Dr. Karishma S Chhabria

Background: Technology-mediated interventions have poor long-term adherence. Supportive accountability (social support and monitoring of goal achievement) may improve outcomes in technology-mediated interventions. However, no validated tool has been developed to measure supportive accountability.
Objective: To develop and psychometrically validate a supportive accountability measure (SAM) within the context of technology-mediated obesity treatments.

Methods: SAM was developed to reflect social support (10-items) and accountability (10-items). SAM was included in two technology-mediated obesity treatment studies. Study 1 (n = 353) reviewed SAM’s reliability, criterion validity and construct validity using exploratory factor analysis. Study 2 (n = 80) reviewed construct validity by comparing SAM between intervention groups 1) traditional self-monitoring tools (SC), 2) technology-based self-monitoring tools (TECH), or 3) technology tools plus phone-based support (TECH+PHONE). It was hypothesized that SAM scores would be highest in TECH+PHONE.

Results: SAM showed strong reliability in Studies 1 and 2 (α = .92 and .95). Factor analysis revealed a 3-factor solution (support for healthy eating, support for exercise, and accountability). SAM was also correlated with measures of social motivation and social pressure (P’s <.001), demonstrating convergent validity. In Study 2, the TECH+PHONE group reported significantly higher SAM scores compared to SC and TECH. Higher SAM scores were associated with better adherence to weight management behaviors. The association between SAM scores and weight loss was in the expected direction but not statistically significant.

Conclusion: SAM has strong reliability and validity. Future studies may consider using the SAM to better understand how supportive accountability impacts treatment adherence and outcomes.

Background/Purpose: Nearly all Head and Neck Cancer (HNC) patients experience some degree of treatment related fear on cancer diagnosis. Given the high prevalence of treatment related side effects and burden of treatment-related fear in HNC population, this prospective study aims to evaluate the relationship between fear of treatment and treatment outcomes following chemo-radiation therapy (CRT) in HNC patients. Results of this study will further our understanding of the relationship between psychological co-morbidities and physical symptoms/outcomes.

Methods: Forty-eight newly diagnosed HNC patients at Florida Health Center completed a set of surveys at the time of diagnosis and end of CRT. Data collection included disease and treatment related information along with surveys such as fear of treatment, adherence to self-management, pain, depression, and worry. Associations between demographic and outcome variables were evaluated using chi-squared and T tests. To further investigate the primary outcome variables, cross correlations, t-tests, repeated measures ANOVA were applied.

Results: Majority of the patients were Caucasian males, with mean age 62.6 years and modal tumor stage 2. Pretreatment fear was correlated with uncertainty about the future, intrusive thoughts, and anxiety about treatment. Post hoc analysis revealed patients consuming food via mouth post treatment were significantly less fearful as compared to those feeding via tube. Further, results suggest higher fear and pain levels at baseline are associated with lower adherence to self-management behaviors.

Conclusions and Implications: Our findings suggest higher levels of fear prior to treatment may be related to poorer treatment outcomes in HNC patients thus impacting survivorship and quality of life. Adherence to self-management behaviors is crucial in cancer care and quality of life. This study provides evidence that psychological fear impacts physical treatment outcomes in HNC patients, thus efforts to overcome fear are needed to improve survivorship following CRT.