Catherine Mosher

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https://hdl.handle.net/1805/29973

Supportive Care for Adults with Advanced Cancer and their Family Caregivers

Dr. Catherine Mosher's field of research, Pyscho-Oncology, is the study of the behavioral, psychological, and social aspects of cancer. She is interested in the experiences of both patients and their family caregivers. We know that patients often suffer from a range of debilitating symptoms such as depression, anxiety, pain and fatigue. And family caregivers are often just as distressed, if not more distressed, than the patients themselves.

Dr. Mosher's research aims to address both patients' and family caregivers' concerns by developing and testing new counseling approaches. The approaches are delivered over the telephone and online to have the broadest reach to patients and caregivers throughout the state of Indiana.

Dr. Mosher's goal is to implement and disseminate these counseling interventions into clinical practice for improved outcomes for patients with advanced cancer and their family caregivers is another excellent example of how IUPUI's faculty members are TRANSLATING their RESEARCH INTO PRACTICE.

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Change in self-efficacy partially mediates the effects of the FRESH START intervention on cancer survivors' dietary outcomes
(Wiley, 2008) Mosher, Catherine E.; Fuemmeler, Bernard F.; Sloane, Richard; Kraus, William E.; Lobach, David F.; Snyder, Denise Clutter; Demark-Wahnefried, Wendy
Objective: This study examined change in self-efficacy as a mediator of the effects of a mailed print intervention on the dietary and exercise practices of newly diagnosed breast and prostate cancer survivors. Method: A total of 543 breast and prostate cancer patients were recruited from 39 states and two provinces within North America. Participants were randomly assigned to receive a 10-month program of tailored mailed print materials that aimed to increase fruit and vegetable consumption, reduce fat intake, and/or increase exercise or a 10-month program of publically available materials on diet and exercise. Telephone surveys conducted at baseline and 1 year assessed dietary practices, physical activity, and self-efficacy for engaging in these health behaviors. Results: Results indicated that changes in self-efficacy for fat restriction and eating more fruits and vegetables were significant mediators of the intervention's effects on dietary outcomes at 1-year follow-up. The intervention did not significantly affect self-efficacy for exercise; however, a significant, positive relationship was found between self-efficacy for exercise and exercise duration at follow-up. Conclusions: Findings are largely consistent with Social Cognitive Theory and support the use of strategies to increase self-efficacy in health promotion interventions for cancer survivors. Copyright © 2008 John Wiley & Sons, Ltd.
Cancer Survivors' Health Worries and Associations with Lifestyle Practices
(SAGE, 2008-11-01) Mosher, Catherine E.; Lipkus, Isaac M.; Sloane, Richard; Kraus, William E.; Snyder, Denise Clutter; Peterson, Bercedis; Jones, Lee W.; Demark-Wahnefried, Wendy
This study examined among recently diagnosed breast and prostate cancer survivors (N = 678) associations between worry about a future diagnosis of heart disease or cancer and hypothetical and actual adherence to exercise and dietary guidelines. Greater worry about future illness was reported under the hypothetical scenario of nonadherence to guidelines relative to the scenario of adherence. Worry about potential heart disease was associated with actual adherence to guidelines, whereas worry about a potential cancer diagnosis was not. Findings suggest that the motivational properties of worry should be considered when developing interventions to reduce heart disease risk among cancer survivors.
Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature
(Wiley, 2009) Mosher, Catherine E.; Redd, William H.; Rini, Christine M.; Burkhalter, Jack E.; DuHamel, Katherine N.
Objective: This article reviews recent literature on adults' quality of life following hematopoietic stem cell transplantation (HSCT). Methods: We identified 22 prospective reports with at least 20 participants at baseline through a search of databases (Medline and PsycInfo) and handsearching of articles published from 2002 to October 2007. If longitudinal data were not available or were scarce for a particular topic or time point, cross-sectional studies were reviewed. Results: Although physical, psychological, and social aspects of quality of life tend to improve during the years following transplantation, a significant proportion of HSCT survivors experience persistent anxiety and depressive symptoms, fatigue, sexual dysfunction, and fertility concerns. Despite ongoing treatment side effects, the majority of HSCT survivors resume their work, school, or household activities. Conclusion: We conclude that theory-driven research with larger samples is needed to identify subgroups of HSCT survivors with adjustment difficulties. Such research would examine survivors' evolving standards and definitions of quality of life to improve the accuracy and meaningfulness of assessment and incorporate biological, psychological, and contextual factors that may contribute to positive adjustment. Copyright © 2008 John Wiley & Sons, Ltd.
