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Health SMART (Stress Management and Relaxation Training) to Improve Vaccine Immune Response

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00121160
Recruitment Status : Completed
First Posted : July 21, 2005
Last Update Posted : March 27, 2012
National Cancer Institute (NCI)
Information provided by:
Fred Hutchinson Cancer Research Center

Brief Summary:

The proposed investigation will conduct a randomized, clinical trial to test the efficacy of a cognitive behavioral stress management (CBSM) group intervention on immune response to vaccine and distress among women at elevated risk for breast cancer.

Hypothesis 1: Women who participate in the CBSM intervention will have a larger primary and secondary antibody response to vaccines compared to women in the comparison group.

Hypothesis 2: Women who participate in a 10-week CBSM group intervention will report lower levels of distress immediately after and 6 months after the intervention compared to women in the comparison group.

Condition or disease Intervention/treatment Phase
Psychological Stress Behavioral: Cognitive Behavioral Stress Management (CBSM) group intervention Phase 1

Detailed Description:

Chronic stress can impair immune function, including immune response to vaccines. This has important implications for cancer control and prevention because tumor vaccines are emerging as tools for cancer treatment and prevention, and the cohort that would benefit from the vaccines is likely to be stressed. Women at elevated risk for breast cancer experience significant levels of distress that have been associated with immune function decrements. Interventions to treat distress-related immune decrements among these women are needed because these women will be among the first candidates for breast cancer vaccines. In theory, stress-management interventions should improve immune function and response to vaccines, but the findings to date are mixed, in part because most intervention studies have been done with medical patients who by nature have immune confounds. Thus, it is unknown how stress management interventions affect immune function in stressed but otherwise healthy people, such as women at elevated risk for breast cancer.

Comparison: Women will be randomly assigned to a 10-week structured, CBSM intervention or a wait-list comparison group with delay participation in the intervention. The comparison group will be offered the full CBSM intervention after all assessment time points have been completed.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 126 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Can Stress Management Improve Vaccine Immune Response
Study Start Date : September 2005
Actual Primary Completion Date : June 2010
Actual Study Completion Date : July 2010

Intervention Details:
  • Behavioral: Cognitive Behavioral Stress Management (CBSM) group intervention
    Participants will meet in closed, structured groups of 4 to 6 women for ten weekly, 2-hour group sessions. The intervention employs CBSM techniques interwoven with information in a supportive group format. The information portion of the intervention focuses on learning to cope with daily stressors, and learning about optimal use of social support. Group members and group leaders are used as role models for effective coping and the use of social support. The groups also encourage emotional expression and provide an opportunity to practice techniques learned in the group and experience social support. Avoidance coping is discouraged, and acceptance and reframing are instead encouraged as coping responses. Health behavior change, framed as a coping technique, will also be discussed using motivational interviewing techniques. Each week participants also experience a different relaxation technique. The goal of the CBSM intervention is thus to reduce distress through a variety of techniques.

Primary Outcome Measures :
  1. Independent sample t-test will be used to compare 1) antibody change scores from before to after the first and second dose of vaccine, and 2) distress change scores from before to after the intervention [ Time Frame: length of protocol ]

Secondary Outcome Measures :
  1. Multiple regression analyzes will be used to test changes in cortisol and changes in perceived risk of breast cancer; coping or social support mediate the effects of the intervention on antibody response to vaccine and distress [ Time Frame: length of protocol ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Female, age 18-60 years
  • Family history of breast cancer
  • Fluent in English
  • Working phone
  • Working address
  • Plan to live in the area for one year

Exclusion Criteria:

  • Prior cancer diagnosis (except non-melanoma skin cancer)
  • Current major depressive episode
  • History of Bipolar Disorder or Schizophrenia
  • History of autoimmune disease
  • History of Hepatitis A or HA vaccination
  • Current infectious disease
  • Use of immune modulating drugs

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00121160

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United States, Washington
Fred Hutchinson Cancer Research Center
Seattle, Washington, United States, 98109
Sponsors and Collaborators
Fred Hutchinson Cancer Research Center
National Cancer Institute (NCI)
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Principal Investigator: Bonnie A. McGregor, PhD Fred Hutchinson Cancer Research Center

Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Bonnie A. McGregor, PhD / Assistant Member, Fred Hutchinson Cancer Research Center Identifier: NCT00121160    
Other Study ID Numbers: IRB-6003
First Posted: July 21, 2005    Key Record Dates
Last Update Posted: March 27, 2012
Last Verified: March 2012
Keywords provided by Fred Hutchinson Cancer Research Center:
immune response to vaccines
stress management
breast cancer
Additional relevant MeSH terms:
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Stress, Psychological
Behavioral Symptoms