Writing Interventions in Breast Cancer Patients Taking Aromatase Inhibitors

NCT ID: NCT04651452

Last Updated: 2025-10-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-02-01

Study Completion Date

2026-04-30

Brief Summary

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Aromatase inhibitors are a powerful medication for reducing the risk of recurrence and increasing survival in postmenopausal breast cancer patients. However, these medications can lead to intolerable side effects, poor medication adherence, and increased stress levels. This project's broad objective is to assess whether an intervention can improve medication adherence and reduce physical symptoms and stress in breast cancer patients prescribed aromatase inhibitors. Participants will be randomly assigned to a values affirmation or reflective journaling condition. Interventions will be writing-based, one essay per month for six months. Physical symptoms and perceived stress will be assessed at baseline, post-intervention (one month after the intervention), and follow-up (six months from the post-intervention assessment and seven months after the end of the intervention). Furthermore, an electronic pill bottle will continuously assess daily compliance so that medication adherence rates during the intervention, post-intervention, and follow-up can be calculated.

Detailed Description

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A sample of 250 participants will be recruited and randomly assigned to either the value affirmation (N=125) or reflective journaling (N=125) condition. Participants will complete baseline measures of physical symptoms, perceived stress, and other covariates. They will also be given an electronic pill bottle that will record whether they have daily opened and closed the bottle, signifying adherence to their prescribed medication regime. This pill bottle will sync to an online dashboard. Participants in both conditions will complete a brief essay online (or via paper and pencil for those who prefer or do not have internet access) every month for six months. Value affirmation condition essays will include prompts about important, core personal values. Reflective journaling essays will have prompts that do not include any core personal value content but ask participants, in part, to write about typical daily routines. Following the conclusion of the intervention, participants will report on their levels of perceived stress and physical symptoms. Six months following the post-intervention assessment, participants will again report their perceived stress levels and physical symptoms. A sample size of 250 has been selected for feasibility and because this sample size provides at least 80% power to detect differences for all three outcomes of interest.

A sub-study will be conducted on 80 of these participants who will complete their 3rd essay prompt in an fMRI scanner. In the scan session, participants will also complete a stress reactivity task. The sub-study will allow examination of the neural mechanism of value affirmation and reflective journaling to determine whether these neural mechanisms lead to enhanced medication adherence rates and reductions in stress and physical symptoms.

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
The participant and their care provider, who prescribes their aromatase inhibitor, will remain masked to which writing condition (self-affirmation or reflective journaling) the participant is randomized into. The outcomes assessor will remain masked to which condition the participants will complete. However, the experimenter will help set up the participant's online content and, therefore, will not be masked to the writing condition.

Study Groups

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Value Affirmation

Participants in the value affirmation condition will complete six writing prompts regarding their personal values over the course of six months. For example, participants will be given a list of values and will be asked to rate them in order of importance within their own lives and write about a time when their top value was particularly important. Participants will write for about ten minutes each session. The intervention tasks will be completed on a secure, online website that each individual participant will be emailed a link to. Participants can also receive paper copies via postal mail if they prefer.

Group Type ACTIVE_COMPARATOR

Value Affirmation

Intervention Type BEHAVIORAL

Participants will complete writing tasks regarding their personal values.

Reflective Journaling

Participants in the reflective journaling condition will complete six writing prompts over the course of six months. However, the reflective journaling condition will be writing about values that are not important to them and discuss why they could be important to others. In other tasks, they will write about aspects of daily life (e.g. morning routine). Participants will write for about ten minutes each session. The intervention tasks will be completed on a secure, online website that each individual participant will be emailed a link to. Participants can also receive paper copies via postal mail if they prefer.

Group Type ACTIVE_COMPARATOR

Reflective Journaling

Intervention Type BEHAVIORAL

Participants will complete writing tasks regarding their least important values and discuss why they may be important to others. They will also describe aspects of daily life.

Interventions

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Value Affirmation

Participants will complete writing tasks regarding their personal values.

Intervention Type BEHAVIORAL

Reflective Journaling

Participants will complete writing tasks regarding their least important values and discuss why they may be important to others. They will also describe aspects of daily life.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Breast cancer diagnosis
* Prescribed an aromatase inhibitor within four weeks of enrollment or anticipates being prescribed one in the future
* Intention to take the prescribed aromatase inhibitor
* Fluency in English
* Own a smartphone that can support downloaded apps

Exclusion Criteria

* Have implanted metal
* Have an implanted electronic medical device
* Have an IUD that contains metal
* Are currently pregnant
* Have a history of claustrophobia
* Weigh more than 300 pounds
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Carnegie Mellon University

OTHER

Sponsor Role lead

Responsible Party

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David Creswell

Dr. J. David Creswell

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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J. David Creswell, Ph.D

Role: PRINCIPAL_INVESTIGATOR

Carnegie Mellon University

Janine Dutcher, Ph.D

Role: STUDY_DIRECTOR

Carnegie Mellon University

Locations

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Carnegie Mellon University

Pittsburgh, Pennsylvania, United States

Site Status

Countries

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United States

References

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Other Identifiers

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1R01CA236860-01A1

Identifier Type: NIH

Identifier Source: secondary_id

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1R01CA236860-01A1

Identifier Type: NIH

Identifier Source: org_study_id

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