Wenzel, L., Osann, K., Hsieh, S., Tucker, J.A., Monk, B.J., & Nelson, E.L. (2015). Psychosocial telephone counseling for survivors of cervical cancer: Results of a randomized biobehavioral trial. Journal of Clinical Oncology, 33, 1171–1179. 

To study the effects of psychosocial telephone counseling on anxiety, quality-of-life domains, and biomarkers

Eligible patients were randomly assigned to the telephonic intervention or usual care. Those receiving the intervention received a five-minute pre-call to reintroduce the purpose of the intervention and schedule initial sessions. Patients received four sessions of 20-60 minutes for education and counseling for problem solving, social support, communication skill development, and problem identification based on the transactional model of stress and coping. Follow-up letters with session summary and suggested homework assignments were mailed after each session. Surveys were mailed to participants for completion at baseline, 4 months, and 9 months.

• N = 168 at 4 months, 151 at 9 months  
• MEAN AGE = 44.75 years
• FEMALES: 00%
• KEY DISEASE CHARACTERISTICS: All had cervical cancer
• OTHER KEY SAMPLE CHARACTERISTICS: More than half had some college education. About 40% were Hispanic.

• SITE: Single site  
• SETTING TYPE: Home  
• LOCATION: California

• PHASE OF CARE: Late effects and survivorship

Randomized, controlled trial

• PROMIS depression short form
• Brief Symptom Inventory (BSI)
• Gynecologic Problems Checklist
• FACT (cervical and general questionnaires)
• Plasma cytokine measurement

Patients assigned to the intervention had significantly better scores for depression (p = 0.041) and cancer-specific concerns at four months (p < 0.05). There was no difference between groups in anxiety at four months. Patients assigned to the intervention demonstrated continued improvement in gynecologic problems at nine months. At nine months, there was no difference between groups in depression or anxiety.

Longitudinal evaluation of a telephonic psychoeducational intervention among survivors of cervical cancer showed benefit for depression and gynecologic problems in the first four months after the intervention. These differences were not maintained over the longer term.

• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Participant withdrawals of 10% or greater

Telephone-delivered psychoeducational intervention was associated with reduced depression and cancer concerns within the first few months of the intervention; however, these benefits did not appear to be maintained over the longer term. It is possible that there is a need for continued intervention in order to benefit patients in the longer term. Findings suggest that a telephone intervention delivery can be effective, and may be a practical way to be able to deliver this type of intervention, particularly for patients in rural areas, or those otherwise unable to travel to healthcare facilities.