Mindfulness Based Couples Therapy

Study Overview
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Brief Summary
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The goal of this study is to explore the effects of a Mindfulness Based Couples Intervention on relationship satisfaction with quality of life and immune system function among breast cancer survivors and their partners.

Detailed Description
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Baseline Visit: If you are found to be eligible to take part in this research study, you will return to the clinic about a week later for the Baseline Visit. You will be instructed to fast (eat nothing and drink only water) for at least 8 hours before this visit. Blood (about 4-5 tablespoons) will be drawn for tests of your immune function, stress hormone levels, and blood sugar levels. After this blood test, you will be given breakfast. You will complete a pain assessment which involves you submerging your hand in cold water. Researchers will use your response to measure your pain tolerance. You will have electrocardiograms (EKGs) to check your heart function. The sensors will be attached at the beginning of the visit and then removed before you leave. You will be attached to the machine for several hours, but you will be able to be disconnected to take bathroom breaks, if needed. You will complete questionnaires about fatigue, mood, stress, social support, marital satisfaction, depression, and general demographics (age, race and so on). It should take about 1½ hours total to complete the questionnaires. You will complete a series of traditional neurocognitive tests (for example, tests to check your memory and thinking abilities). You will take these tests on the computer and with a pen and paper. Your blood pressure will be measured multiple times throughout the visit. Study Groups and Interventions: After the Baseline visit, you will be assigned to one of 2 groups. If you are in Group 1, you and your partner will take part in an 8-week Mindfulness-Based Relationship Enhancement (MBRE) intervention course designed to alleviate stress and other symptoms among couples. The MBRE course will consist of eight sessions taught by a professional Mindfulness instructor. The sessions will occur 1 time a week and last about 2½ hours each time. The MBRE course will consist of meditation and yoga techniques and handouts. The sessions will focus on teaching participants (all female breast cancer survivors and partners) the basics of Mindfulness Based Relationship Enhancement. Attendance at these sessions and completion of daily homework assignments requiring up to 45 minutes per day are essential to the program. If you are in Group 2, you will receive self-help materials that have been previously developed by MD Anderson's Office of Public Education, the American Cancer Society, and the National Cancer Institute. Post-Intervention Follow-Up Visit: If you are in Group 1, you will have a post-intervention follow-up visit about 12 weeks after your Baseline visit (4 weeks after you finish your 8-week intervention sessions). If you are in Group 2, you will have a post-intervention follow-up visit about 8 weeks after the Baseline Visit. You will fast for 8 hours before a post-intervention follow-up visit. Blood (about 4 to 5 tablespoons) will be drawn to check your immune function, stress hormone levels, and blood sugar. After the blood is drawn you will be given breakfast. You will complete the cold water pain tolerance test. You will have electrocardiograms (EKGs). You will complete questionnaires about fatigue, mood, stress, social support, marital satisfaction, depression, and general demographics (age, race and so on). It should take about 1½ hours total to complete the questionnaires. You will complete a series of traditional neurocognitive tests. Your blood pressure will be measured multiple times throughout the visit. Cortisol Testing: After the Baseline and Follow-up Visits, you will be asked to give samples to measure cortisol, a hormone related to stress. You will place a small cotton tube in your mouth for about 2 minutes, or until the swab is completely soaked with your saliva. After this, you will place the swab back in the tube, and freeze the sample. You will be given containers to hold the samples when you freeze them, as well as to mark which day and time each sample was collected. You will take these samples 7 times a day (right when you wake up; about 30, 45, and 60 minutes after waking; and then at noon, 4:00 p.m., and 8:00 p.m.). Researchers will use these samples to measure the changes in cortisol throughout the day. You will collect these samples for 2 days during the week, and 2 days on the weekend. After you complete 4 total days of collecting saliva samples after each visit, you will mail them back to MD Anderson in pre-paid envelopes. Program Satisfaction Evaluations: After the follow-up visits, the study staff will conduct individual interviews with a small group of participants. Interview questions will address participants' overall reactions to and satisfaction with the mind-body intervention, the impact they felt from social support, motivation, and their own ability for increasing physical activity and well-being. The study staff will also ask questions about both positive and negative effects of participating in the intervention. Interviews will be conducted by the PI or a trained research coordinator. All interviews will last no longer than 90 minutes and will be audio-taped using a digital recorder and transcribed. All audio files will be destroyed after they are transcribed. This is an investigational study. Up to 30 couples (60 participants) will take part in this research study. All will be enrolled at MD Anderson.

