A Structured Peer Support Intervention for Patients Undergoing Hematopoietic Stem Cell Transplantation

About This Grant

PROJECT SUMMARY/ABSTRACT Overview: The goal of this study is to test the efficacy of a brief, patient-centered, theoretically-based, telephonedelivered structured peer support intervention (STEPP) compared to minimally enhanced usual care for patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT). Background: HSCT is a curative treatment for patients with hematologic malignancies. However, most HSCT recipients report that the extremely intensive HSCT regimen and prolonged recovery period exacerbate psychosocial risk factors (e.g., debilitating social isolation) and reduce protective factors (e.g., self-efficacy), contributing to worse health-related outcomes (e.g., elevated depression symptoms). Despite these substantial needs, the few existing psychosocial interventions for HSCT recipients do not directly target risk factors like social isolation and loneliness. Moreover, existing interventions are primarily delivered during or after HSCT hospitalization, missing critical opportunities for early intervention before HSCT, and are often inaccessible to most HSCT recipients due to in-person delivery by specialty-trained clinicians, who are in short supply nationwide. This study addresses psychosocial care gaps for HSCT recipients, aligning with the NCI’s mission to advance accessible, cost-effective, and scalable interventions for vulnerable oncology populations. Informed by a psychotherapeutic skill enhancement conceptual framework, we developed the STEPP intervention, which is delivered by psychologist-trained HSCT survivors. Our pilot work has shown feasibility, acceptability, and preliminary efficacy of STEPP for improving depression and anxiety symptoms and quality of life (QOL) in HSCT recipients. Research Plan: Following the NIH Stage Model for Behavioral Intervention Development, the next critical step is a large-scale, multi-site randomized clinical trial involving 350 patients preparing to undergo HSCT, to rigorously test the efficacy of STEPP vs. minimally enhanced usual care for improving psychological distress (e.g., anxiety symptoms), QOL, psychosocial risk factors (e.g., social isolation), and protective factors (e.g., selfefficacy). We will also explore mediators and moderators of STEPP’s effects on psychological distress. Environment: This multi-site trial will be conducted at NCI- designated comprehensive cancer centers across the country, including the Dana-Farber Cancer Institute, Fred Hutchinson Cancer Center, and Moffitt Cancer Center, each of which conducts 400-500 HSCTs annually. Dr. Amonoo and the multi-site research team will leverage their long-term collaborations, extensive expertise in developing and testing psychosocial interventions for patients with hematologic malignancies undergoing HSCT, and robust supportive oncology research infrastructure to successfully execute this trial. Relevance of Research: Results from this trial will lay the essential groundwork for future scale-up dissemination and implementation trials of our novel and scalable STEPP intervention in clinical practice with vast potential to benefit HSCT and other underserved oncologic populations in healthcare systems nationwide.