Cancer Health Empowerment for Living Without Pain (Ca-HELP): Study Design and Rationale for a Tailored Education and Coaching Intervention to Enhance Care of Cancer-related Pain

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2009 Sep 10

PMID 19737424

Citations 8

Authors

Richard L Kravitz

Daniel J Tancredi

Richard L Street Jr

Donna Kalauokalani

Tim Grennan

Ted Wun

Christina Slee

Dionne Evans Dean

Linda Lewis

Naomi Saito

Peter Franks

Affiliations

Soon will be listed here.

Abstract

Background: Cancer-related pain is common and under-treated. This article describes a study designed to test the effectiveness of a theory-driven, patient-centered coaching intervention to improve cancer pain processes and outcomes.

Methods/design: The Cancer Health Empowerment for Living without Pain (Ca-HELP) Study is an American Cancer Society sponsored randomized trial conducted in Sacramento, California. A total of 265 cancer patients with at least moderate pain severity (Worst Pain Numerical Analog Score > or =4 out of 10) or pain-related impairment (Likert score > or = 3 out of 5) were randomly assigned to receive tailored education and coaching (TEC) or educationally-enhanced usual care (EUC); 258 received at least one follow-up assessment. The TEC intervention is based on social-cognitive theory and consists of 6 components (assess, correct, teach, prepare, rehearse, portray). Both interventions were delivered over approximately 30 minutes just prior to a scheduled oncology visit. The majority of visits (56%) were audio-recorded for later communication coding. Follow-up data including outcomes related to pain severity and impairment, self-efficacy for pain control and for patient-physician communication, functional status and well-being, and anxiety were collected at 2, 6, and 12 weeks.

Discussion: Building on social cognitive theory and pilot work, this study aims to test the hypothesis that a brief, tailored patient activation intervention will promote better cancer pain care and outcomes. Analyses will focus on the effects of the experimental intervention on pain severity and impairment (primary outcomes); self-efficacy and quality of life (secondary outcomes); and relationships among processes and outcomes of cancer pain care. If this model of coaching by lay health educators proves successful, it could potentially be implemented widely at modest cost.

Trial Registration: [Clinical Trials Identifier: NCT00283166].

Citing Articles

Improving Pain Self-Management Among Rural Older Adults With Cancer.

Shen M, Stokes T, Yarborough S, Harrison J JAMA Netw Open. 2024; 7(7):e2421298.

PMID: 39018074 PMC: 11255907. DOI: 10.1001/jamanetworkopen.2024.21298.

Ca-HELP: Adaptation of a Communication Tool to Help Geriatric Cancer Patients in Rural Settings Talk to Their Doctors About Pain.

Harrison J, Stokes T, Hahne J, Shen M Innov Aging. 2024; 7(10):igad087.

PMID: 38638362 PMC: 11025374. DOI: 10.1093/geroni/igad087.

Planning for Your Advance Care Needs (PLAN): A Communication Intervention to Improve Advance Care Planning among Latino Patients with Advanced Cancer.

Shen M, Cho S, Santos C, Yarborough S, Maciejewski P, Prigerson H Cancers (Basel). 2023; 15(14).

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The Question-prompt list (QPL): Why it is needed in the Indian oncology setting?.

Chawak S, Chittem M, Maya S, Dhillon H, Butow P Cancer Rep (Hoboken). 2020; 4(2):e1316.

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Finding common ground: meta-synthesis of communication frameworks found in patient communication, supervision and simulation literature.

Links M, Watterson L, Martin P, ORegan S, Molloy E BMC Med Educ. 2020; 20(1):45.

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