As cancer survivorship continues to rise in the United States1, developing support solutions that manage the material, social, physical, and mental well-being of cancer survivors is vital to their continued success post-treatment and therapy.2 While many solutions have focused on singular aspects of survivorship care, such as physical activity3, nutritional habits4, and mental wellness5, many survivors across cancer types need a comprehensive solution that not only addresses multiple health needs but also complements their medical care.
Enter the COACH Study.
The study, titled “Comprehensive Outcomes for After Cancer Health (COACH): The Feasibility and Impact of an mHealth Augmented Coaching Program for Self-Management in Cancer Survivors Who Have Completed Primary Cancer Therapy” (NCT05349227) , is one of the first to investigate the impact of digital health coaching on individuals’ health outcomes and non-clinical needs following primary treatment.6,7,8 Spearheaded by Pack Health, a Quest Diagnostics company, this multisite study, in collaboration with Dana-Farber Cancer Institute, the Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, The Ohio State University Comprehensive Cancer Center (OSUCC – James), The University of Texas Health Science Center at Houston (UTHealth Houston), and the University of Florida, currently has over 60 participants enrolled to date, with a total enrollment goal of 550 participants.
Study participants must be within one year of completion of their primary cancer therapy and may be on active surveillance, follow-up care, or maintenance therapies. Participants in the Intervention group receive six months of digital health coaching from Pack Health immediately following study enrollment, while those in the waitlist group receive coaching in months seven to 12. All participants communicate weekly with a Pack Health Advisor, receiving survivorship support and resources via phone, SMS, or email. Patient-reported outcomes, gut microbiome samples, and data from a wearable activity tracker are collected over 12 months for all participants.
“This is a study that has real-world potential for improving the symptom trajectory, health habits and quality of life for people after receiving primary cancer treatment,” University of Florida site co-primary investigator and Chamings School of Nursing Professor, Angela Starkweather, PhD, ACNP-BC, FAANP, FAAN, said.
Dana-Farber Cancer Institute is one of the world’s leading centers of cancer research and treatment. Dana-Farber’s mission is to reduce the burden of cancer through scientific inquiry, clinical care, education, community engagement, and advocacy. We provide the latest treatments in cancer for adults through Dana-Farber Brigham Cancer Center and for children through Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. Dana-Farber is the only hospital nationwide with a top 5 U.S. News & World Report Best Cancer Hospital ranking in both adult and pediatric care.
As a global leader in oncology, Dana-Farber is dedicated to a unique and equal balance between cancer research and care, translating the results of discovery into new treatments for patients locally and around the world, offering more than 1,100 clinical trials.
We are Nebraska Medicine and UNMC. Our mission is to lead the world in transforming lives to create a healthy future for all individuals and communities through premier educational programs, innovative research, and extraordinary patient care.
The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection, and treatment. Ohio State is one of only 51 National Cancer Institute (NCI)-designed Comprehensive Cancer Centers and one of only a few centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs sponsored by the NCI. As the cancer program’s 356-bed adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet R designation, the highest honor an organization can receive for quality patient care and professional nursing practice. With 21 floors and more than 1.1. million square feet, The James is a transformational facility that fosters collaboration and integration of cancer research and clinical cancer care.
Established in 1972 by The University of Texas System Board of Regents, The University of Texas Health Science Center at Houston (UTHealth Houston) is Houston’s Health University and Texas’ resource for health care education, innovation, scientific discovery and excellence in patient care. The most comprehensive academic health center in the UT System and the U.S. Gulf Coast region, UTHealth Houston is home to Jane and Robert Cizik School of Nursing, John P. and Kathrine G. McGovern Medical School, and schools of biomedical informatics, biomedical sciences, dentistry, and public health. UTHealth Houston includes the Dunn Behavioral Sciences Center and Harris County Psychiatric Center, as well as clinical practices UT Physicians, UT Dentists, and UT Health Services. The university’s primary teaching hospitals are Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital, and Harris Health Lyndon B. Johnson Hospital. For more information, visit www.uth.edu.
The University of Florida is a public land-grant research university, one of the most comprehensive in the United States, and ranked fifth-best in the country by U.S. News & World Report. UF is the oldest of Florida’s 12 universities and is the only institution in the state to be a member of the prestigious Association of American Universities. The UF College of Nursing is one of six colleges of the UF Health Academic Health Center, which includes nine major health-related research centers and institutes, as well as a comprehensive quaternary clinical enterprise. Founded in 1956, the College of Nursing’s vision, mission and values support the University of Florida’s aspiration to be known as a premier university at the state, national and global levels. The College of Nursing is driven to transform health through innovative practice, preeminent research, and exceptional academic programs.
While the central focus of the COACH study is framed around survivorship, the study’s investigators are eager to see what additional oncology scholarship will develop from the results. “In addition to the novel intervention, study findings will contribute to our understanding of why there is so much interindividual variability in symptom experiences,” lead site investigator for Dana-Farber Cancer Institute, Marilyn Hammer, PhD, DC, RN, FAAN, explained.
