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Our Research

Our group focuses our research in the areas of cancer control and behavioral science. Key to our efforts is to understand and reduce morbidity from cancer and treatment related physical and psychosocial symptoms with an intent to improve patient reported outcomes (PROs). We design IT enabled interventions to improve quality of life through development and testing of remote monitoring and care management systems designed to reduce cancer patient symptoms and improve family caregiver well-being. Within this focus we propose and test strategies to improve oncology provider and cancer patient/family caregiver communication about physical and psychosocial symptoms, quality of life, and goals of care throughout the cancer continuum. The Mooney group is very collaborative and conducts their research with a number of other research groups.

We are involved with a variety of extramurally funded and pilot studies to achieve our goal to understand and reduce morbidity from cancer and treatment and improve quality of life for those with cancer and their family members.

Our current projects include the following:

SymptomCare@Home:Deconstructing an effective, technology-assisted, symptom management intervention (R01CA206522; under review)
Role: PI with Co-investigator Susan Beck

  • This is the third of three NCI funded R01 projects which determine the most important and cost effective components of the SymptomCare@Home system, a new approach to cancer chemotherapy symptom care that has been shown to reduce problematic symptoms through automated daily monitoring, automated self-management coaching, and oncology team follow-up care using decisional support for patients at home when their symptoms are most likely at their worse. Once the key parts of the intervention and its cost effectiveness are known, it can be moved into everyday cancer care. Pending approval this study will begin in the Spring or Summer of 2016.

Automated Symptom Care during Cancer Treatment (R01 CA120558)
Role: PI with Co-investigator Susan Beck

  • This is the second of three NCI funded R01 projects to develop and test, in a randomized controlled trial, an IT enabled telephone-based automated symptom monitoring and coaching system, SymptomCare@Home. Patients receiving a course of chemotherapy called into the automated system daily and reported presence and severity of 11 common symptoms. The intervention group received automated coaching about symptom self-care based on the reported symptom pattern. In addition symptoms at moderate or higher levels generated an automated symptom alert to a nurse practitioner who, utilizing a case management system based on national symptom guidelines, called the patient and intensified symptom care. The study found significant symptom reduction for those in the intervention group, reducing symptoms by 40-67% over usual care.  This is the first reported use of a remote telemonitoring and care delivery system for cancer patients receiving chemotherapy that measured symptom outcomes and their significant reduction. The study is in the dissemination phase.

Automated Monitoring and Coaching of Cancer Family Caregivers during Home Hospice Care (Project 1 in PO1CA138317)
Role: PI with Lee Ellington and Michael Caserta, project leaders of the other two projects

  • This is one of three projects in a NCI funded program project grant (PPG). The PPG is focused on supporting cancer family caregivers in the home hospice setting extending into bereavement. In a randomized controlled trial, an IT enabled telephone-based automated symptom monitoring and coaching system, SymptomCare@Home, was adapted for family caregivers. Cancer family caregivers call into the automated system daily and report presence and severity of common end-of-life symptoms for their family member and also report their own well-being (such as fatigue, sleep, anxiety, and their confidence in caregiving). The intervention group receives automated coaching about how to care for their family member’s symptoms based on the reported pattern and also suggests ways to improve the caregiver’s well-being. In addition patient symptoms and caregiver concerns at moderate or higher levels generates an automated symptom alert to their hospice nurse who views the alert through a secure website. The study is in the dissemination phase. Findings demonstrated that the intervention significantly reduces patient symptoms and improves caregiver well-being.

Gene Variants related to Symptom Expression
Role PI with Co-PI Lisa Cannon Albright

  • Cancer patients receiving the same chemotherapy for cancer often experience different patterns of symptom severity. We are building a bioresource of cancer treatment-related symptom phenotypes-genotypes. With this unique resource, we are interested in identifying potential genetic variants associated with symptom expression. Once the resource has sufficient samples we will complete pilot work and submit an extramural grant application.                         

Provider-Patient Communication about Symptoms during Oncology Office Visits
Role: PI

  • This is a descriptive pilot study to determine patterns of communication about treatment-related symptoms at oncology clinic visits during a course of chemotherapy. Visits are audio recorded and later coded for the content, communication style, and length of symptom talk. Visit symptom content is correlated with patient-reported patterns of symptoms reported daily during the weeks prior to the visit utilizing the SymptomCare@Home monitoring system. We are interested in exploring how to improve communication about bothersome symptoms at clinic visits.

Patient/Family Caregiver Communication with Providers about Symptoms, Quality of Life and Goals of Care during Oncology Office Visits for Life-Limiting Cancer
Role: Co-PI with Co-PI Lee Ellington

  • People with life limiting cancers must make decisions about the balance of continuing life extending treatment and maintaining quality of life in the face of disease progression. These discussions occur with providers during oncology office visits that determine treatment response and next plans. We are conducting a descriptive pilot study of communication during oncology office visits with patients with life limiting cancer and their family caregivers. We are interested in understanding the degree of conversation directed at care planning and the decisions and treatment choices of patients/families for both life extending and palliative focused treatments. Successive office visits are audio recorded and coded for decision points, patterns of life-extending and palliative focused care, and communication styles.

Retrospective EMR Chart Review of the Pattern of Care Provision for Cancer Patients during the Last 6 Months of Life
Role Co-PI with Co-PIs Lee Ellington and Anna Beck

  • We are conducting a descriptive, retrospective patterns-of-care EMR chart review to determine the usual patterns of care, life extending and palliative focused treatments, resources, and referrals received by cancer patients in the last 6 months of life. This study is currently in data collection. This pilot study is currently in the dissemination phase.

Transitional Support for Women Completing Initial Treatment for Breast Cancer and Entering Survivorship: the MAP project to enhance communication with providers
Role: Co-investigator with PI Margaret Clayton

  • Completing initial treatment for breast cancer  requires women to make the transition to the survivorship phase characterized by less frequent provider contacts but lingering unresolved or new symptoms and the need for continuing surveillance and follow-up care. Concerns and worries often occur between outpatient follow-up visits. We have developed and piloted a web-enabled interactive toolkit for women to track their symptoms and concerns and to prepare and prioritize their concerns for discussion at upcoming provider visits. The tool also assists women to plan strategies to effectively communicate their priority concerns to providers and to persist if concerns are not sufficiently addressed. We are preparing a R01 application to test the efficacy of the toolkit to improve engagement and communication and to reduce symptoms and psychological concerns.