NCT06532877

Brief Summary

The goal of this clinical trial is to see if telephone support programs help patients and their family caregivers adjust to advanced gastrointestinal cancer. A new telephone counseling program that involves practicing strategies for managing stress and symptoms will be compared to a telephone program involving education on quality-of-life issues and psychosocial support. The main questions it aims to answer are: Does our telephone counseling program lower the negative impact of patients' fatigue on their activities, emotions, and thinking abilities compared to a telephone program involving education and support? Does our telephone counseling program lower family caregivers' feelings of burden compared to a telephone program involving education and support? Participants in both study conditions will: Complete 6 weekly telephone sessions of counseling or education/support Complete a telephone booster session Complete 3 telephone interviews over about 5 months

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
488

participants targeted

Target at P75+ for not_applicable

Timeline
33mo left

Started Aug 2024

Longer than P75 for not_applicable

Geographic Reach
1 country

4 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress38%
Aug 2024Feb 2029

First Submitted

Initial submission to the registry

July 29, 2024

Completed
3 days until next milestone

First Posted

Study publicly available on registry

August 1, 2024

Completed
20 days until next milestone

Study Start

First participant enrolled

August 21, 2024

Completed
4.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2029

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2029

Last Updated

January 23, 2026

Status Verified

January 1, 2026

Enrollment Period

4.5 years

First QC Date

July 29, 2024

Last Update Submit

January 22, 2026

Conditions

Keywords

Gastrointestinal NeoplasmsFamily CaregiversAcceptance and Commitment TherapyFatiguePsychotherapyCaregiver Burden

Outcome Measures

Primary Outcomes (2)

  • Fatigue Interference Subscale of Fatigue Symptom Inventory

    Seven items are rated on 11-point scales (0=no interference to 10=extreme interference) that assess the extent to which fatigue in the past week interfered with general level of activity, ability to bathe and dress, normal work activity (including housework), ability to concentrate, relations with others, enjoyment of life, and mood. The seven items are summed with higher total scores indicating greater fatigue interference. The total score range is 0 to 70. This is the primary outcome for patients.

    2 weeks and 3 months post-intervention

  • Short-form of Zarit Burden Interview

    Twelve items are rated on 5-point scales (0=never to 4=nearly always) that assess personal strain and role strain due to caregiving. The 12 items are summed with higher total scores indicating greater caregiving burden. The total score range is 0 to 48. This is the primary outcome for caregivers.

    2 weeks and 3 months post-intervention

Secondary Outcomes (3)

  • Patient-Reported Outcome Measurement Information System (PROMIS) Sleep-Related Impairment

    2 weeks and 3 months post-intervention

  • PROMIS Ability to Participate in Social Roles and Activities

    2 weeks and 3 months post-intervention

  • PROMIS Global Health measure

    2 weeks and 3 months post-intervention

Study Arms (2)

Acceptance and Commitment Therapy

EXPERIMENTAL

Across six weekly 50-minute sessions and a booster session, advanced gastrointestinal cancer patients and caregivers practice various mindfulness exercises, clarify their values, and set specific goals in alignment with their values. Through in-session and home practice of skills, participants learn new and more adaptive ways to respond to unwanted internal experiences (e.g., fatigue, distress). Participants receive handouts on session topics and a compact disc (CD) that the team developed to guide mindfulness practices.

Behavioral: Acceptance and Commitment Therapy

Education/Support

ACTIVE COMPARATOR

Across six weekly 50-minute sessions and a booster session, advanced gastrointestinal cancer patients and caregivers are directed to resources for practical and health information and contact information for psychosocial services. Sessions include an orientation to the patient's medical center and treatment team, education regarding common quality-of-life concerns experienced by cancer patients and caregivers, and an overview of medical center and community resources for addressing these concerns. The therapist also describes resources for addressing financial concerns and methods of evaluating health information available via the Internet and other modalities. Participants receive handouts summarizing session topics and are asked to review them as homework.

Behavioral: Education/Support

Interventions

Patients and caregivers in the education/support arm discuss their cancer-related concerns and receive education on services available in their medical center and community.

Education/Support

Patients and caregivers in the acceptance and commitment therapy arm learn new and more adaptive ways to respond to difficult internal experiences (e.g., fatigue, thoughts, and feelings).

