Virtual Mindful After Cancer Intervention to Promote Sexual Health for Breast and Gynecologic Cancer Survivors

PROJECT SUMMARY Sexual concerns are among the most common, distressing, and persistent aspects of life after cancer. For at least half of breast and gynecological cancer survivors, cancer treatment adversely affects physical, social, or psychological aspects of sexual health. Examples include vaginal pain, loss of sensation, poor body image,

disrupted intimate relationships, and loss of sexual interest. Despite this, sexual concerns are often unaddressed, with one major reason being lack of access to evidence-based interventions. In short, to improve sexual health in cancer survivorship, there is an urgent need to test and implement accessible, evidence-based

interventions that can effectively reach cancer survivors in need. Mindfulness-based interventions have demonstrated efficacy in addressing a range of sexual concerns and improving psychosexual health outcomes. Our preliminary research demonstrated support for the acceptability of a virtually delivered mindfulness-based

intervention adapted specifically for breast and gynecological cancer survivors experiencing sexual concerns. However, a more rigorous evaluation of this promising intervention, called Mindful After Cancer (MAC), is needed to support wide implementation and dissemination. A pragmatic trial would be ideal because it would

facilitate the evaluation of MAC in the context of routine practice, which leads to more generalizable results and shortens the gap from research to implementation outside of the trial setting, thus more quickly increasing access for cancer survivors in need. The Specific Aims of the proposed R34 are 1) To conduct a pilot trial in

preparation for a future multisite pragmatic trial of the virtual MAC intervention and 2) To identify contextual factors that may shape equitable reach and future implementation of the intervention. Our feasibility objectives are to develop protocols for 1) recruitment, 2) retention, and 3) training and supervision for adequate

intervention fidelity for the planned future trial. Results of the proposed pilot trial will provide a robust scientific foundation and preparation for a rigorously designed multisite pragmatic trial. Evaluation of intervention access barriers and strategies to improve equitable recruitment and reach in both academic- and community-based

care settings will inform future implementation and dissemination of mindfulness-based interventions such as MAC. Overall, results of the proposed project will readily translate to the protocol for rigorous, well-designed multisite pragmatic trial to evaluate the effectiveness of the virtual MAC intervention in real world conditions

where we expect to implement and disseminate the intervention.