Official Title
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Mindfulness Based Couples Therapy for Breast Cancer Survivors: A Pilot Study

Conditions
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Breast Cancer

Intervention / Treatment
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* Behavioral: Mindfulness-Based Relationship Enhancement (MBRE)
* Behavioral: Self-Help Materials
* Behavioral: Pain Assessment
* Behavioral: Questionnaires
* Behavioral: Neurocognitive Tests
* Procedure: Cortisol Tests
* Behavioral: Interviews


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Stage 0-IIIA breast cancer survivors and their partner All the female breast cancer survivors will be at least two months from receiving cancer treatment (surgery, adjuvant therapy or radiation) and within three years from completing cancer treatment, except for tamoxifen/aromatase inhibitors. Are able to read and write in English Are able to pass the Physical Activity Readiness Questionnaire or participant provides a letter from their physician or nurse practitioner clearing them for study participation All couples co-habiting for at least 3 years with current partner who is willing to participate in study Are 21 years of age or older Exclusion Criteria: Male breast cancer survivors; Participants with a diagnosis of diabetes, unless they are able to provide a letter from a physician who will continue to monitor the participant during the research study Anti-inflammatory medications (e.g. statins, cholesterol medication) Consume excessive amounts of alcohol (>30 drinks/week) Pregnant or thinking about becoming pregnant during the study period Lactating women Major medical conditions involving the immune system such as autoimmune and/or inflammatory diseases Pressure readings >/=140/90 mm Hg, as defined by the 7th Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, will be deemed ineligible to participate and excluded from the study. They will be referred to their family physician or community services. Those ineligible based on their initial blood pressure reading are allowed to participate if they provide a letter from a physician who will continue to monitor the participant during the research study. A hemoglobin level < 10g/dl Person less than 21 years of age

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mindfulness Based Stress Reduction Intervention (MBRE)<br>Participant and partner take part in an 8-week Mindfulness-Based Relationship Enhancement (MBRE) intervention course. MBRE course consists of meditation and yoga techniques and handouts. Pain assessment administered at baseline and at follow up visit. Questionnaires completed at baseline and at follow up visit. Neurocognitive tests administered at baseline and at follow up visit. Cortisol testing performed after baseline visit and at follow up visit. Interviews conducted after follow up visit. These interviews are audio-taped and transcribed. | Behavioral: Mindfulness-Based Relationship Enhancement (MBRE)<br>* Participant and partner take part in an 8-week Mindfulness-Based Relationship Enhancement (MBRE) intervention course. MBRE course consists of meditation and yoga techniques and handouts.<br>Behavioral: Pain Assessment<br>* Pain assessment administered at baseline and at follow up visit. Pain assessment involves submerging hand in cold water.<br>Behavioral: Questionnaires<br>* Questionnaires completed at baseline and at follow up visit. Questionnaires ask about fatigue, mood, stress, social support, marital satisfaction, depression, and general demographics (age, race and so on). It should take about 1½ hours total to complete the questionnaires.<br>* Other names: Surveys;Behavioral: Neurocognitive Tests<br>* Neurocognitive tests administered at baseline and at follow up visit. Tests to check memory and thinking abilities.<br>Procedure: Cortisol Tests<br>* Cortisol testing performed after baseline visit and at follow up visit. Participants asked to collect saliva samples for cortisol assays immediately, 30, 45, and 60 minutes after awakening (representing the cortisol awakening response) and at noon, 4 P.M. and 8 P.M.<br>* Other names: Saliva tests;Behavioral: Interviews<br>* Interviews conducted after follow up visit. These interviews are audio-taped and transcribed.<br>|
| Active Comparator: Standard of Care<br>Participants receive self-help materials that have been previously developed by MD Anderson's Office of Public Education, the American Cancer Society, and the National Cancer Institute. Pain assessment administered at baseline and at follow up visit. Questionnaires completed at baseline and at follow up visit. Neurocognitive tests administered at baseline and at follow up visit. Cortisol testing performed after baseline visit and at follow up visit. Interviews conducted after follow up visit. These interviews are audio-taped and transcribed. | Behavioral: Self-Help Materials<br>* Participants and partner receive self-help materials.<br>Behavioral: Pain Assessment<br>* Pain assessment administered at baseline and at follow up visit. Pain assessment involves submerging hand in cold water.<br>Behavioral: Questionnaires<br>* Questionnaires completed at baseline and at follow up visit. Questionnaires ask about fatigue, mood, stress, social support, marital satisfaction, depression, and general demographics (age, race and so on). It should take about 1½ hours total to complete the questionnaires.<br>* Other names: Surveys;Behavioral: Neurocognitive Tests<br>* Neurocognitive tests administered at baseline and at follow up visit. Tests to check memory and thinking abilities.<br>Procedure: Cortisol Tests<br>* Cortisol testing performed after baseline visit and at follow up visit. Participants asked to collect saliva samples for cortisol assays immediately, 30, 45, and 60 minutes after awakening (representing the cortisol awakening response) and at noon, 4 P.M. and 8 P.M.<br>* Other names: Saliva tests;Behavioral: Interviews<br>* Interviews conducted after follow up visit. These interviews are audio-taped and transcribed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of Mindfulness Based Couples Therapy Intervention Among Breast Cancer Survivors and Their Partners (intervention adherence rate, defined as the proportion of sessions completed out of a total of 8 sessions) | Feasibility endpoint is intervention adherence rate, defined as the proportion of sessions completed out of a total of 8 sessions. | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Yoga, Pain Assessment, Self-help materials, Breast cancer, Breast cancer survivors, Breast cancer partners, Mindfulness-Based Relationship Enhancement, MBRE, Standard of care, Questionnaires, Surveys, Neurocognitive Tests, Cortisol Tests, Saliva tests, Interviews, Meditation