Acceptance and Commitment Therapy

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patient is at least 3 weeks post-diagnosis of unresectable stage III or stage IV gastrointestinal cancer (i.e., ampullary, anal, appendix, bile duct, colon, esophageal, gallbladder, liver, pancreatic, rectal, small intestine, or stomach cancer) and is receiving cancer care at one of the study sites.
  • Patient is at least 18 years of age.
  • Patient can speak and read English.
  • Patient has an eligible, consenting family caregiver (see criteria below).
  • Patient has moderate to severe fatigue interference with functioning.

You may not qualify if:

  • Patient shows significant psychiatric or cognitive impairment that would preclude providing informed consent and study participation.
  • Patient reports being able to do little activity on a functional status measure.
  • Patient is receiving hospice care at screening.
  • Patient does not have working phone service.
  • Patient has hearing impairment that precludes participation.
  • Patient participated in the pilot trial testing the same intervention.
  • Family caregiver identified by a gastrointestinal cancer patient who meets the eligibility criteria.
  • Caregiver has significant caregiving burden.
  • Caregiver lives with the patient or has visited the patient in-person at least twice a week for the past month.
  • Caregiver is at least 18 years of age.
  • Caregiver can speak and read English.
  • Caregiver shows significant psychiatric or cognitive impairment that would preclude providing informed consent and study participation.
  • Caregiver does not have working phone service.
  • Caregiver has hearing impairment that precludes participation.
  • Patient declines study participation.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Northwestern Medicine

Chicago, Illinois, 60611, United States

RECRUITING

Eskenazi Health

Indianapolis, Indiana, 46202, United States

NOT YET RECRUITING

Indiana University Health

Indianapolis, Indiana, 46202, United States

RECRUITING

MD Anderson Cancer Center

Houston, Texas, 77030, United States

RECRUITING

Related Publications (1)

  • Mosher CE, Shinn EH, Addington EL, Wu W, Bricker JB, Helft PR, Turk AA, Vater LB, Masood A, Jalal SI, Loehrer PJ Sr, Champion VL, Johns SA. Protocol of a randomized trial of acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer. Contemp Clin Trials. 2026 Jan;160:108168. doi: 10.1016/j.cct.2025.108168. Epub 2025 Nov 26.

MeSH Terms

Conditions

Gastrointestinal NeoplasmsCaregiver BurdenFatigue

Interventions

Acceptance and Commitment TherapyEducational StatusPalliative Care

Condition Hierarchy (Ancestors)

Digestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesStress, PsychologicalBehavioral SymptomsBehaviorSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Cognitive Behavioral TherapyBehavior TherapyPsychotherapyBehavioral Disciplines and ActivitiesSocioeconomic FactorsPopulation CharacteristicsPatient CareTherapeuticsHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Catherine E Mosher, Ph.D.

    Indiana University Indianapolis

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Hannah Mullin

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
Research staff will be blind to study condition when administering assessments to participants via phone.
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Model Details: Advanced gastrointestinal cancer patient-family caregiver dyads (N = 244) will be randomly assigned in equal numbers to Acceptance and Commitment Therapy (ACT) or education/support using a stratified block randomization scheme to balance the groups by patient age (\<65 vs. \>=65 years) and performance status (patient-reported Eastern Cooperative Oncology Group \[ECOG\] scores 0 or 1 vs. 2).
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor of Psychology

Study Record Dates

First Submitted

July 29, 2024

First Posted

August 1, 2024

Study Start

August 21, 2024

Primary Completion (Estimated)

February 1, 2029

Study Completion (Estimated)

February 1, 2029

Last Updated

January 23, 2026

Record last verified: 2026-01

Data Sharing

IPD Sharing
Will share

The dataset to be shared will include individual-level baseline, procedural-based (intervention session attendance, homework completion), and outcome data for approximately 244 patients and 244 family caregivers. Data will be collected from self-report surveys and the Electronic Medical Record (EMR). Data from scored assessments (e.g., psychosocial questionnaires) will include both raw data elements (e.g., individual item responses) and summary information (e.g., total scores) where feasible. To protect the privacy of study participants, the investigators will develop a plan for de-identification of this dataset, which will address participant identifiers, dates, variables that are administrative or sensitive in nature, unedited verbatim responses that are stored as text data, and variables with low frequencies for some values.

Shared Documents
STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
Time Frame
The research community will have access to the data no later than the time of an associated publication or end of the performance period, whichever is first.
Access Criteria
Data will be findable for the research community through the Harvard Dataverse. A data digital object identifier (DOI) generated by the Harvard Dataverse will be referenced in all publications to allow the research community easy access to the exact data used in the publication. Access to the data will be restricted to qualified researchers to prevent misuse, misinterpretation, and confusion.

Locations