A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention

Authors

Daniel L. Hall, Harvard Medical School, Massachusetts General Hospital, 100 Cambridge St., 16th floor, Boston, MA, 02114, USA. hall@mgh.harvard.edu.
Beverly J. Levine, Wake Forest University School of Medicine, Winston Salem, NC, USA.
Elizabeth Jeter, Wake Forest University School of Medicine, Winston Salem, NC, USA.
Allison Chandler, Wake Forest University School of Medicine, Winston Salem, NC, USA.
Janet A. Tooze, Wake Forest University School of Medicine, Winston Salem, NC, USA.
Jenna Duffecy, University of Illinois, Chicago, IL, USA.
David Victorson, Northwestern University, Chicago, IL, USA.
William Gradishar, Northwestern University, Chicago, IL, USA.
Joseph Leach, Minnesota Oncology, Minneapolis, MN, USA.
Thomas Saphner, Advocate Aurora HealthFollow
Mary Lou Smith, Research Advocacy Network, Plano, TX, USA.
Frank Penedo, University of Miami, Coral Gables, FL, USA.
David C. Mohr, Northwestern University, Chicago, IL, USA.
David Cella, Northwestern University, Chicago, IL, USA.
Lynne I. Wagner, Wake Forest University School of Medicine, Winston Salem, NC, USA.

Recommended Citation

Hall DL, Levine BJ, Jeter E, et al. A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention. J Behav Med. 2022;45(5):771-781. doi:10.1007/s10865-022-00349-8

Affiliations

Aurora NCORP

Abstract

Background: Fear of recurrence (FoR) is prevalent among breast cancer survivors (BCS) and may be exacerbated by avoidance coping. This study examined BCS with avoidance coping and their engagement in a FoR eHealth intervention (FoRtitude).

Methods: BCS (N = 196) with elevated FoR participated in FoRtitude. Patient-reported measures assessed avoidance coping with FoR and baseline emotional and behavioral health. Intervention engagement was measured quantitatively (e.g., website logins, telecoaching attendance) and qualitatively (i.e., telecoaching notes).

Results: 38 BCS (19%) endorsed avoidance coping, which was associated with more severe post-traumatic anxiety-related symptoms and worse global mental health (ps < .05), but not anxiety (p = .19), depression (p = .11), physical health (p = .12), alcohol consumption (p = .85), or physical activity (p = .39). Avoidance coping was not associated with engagement levels (ps > .05) but did characterize engagement-related motivators and barriers.

Conclusions: Avoidance coping was not a barrier to FoRtitude engagement. eHealth delivery is a promising modality for engaging survivors with avoidance coping in FoR interventions.

Document Type

Article

PubMed ID

35930212