Brain Tumor
Conditions
Brief summary
The goal of this clinical trial is to learn about the acceptability and feasibility of Cognitive Strategies, Mindfulness, and Rehabilitation Therapy (C-SMART) and Brain health Education and Wellness (BE Well) in adults with brain tumors and their caregivers. Participants will be assigned to one of the two groups: * Cognitive Strategies, Mindfulness, and Rehabilitation Therapy (C-SMART) is a recently developed virtual intervention combining both cognitive rehabilitation with mindfulness meditation training. The manualized program consists of 8 weekly 1:1 tele intervention sessions, targeting cognitive weaknesses identified from baseline cognitive testing. * Brain health Education and Wellness (BE Well) intervention consists of 8 weekly videos focused on maximizing brain health in the context of brain tumor. Participants will also be asked to: * participate in two in-person visits involving an MRI and neurocognitive tests * complete a survey the the beginning and end of the study * if in BE Well group, answer a few questions after watching each video
Interventions
BEHAVIORALC-SMART
Eight weekly, 45-60 minute, 1:1 tele-intervention sessions, targeting neurocognitive weaknesses identified from baseline cognitive testing
BEHAVIORALBE Well
Eight weekly 45- to 60-minute video lectures
Sponsors
Virginia Commonwealth University
American Psychological Foundation
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Double (Participant, Outcomes Assessor)
Intervention model description
Parallel Assignment, Patients with primary brain tumor and their caregivers. 42 participants (24 patients and 18 caregivers)\[Anticipated\]
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patient Inclusion Criteria: * Patient of Virginia Commonwealth University Neuro-Oncology clinic * Confirmed primary brain tumor diagnosis by histology or neuro-oncologist review of imaging * At least one domain of neurocognitive function \>1.5 SD below the average or the individual's estimated premorbid functioning, using the expanded International Cognition and Cancer Task Force (ICCTF) clinical trials battery and Test of Premorbid Functioning62 for comparison; (3) \>1 month post brain surgery and/or radiation therapy, if applicable; * Estimated premorbid intelligence \>75. * Patients must be age 18+ and * Primarily English speaking. Patient
Exclusion criteria
* Presence of major neurocognitive impairment that would prevent participation in the intervention, and/or severe aphasia, and/or inability to understand and provide informed consent * Inability to attend weekly telehealth appointments * Clinically significant insomnia symptoms coupled with report that insomnia is more interfering than cognitive symptoms * \< 1 month post brain surgery and/or radiation therapy * Unstable internet connection or an inability to work teleconferencing software. Participants will be supplied an iPad if they do not have an adequate device. * Participants cannot have metal in their body as the MRI scan could cause them harm * If female of childbearing years, they cannot be pregnant as the MRI scan may pose risk to the unborn fetus Caregiver Inclusion Criteria * Must enroll with a patient (see criteria above) * Must be age 18+ and * Primarily English speaking Caregiver
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assess the feasibility of the C-SMART and BE Well protocols in brain tumor patients- Eligibility Rate | From time participant indicates interest to screening completion, 4 weeks | The percentage of participants that are eligible to enroll |
| Assess the feasibility of the C-SMART and BE Well protocols in brain tumor patients - Enrollment Rate | From screening to intervention initiation, 8 weeks | The percentage of participants that enroll |
| Assess the feasibility of the C-SMART and BE Well protocols in brain tumor patients -- retention rate | From baseline to end of study, 28 weeks | The percentage of participants that complete the post-intervention data collection |
| Assess the acceptability of the C-SMART and BE Well protocols in brain tumor patients -- intervention completion rate | From baseline to end of intervention, 16 weeks | The percentage of participants that complete the the protocol assigned interventions |
| Assess the acceptability of the C-SMART and BE Well protocols in brain tumor patients - Participant satisfaction ratings | From baseline to post-intervention survey completion, 20 weeks | Participant ratings of satisfaction. Participants will rate the following questions on a scale from completely disagree to completely agree: C-SMART/BE Well Meets my approval; C-SMART/BE Well is appealing to the patient; "I like C-SMART/BE Well"; "I welcome C-SMART/BE Well". Additionally, participants will answer the following question on a scale from extremely dissatisfied to extremely satisfied: "When you signed up for the study, you were told that you would be randomized to either C-SMART or BE Well Videos. How satisfied are you with the group you were randomized to?" |
| Assess the acceptability of the C-SMART and BE Well protocols in brain tumor patients - Participant recommendation ratings. | From baseline to post-intervention survey completion, 20 weeks | Participant ratings of intervention recommendation Participants will answer the following question: Would "you" (the patient) recommend C-SMART/BE Well to other brain tumor patients? |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Assess the feasibility of the C-SMART and BE Well protocols in caregivers of brain tumor - Enrollment Rate | From screening to intervention initiation, 8 weeks | The percentage of participants that enroll |
