SCP-specific PSST intervention; (3) barriers to
consistent participation of supportive others (SO) in PSST; and (4) recruitment rates for a future trial. The team
will also collect patient healthcare utilization data to test whether patients in the PSST arm will have fewer
hospital and ED admissions than care-as-usual (CAU) patients. Finally, the outside consultant will interview
patients, caregivers and providers about any threats to the intervention sustainability and organizational
barriers to its adaptation. The evidence from this pilot study will help guide development of a future multi-site
randomized clinical trial of the effect of PSST on cancer survivorship care. To account for regional variation in
care delivery, the study will be conducted in three oncology clinics from different regions which have
collaborated before on a PCORI Engagement Project that developed a regional virtual oncology network
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