A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention

J Behav Med. 2022 Oct;45(5):771-781. doi: 10.1007/s10865-022-00349-8. Epub 2022 Aug 5.

Abstract

Background: Fear of recurrence (FoR) is prevalent among breast cancer survivors (BCS) and may be exacerbated by avoidance coping. This study examined BCS with avoidance coping and their engagement in a FoR eHealth intervention (FoRtitude).

Methods: BCS (N = 196) with elevated FoR participated in FoRtitude. Patient-reported measures assessed avoidance coping with FoR and baseline emotional and behavioral health. Intervention engagement was measured quantitatively (e.g., website logins, telecoaching attendance) and qualitatively (i.e., telecoaching notes).

Results: 38 BCS (19%) endorsed avoidance coping, which was associated with more severe post-traumatic anxiety-related symptoms and worse global mental health (ps < .05), but not anxiety (p = .19), depression (p = .11), physical health (p = .12), alcohol consumption (p = .85), or physical activity (p = .39). Avoidance coping was not associated with engagement levels (ps > .05) but did characterize engagement-related motivators and barriers.

Conclusions: Avoidance coping was not a barrier to FoRtitude engagement. eHealth delivery is a promising modality for engaging survivors with avoidance coping in FoR interventions.

Keywords: Avoidance; Cancer; Fear of recurrence; Survivorship; eHealth.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Breast Neoplasms* / psychology
  • Cancer Survivors* / psychology
  • Fear / psychology
  • Female
  • Humans
  • Neoplasm Recurrence, Local / psychology
  • Quality of Life / psychology
  • Survivors / psychology
  • Telemedicine*