The National Palliative Care Research Center

Curing suffering through palliative care research.

Hagan Thomas

Teresa Hagan Thomas PhD, RN

Assistant Professor

University of Pittsburgh

Grant Year
Grant Term
2 years
Grant Type
Junior Faculty Career Development

Project Description
Strong Together: Piloting a Serious Game to Improve Self-Advocacy among Female Patients with Advanced Cancer

When faced with the challenges of advanced cancer, women must advocate (or stand up) for their needs and priorities. However, there are no interventions to promote self-advocacy in advanced cancer patients. Serious games offer a novel mechanism by which to deliver interactive, engaging health education. The fully-automated Strong Together self-advocacy serious game may allow women with advanced cancer to learn self-advocacy skills and therefore improve their health outcomes. The purpose of this pilot randomized controlled trial (RCT) is to evaluate the feasibility, acceptably, and preliminary efficacy of the Strong Together serious game. The aims of this study are to: (1) evaluate the feasibility and acceptability of the 3-month Strong Together intervention and (2) explore the differences in self-advocacy and symptom burden between groups over time. This pilot RCT will recruit (N=81) women. Eligibility criteria include: female; age ≥ 18 years; diagnosis of Stage III or IV gynecological or Stage IV breast cancer within the past 3 months; 6-month prognosis; scoring below the mean of the FSACS Scale; Eastern Cooperative Oncology Group performance status score of 0-1; and ability to read and write in English. Measures will be collected at baseline, 3-months, and 6-months. Randomization (2:1) will occur to the 3-month Strong Together intervention group or the enhanced care as usual group. Feasibility will be assessed by calculating percentages of the intervention’s dosage, engagement, recruitment, retention, and data completion. Acceptability will be assessed through exit interviews and an acceptability scale. Preliminary efficacy will be measured by exploring differences in self-advocacy and symptom burden scores and calculating point- and interval-estimates between the groups at 3 and 6 months. This study represents a unique opportunity to address the lack of self-advocacy interventions in advanced cancers, reduce the risks of women with low self-advocacy, and guide an adequately-powered RCT.

Teresa Hagan Thomas, PhD, RN is an Assistant Professor in the Department of Health Promotion & Development at the University of Pittsburgh School of Nursing in Pittsburgh, PA. Her research focuses on patient self-advocacy among patients with advanced cancer, especially those from vulnerable populations. Dr. Thomas is a 2018 NPCRC and American Cancer Society Career Development Award grantee.