Developing an ACT-based intervention to address lung cancer stigma: Stakeholder recommendations and feasibility testing in two NCI-designated cancer centers

Abstract

Objective: Few psychosocial interventions have been tailored to meet the unique needs of patients diagnosed with lung cancer. This pilot study developed and tested a six-week intervention for reducing lung cancer stigma.Design and Subjects: Guided by qualitative interviews conducted with 9 lung cancer patients and 5 thoracic oncology care providers, Acceptance and Commitment Therapy was adapted for treatment of lung cancer stigma (ACT-LCS). In a subsequent single arm pilot study, 22 lung cancer patients reporting high levels of stigma completed the intervention.Setting: NCI-designated cancer centers in the Southwestern and Eastern United States.Results: Of 46 eligible patients, 22 provided consent, with 20 completing the intervention (10 in-person, 10 telehealth). Overall stigma decreased across timepoints, largely driven by reductions in internalized stigma. There were also significant reductions in social isolation, sleep disturbance, and fatigue.Conclusions: The ACT-LCS protocol demonstrates preliminary feasibility and acceptability. This intervention may be particularly suited for helping patients navigate feelings associated with internalized stigma.

Keywords:

• acceptance and commitment therapy
• lung neoplasm
• psycho-oncology
• social adjustment: stakeholder-informed research

Acknowledgment

The authors thank all study participants for their valuable contributions to this research.

Disclosure statement

All authors confirm that they have no conflicts of interest to disclose.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by the National Cancer Institute under grants T32CA009461 and P30CA008748; the University of Arizona Cancer Center—Cancer Center Support under grant P30CA023074-36; and a Basic/Clinical Partnership grant from the University of Arizona Cancer Center. Preparation of this manuscript was additionally supported by the National Heart Lung and Blood Institute under grant 1F32HL154751-01 (Kaplan) and the National Cancer Institute under grant K99-CA-256351 (Williamson).