Adaptation and Testing of an Evidence-Based Sexual Health Communication Skills Training Intervention for Patients with Prostate Cancer

Prostate cancer (PCa) is the most common non-cutaneous cancer in U.S. men and causes sexual dysfunction in up to 90% of patients. Sexual dysfunction is associated with long-term reductions in psychological health and quality of life. Addressing sexual dysfunction is a critical component of PCa care that requires effective

patient-provider communication, as communication facilitates access to evidence-based sexual dysfunction therapies. Our prior qualitative studies identified gaps in patient-provider communication about sexual health as a key barrier to patients’ sexual recovery. Although most U.S. patients receive sexual health counseling

from PCa providers, many patients do not discuss their sexual health concerns with providers despite a desire for help. PCa patients face significant barriers to communicating with providers about sexual dysfunction, including loss of confidence due to impaired masculinity as a result of dysfunction. Furthermore, lack of patient

communication about sexual health is associated with worse quality of life. Although there is a critical need for an intervention to improve PCa patients’ sexual health communication with providers, no efficacious interventions exist. Starting the Conversation (STC) is an evidence-based sexual health communication skills

training intervention that has proven efficacious in improving breast cancer patients’ self-efficacy for sexual health communication with providers, rates of sexual health communication with providers, and sexual health. STC is a patient-facing, self-directed, multimedia intervention, and the core elements of the skills training are

broadly applicable across cancer type and stage. However, in its current format, STC focuses on female cancer survivors’ sexual health concerns and does not address PCa patients’ barriers to communication. Therefore, to address the critical need for an intervention to improve PCa patients’ sexual health

communication with providers, we propose to rigorously adapt STC for PCa and to pilot test the adapted intervention. In Aim 1, we will conduct focus groups with PCa patients and individual interviews with PCa providers to identify barriers and facilitators of patient-provider communication about sexual health in PCa care

and elicit feedback to adapt STC for PCa. In Aim 2, we will conduct usability testing with PCa patients to refine the intervention. In Aim 3, we will conduct a pilot randomized controlled trial of STC adapted for PCa to assess feasibility outcomes and preliminary effects of STC on patients’ self-efficacy for sexual health communication

with providers, rates of sexual health communication with providers, and sexual health. Conducting this study will contribute to Dr. Gupta’s development into an independent investigator with expertise in sexual health and urologic cancer survivorship, community engagement in research, development of behavioral interventions

(with a focus on patient-provider communication), design and conduct of behavioral intervention trials, and dissemination and implementation science. Findings from this study will generate preliminary data for a future NCI R01 submission for a definitive efficacy trial of the proposed intervention.