Evidence map›Paper›PMID 34057469›Full record

Trial reportJournal of the National Cancer Institute2021

Targeted eHealth Intervention to Reduce Breast Cancer Survivors' Fear of Recurrence: Results From the FoRtitude Randomized Trial.

Lynne I Wagner, Janet A Tooze, Daniel L Hall, Beverly J Levine, Jennifer Beaumont, Jenna Duffecy, David Victorson, William Gradishar, Joseph Leach, Thomas Saphner and 5 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06476938 (Testing the Efficacy of an eHealth Decision Support Tool to Help Latinx Cancer Patients Make Informed Decisions About Tumor Genomic Testing), which is not on this map. Cited by 41 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 4 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06476938 narecruitingnot on this mapstarted 2025, after this paper: background citation

Testing the Efficacy of an eHealth Decision Support Tool to Help Latinx Cancer Patients Make Informed Decisions About Tumor Genomic Testing

TypeinterventionalSponsorFox Chase Cancer CenterRan2025 to 2027Enrolled232ConditionsCancerArmsGene PilotLX
3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 4 syntheses or guidelines pooled it, 67 citations in OpenAlex.

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  20. Digital Health Education for Chronic Lung Disease: Scoping Review.Journal of medical Internet research · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 9 institutions in 1 country.

Lynne I WagnerDepartment of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston Salem, NC, USA.ORCID 0000-0001-9685-4796
Janet A ToozeDepartment of Biostatistics and Data Science, Wake Forest School of Medicine, Winston Salem, NC, USA.ORCID 0000-0002-5160-0407
Daniel L HallDepartment of Psychiatry, Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-4069-5324
Beverly J LevineDepartment of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston Salem, NC, USA.
Jennifer BeaumontClinical Outcomes Solutions, Tucson, AZ, USA.ORCID 0000-0002-1484-260X
Jenna DuffecyDepartment of Psychiatry, University of Illinois, Chicago, IL, USA.ORCID 0000-0002-4505-6820
David VictorsonDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.ORCID 0000-0002-3530-8633
William GradisharDepartment of Medicine/Division of Hematology and Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Joseph LeachMinnesota Oncology, Minneapolis, MN, USA.
Thomas SaphnerAurora NCORP, Milwaukee, WI, USA.
Keren SturtzWestern States NCORP, Denver, CO, USA.
Mary Lou SmithResearch Advocacy Network, Plano, TX, USA.
Frank PenedoDepartments of Medicine and Psychology, University of Miami, Coral Gables, FL, USA.ORCID 0000-0002-2780-0417
David C MohrDepartment of Preventive Medicine and Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.ORCID 0000-0002-5443-7596
David CellaDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Northwestern University · USWake Forest University · USAurora Health Care · USHarvard University · USHealth Outcomes Solutions (United States) · USMinnesota Oncology · USResearch Advocacy Network · USUniversity of Illinois Chicago · USUniversity of Miami · US

Funding

ECOG-ACRIN NCORP Research Base - TMISTUG1CA189828 · NCI · ECOG-ACRIN MEDICAL RESEARCH FOUNDATION · PI Peter J ODwyer, MITCHELL D. SCHNALL · 2014 to 2026
$199.7M
Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
A Multimodal Mind-Body Intervention for Fear of Recurrence among Cancer SurvivorsK23AT010157 · NCCIH · MASSACHUSETTS GENERAL HOSPITAL · PI HALL, DANIEL LEE · 2019 to 2023
$785k
Targeted eHealth intervention to reduce fear of recurrence among cancer survivorsR21CA173193 · NCI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI WAGNER, LYNNE I. · 2013 to 2014
$365k
ECOG-ACRIN Medical Research FoundationNational Cancer Institute at the National Institutes of Health CA173193NCATS NIH HHS UL1 TR001422NCCIH NIH HHS K23 AT010157NCI NIH HHS R21 CA173193NCI NIH HHS UG1 CA189828
6 · The paper itself

Abstract

backgroundFear of recurrence (FoR) is a prevalent concern among breast cancer survivors (BCS), yet few accessible interventions exist. This study evaluated a targeted eHealth intervention, "FoRtitude," to reduce FoR using cognitive behavioral skills training and telecoaching.

methodsBCS (N  = 196) were recruited from an academic medical center and 3 National Cancer Institute Community Oncology Research Program community sites, had stage 0-III breast cancer, were 1-10 years postprimary treatment, with moderate to high FoR and familiarity with the internet. Using the Multiphase Optimization Strategy, participants were independently randomly assigned to 3 cognitive behavioral skills (relaxation, cognitive restructuring, worry practice) vs an attention control condition (health management content [HMC]) and to telecoaching (motivational interviewing) vs no telecoaching. Website content was released across 4 weeks and included didactic lessons, interactive tools, and a text-messaging feature. BCS completed the Fear of Cancer Recurrence Inventory at baseline and at 4 and 8 weeks. Fear of Cancer Recurrence Inventory scores over time were compared using mixed-effects models. All statistical tests were 2-sided.

resultsFCRI scores [SD] decreased statistically significantly from baseline to postintervention (T0 = 53.1 [17.4], T2 = 41.9 [16.2], P < .001). The magnitude of reduction in FCRI scores was comparable across cognitive behavior therapy (CBT) and attention control HMC conditions and was predicted by increased self-efficacy. Telecoaching was associated with lower attrition and greater website use (mean adherence score [SD] = 26.6 [7.2] vs 21.0 [10.5], P < .001).

conclusionsBCS experienced statistically significant reductions in FoR postintervention, but improvements were comparable between CBT and attention controls. Telecoaching improved adherence and retention. Future research is needed on optimal integration of CBT and HMC, dose, and features of eHealth delivery that contributed to reducing FoR. In the COVID-19 era, remote delivery has become even more essential for reaching survivors struggling with FoR.

Indexed as

AdultAgedBreast NeoplasmsCancer SurvivorsCognitive Behavioral TherapyFearFemaleHumansMiddle AgedNeoplasm Recurrence, LocalQuality of LifeTelemedicine

Identifiers

PMID34057469
PMCPMC8244801
OpenAlexW3165011380

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.