R01CA255522

Empathic Communication Skills Training to Reduce Lung Cancer Stigma - Project Summary

Nearly all (95%) patients diagnosed with lung cancer report perceiving stigma, defined as a perception and internalization of negative appraisal and devaluation by self and others attributable to a lung cancer diagnosis. Prior research indicates that 48% of patients with lung cancer experience stigma during clinical encounters with their oncology care providers (OCPs), which may be potentially triggered and/or exacerbated by OCPs' routine assessment of smoking history.

Perceived stigma has negative effects on patients' psychological well-being as well as their medical outcomes. Promoting empathic communication appears to be a potentially effective intervention target to help reduce patients' perceptions of stigma within clinical encounters; however, no formal trainings exist that focus on teaching empathic communication to OCPs.

To address this key need, we developed an Empathic Communication Skills (ECS) training focusing on the communication challenges inherent in OCPs' discussions of smoking behavior and history with lung cancer patients. Building upon favorable findings from a prior R21 (R21CA202793), our goal is to conduct a national trial of ECS training to facilitate improvements in the medical and psychosocial care of lung cancer patients through de-stigmatizing interactions with OCPs.

We will conduct a cluster randomized trial at 16 lung cancer care delivery sites, comparing ECS training (intervention group) with a waitlist control group (WLC) among 160 OCPs (thoracic oncology physicians and advance practice providers) and 960 lung cancer patients (6 patients per clinician). The ECS training will be offered remotely and include all the didactic and experiential training materials that were developed for the pilot trial.

To increase the real-world generalizability of our trial, we will leverage two national networks of community oncology practices, the Care Continuum Centers of Excellence coordinated by our lung cancer patient advocacy partner, the GO2 Foundation for Lung Cancer, and the Extension for Community Healthcare Outcomes (ECHO) sites for lung cancer care, supported by an American Cancer Society ECHO Hub.

The aims of this study are:
1. To evaluate the impact of the ECS training on OCP primary outcomes (communication and empathic skill uptake) and secondary outcomes (training appraisal - relevance, novelty, clarity; self-efficacy, attitude towards communication with patients).
2. To evaluate the impact of the ECS training vs. WLC on patients' reported primary outcomes (lung cancer stigma), and secondary outcomes (perceived clinician empathy, satisfaction with communication, psychological distress, social isolation, and patients' experience of clinical encounter). Additionally, acceptance of referral to tobacco cessation (for current smokers) and relapse prevention (for former smokers) will be explored.
3. To examine potential moderators of OCP and patient outcomes.

Our central hypothesis is that the ECS training will demonstrate significant improvements in clinicians' uptake of empathic skills and self-efficacy and will be superior to WLC with regards to patient reported measures of stigma, clinician empathy, satisfaction, and overall experience.

Sloan-Kettering Institute For Cancer Research

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS, (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION, (3) EPIDEMIOLOGY, (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS, (5) IMMUNOLOGY AND VACCINES, (6) FIELD STUDIES AND STATISTICS, (7) CANCER CHEMOPREVENTION AND INTERCEPTION, (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT, (9) ORGAN SITE STUDIES AND CLINICAL TRIALS, (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES, AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO STIMULATE TECHNICAL INNOVATION, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

New York, New York 100656007 United States

Single Zip Code

Cancer Prevention and Control Clinical Trials Grant Program (R01 Clinical Trial Required) (PAR-18-559)

Amendment Since initial award the End Date has been extended from 08/31/26 to 08/31/27 and the total obligations have increased 389% from $734,084 to $3,592,601.