As two-thirds of cancer survivors are now over 65 years old1, study co-author and member of the Cancer Control Research Program at OSUCC-James, Jessica Krok-Schoen, PhD, MA, is particularly interested in how the implications of the study will help inform developing improved oncology care and support for older patients.9 “We are particularly focused on the needs of older adult patients and supporting them throughout the continuum of care. This patient population has specific concerns —fall risk, incontinence, frailty, malnutrition, and other health conditions – that impact quality of life,” Krok-Schoen explained.
“We are proud at the Fred & Pamela Buffett Cancer Center to collaborate with other NCI-designated cancer centers to bring our patients the opportunity to participate in research capable of directly impacting their cancer survivorship,” study investigator for Nebraska Medicine and member at the Fred & Pamela Buffett Cancer Center, Robin Lally, PhD, MS, BA, RN, AOCN, FAAN said.
With the COACH study getting underway, Pack Health and our research partners are eagerly anticipating how the results from this study will inform existing scholarship surrounding digital health coaching and its significant impact on oncology care, primarily survivorship.10
“Digital health coaching offers a scalable approach to meeting supportive care needs of cancer survivors in their home environment, beyond the clinical care setting. We are excited to explore the usefulness of digital health coaching for self-management of symptoms and general wellness,” said Meagan Whisenant, PhD, study collaborator at the Cizik School of Nursing at UTHealth Houston.
Currently, study investigators have begun to share the vision and methodology of the study at various oncology conferences, including most recently during the San Antonio Breast Cancer Symposium (SABCS) in December 2022 and at the upcoming American Association for Cancer Research (AACR) Annual Meeting this month.
The COACH study is projected to conclude in December 2024.
“Digital health coaching offers a scalable approach to meeting supportive care needs of cancer survivors in their home environment, beyond the clinical care setting. We are excited to join this collaborative group of investigators to examine the experience of cancer survivors and explore the usefulness of digital health coaching for self-management of symptoms and general wellness,” said Meagan Whisenant, PhD, co-study collaborator at UTHealth Houston and assistant professor of nursing at Cizik School of Nursing at UTHealth Houston.
- Miller KD, Nogueira L, Devasia T, Mariotto AB, Yabroff KR, Jemal A, Kramer J, Siegel RL. Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin. 2022 Sep;72(5):409-436. Doi:10.3322/caac/21731. Epub 2022 Jun 23. PMID: 35736631.
- Ross LW, Townsend JS, Rohan EA. Still Lost in Transition? Perspectives of Ongoing Cancer Survivorship Care Needs from Comprehensive Cancer Control Programs, Survivors, and Health Care Providers. Int J Environ Res Public Health. 2022;19(5):3037. Published 2022 Mar 4. doi:10.3390/ijerph19053037
- Lawler S, Maher G, Brennan M, Goode A, Reeves MM, Eakin E. Get Healthy after Breast Cancer – examining the feasibility, acceptability and outcomes of referring breast cancer survivors to a general population telephone-delivered program targeting physical activity, healthy diet and weight loss. Support Care Cancer. 2017;25(6):1953-1962. doi:10.1007/s00520-017-3599-6
- Kenne Sarenmalm E, Mårtensson LB, Andersson BA, Karlsson P, Bergh I. Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Med. 2017;6(5):1108-1122. doi:10.1002/cam4.1052
- Castro-Espin C, Agudo A. The Role of Diet in Prognosis among Cancer Survivors: A Systematic Review and Meta-Analysis of Dietary Patterns and Diet Interventions. Nutrients. 2022;14(2):348. Published 2022 Jan 14. doi:10.3390/nu14020348
- Chan RJ, Crichton M, Crawford-Williams F, et al. The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews. Ann Oncol. 2021;32(12):1552-1570. doi:10.1016/j.annonc.2021.09.001
- Leach CR, Hudson SV, Diefenbach MA, et al. Cancer health self-efficacy improvement in a randomized controlled trial. Cancer. 2022; 128 (3): 597-605. Doi:10.1002/cncr.33947
- Comprehensive Outcomes for After Cancer Health (COACH). ClinicalTrials.gov. Accessed March 24, 2023. https://clinicaltrials.gov/ct2/show/NCT05349227
- Fitch MI, Nicoll I, Newton L, Strohschein FJ. Challenges of Survivorship for Older Adults Diagnosed with Cancer. Curr Oncol Rep. 2022;24(6):763-773. doi:10.1007/s11912-022-01255-7
- Escriva Boulley G, Leroy T, Bernetière C, Paquienseguy F, Desfriches-Doria O, Préau M. Digital health interventions to help living with cancer: A systematic review of participants’ engagement and psychosocial effects. Psychooncology. 2018;27(12):2677-2686. doi:10.1002/pon.4867