| Assess the feasibility of the C-SMART and BE Well protocols in caregivers of brain tumor patients -- retention rate | From baseline to end of study, 28 weeks | The percentage of participants that complete the post-intervention data collection |
| Assess the acceptability of the C-SMART and BE Well protocols in caregivers of brain tumor patients - Participant satisfaction ratings | From baseline to post-intervention survey completion, 20 weeks | Participant ratings of satisfaction. Participants will rate the following questions on a scale from completely disagree to completely agree: C-SMART/BE Well Meets my approval; C-SMART/BE Well is appealing to the patient; "I like C-SMART/BE Well"; "I welcome C-SMART/BE Well". Additionally, participants will answer the following question on a scale from extremely dissatisfied to extremely satisfied: "When you signed up for the study, you were told that your loved one would be randomized to either C-SMART or BE Well Videos. How satisfied are you with the group your loved one was randomized to?" |
| Assess the acceptability of the C-SMART and BE Well protocols in caregivers of brain tumor patients - Participant recommendation ratings. | From baseline to post-intervention survey completion, 20 weeks | Participant ratings of intervention recommendation. Participants will answer the following question: Would "you" (the caregiver) recommend C-SMART/BE Well to other caregivers? |
| Investigate effect of interventions on neurocognitive tests Hopkins Verbal Learning Test (verbal learning and memory) | Baseline to post-intervention assessment, up to 28 weeks | Changes in neurocognitive assessment scores (pre vs post intervention) between groups based on the Hopkins Verbal Learning Test (verbal learning and memory) neurocognitive test. Participant performance on the verbal learning and memory task will consist of three learning trials and a delay. A high score on the learning trials but a very low score on the delayed recall would show that the person can learn but has difficulty retrieving previously learned information. |
| Investigate effect of interventions on neurocognitive test Controlled Oral Word Association (verbal fluency) | Baseline to post-intervention assessment, up to 28 weeks | Changes in neurocognitive assessment scores (pre vs post intervention) between groups based on the Controlled Oral Word Association (verbal fluency) neurocognitive test. Participant performance on the verbal fluency task will consist of generating words in 60 seconds on phonemic trials (words that start with a specific letter) and semantic trials (words that fall into a specific category). Scores are the number of correctly retrieved words. A higher raw score indicates greater verbal fluency. |
| Investigate effect of interventions on neurocognitive test Trail Making (attention and task switching) | Baseline to post-intervention assessment, up to 28 weeks | Changes in neurocognitive assessment scores (pre vs post intervention) between groups based on Trail Making (processing speed and task switching). Participant performance will consist of time (in seconds) to complete a processing speed and switching task in which participants are asked to draw lines in sequential order, and then switch between two overlearned sequences. A shorter time to completion would indicate greater processing speed and task switching. |
| Investigate effect of interventions on subjective cognition | Baseline to post-intervention assessment, up to 20 weeks | Changes in subjective cognition (pre vs post intervention) between groups based on the Neuro-Qol Short Form the National Institutes of Health (NIH) toolbox. Participants rate their experience of cognitive slips on 4 questions from "never" to "very often", and 4 questions from "no difficulty" to "cannot do". Higher scores indicate greater subjective cognition. Scores range from 8-40. Raw scores can be converted into standardized scores (T-scores) with a mean of 50 and a standard deviation (SD) of 10. Thus, a person who has a T-score of 60 is one SD above the average of the US general population. |
| Investigate effect of interventions on fatigue | Baseline to post-intervention assessment, up to 20 weeks | Changes in fatigue (pre vs post intervention) between groups based on the Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue short form. Participants rate their experience of fatigue on 4 items from "not at all" to "very much". Higher scores indicate greater fatigue. Scores range from 4-20. Raw scores can be converted into standardized scores (T-scores) with a mean of 50 and a standard deviation (SD) of 10. Thus, a person who has a T-score of 60 is one SD above the average of the US general population. |
| Structural brain changes | From baseline to post-outcome assessment, 28 weeks | Change in brain volume (pre vs. post intervention) between groups based on brain imaging (MRI) data. The volume of lateral ventricle in the hemisphere opposite to the tumor will be measured, using 3D Slicer (https://www.slicer.org) to calculate the ventricular volume at each time point which will serve as an index of diffuse cerebral volume loss. |
Countries
United States
Contacts
CONTACTSarah Braun, Ph.D
CONTACTBrighton Payne, BS
PRINCIPAL_INVESTIGATORSarah Braun, Ph.D
Virginia Commonwealth University
Outcome results
None listed