Associations between lifestyle factors and quality of life among older long-term breast, prostate, and colorectal cancer survivors
(Wiley, 2009) Mosher, Catherine E.; Sloane, Richard; Morey, Miriam C.; Snyder, Denise Clutter; Cohen, Harvey J.; Miller, Paige E.; Demark-Wahnefried, Wendy
BACKGROUND: Older cancer survivors are at increased risk for secondary cancers, cardiovascular disease, obesity, and functional decline and, thus, may benefit from health-related interventions. However, to the authors' knowledge, little is known regarding the health behaviors of older cancer survivors and the associations of those behaviors with quality-of-life outcomes, especially during the long-term post-treatment period. METHODS: In total, 753 older (aged ≥65 years) long-term survivors (≥5 years postdiagnosis) of breast, prostate, and colorectal cancer completed 2 baseline telephone interviews to assess their eligibility for a diet and exercise intervention trial. The interviews assessed exercise, diet, weight status, and quality of life. RESULTS: Older cancer survivors reported a median of 10 minutes of moderate-to-vigorous exercise per week, and only 7% had Healthy Eating Index scores >80 (indicative of healthful eating habits relative to national guidelines). Despite their suboptimal health behaviors, survivors reported mental and physical quality of life that exceeded age-related norms. Greater exercise and better diet quality were associated with better physical quality-of-life outcomes (eg, better vitality and physical functioning; P < .05), whereas greater body mass index was associated with reduced physical quality of life (P < .001). CONCLUSIONS: The current results indicated a high prevalence of suboptimal health behaviors among older, long-term survivors of breast, prostate, and colorectal cancer who were interested in lifestyle modification. In addition, the findings pointed to the potential negative impact of obesity and the positive impact of physical activity and a healthy diet on physical quality of life in this population. Cancer 2009.
Cancer Patients Versus Cancer Survivors: Social and Emotional Consequences of Word Choice
(SAGE, 2009-03-03) Mosher, Catherine E.; Danoff-Burg, Sharon
Two studies examined the social and emotional implications of different linguistic classifications of individuals with cancer. Undergraduates were randomly assigned to rate their reactions to either cancer patients or cancer survivors. Across studies, participants held more favorable perceptions of the character of cancer survivors relative to cancer patients and displayed more positive attitudes toward the former group. In addition, participants in Study 1 reported greater willingness to interact with cancer survivors compared with cancer patients. Positive perceptions of prognosis did not appear to account for favorable attitudes toward cancer survivors; most participants in Study 2 did not assume that cancer survivors were beyond the treatment phase of their illness or cured of their disease. Findings point to a potentially powerful effect of word choice on reactions to individuals with cancer.
Psychosocial adjustment of family caregivers of head and neck cancer survivors
(Springer, 2009-04-24) Ross, Stephanie; Mosher, Catherine E.; Ronis-Tobin, Victor; Hermele, Sandy; Ostroff, Jamie S.
This study examined the psychosocial adjustment and needs of family caregivers of head and neck cancer survivors at 6–24 months posttreatment.
Barriers to mental health service use among hematopoietic SCT survivors
(Springer, 2010) Mosher, C.E.; Duhamel, K.N.; Rini, C.M.; Li, Y.; Isola, L.; Labay, L.; Rowley, S.; Papadopoulos, E.; Moskowitz, C.; Scigliano, E.; Grosskreutz, C.; Redd, W.H.
This study examined barriers to mental health service use and the demographic, medical and psychosocial correlates of these barriers among hematopoietic SCT (HSCT) survivors. A sample of 253 HSCT survivors who were 1 to 3 years posttransplant completed measures of demographic, physical, psychological and social characteristics as well as a newly modified measure of barriers to mental health service use. Only 50% of distressed HSCT survivors had received mental health services. An exploratory factor analysis of the barriers to mental health service use scale yielded four factors: scheduling barriers, knowledge barriers, emotional barriers and illness-related barriers. Patients with higher social constraints (perceived problems discussing the illness experience with significant others) reported higher levels of all four types of barriers. General distress and transplant-related posttraumatic stress symptoms were positively associated with emotional, knowledge and illness-related barriers to mental health service use, whereas physical and functional well-being were inversely associated with these barriers. Having more knowledge barriers and more emotional barriers predicted a lower likelihood of receiving mental health services, as did lower levels of education and general distress. Results suggest that a significant number of HSCT survivors may benefit from education about mental health services that is tailored to individual barriers.
Self-efficacy for coping with cancer in a multiethnic sample of breast cancer patients: Associations with barriers to pain management and distress
(Wolters Kluwer, 2010) Mosher, Catherine E.; DuHamel, Katherine N.; Egert, Jennifer; Smith, Meredith Y.
Objectives This study examined the interrelations of self-efficacy for coping with cancer, perceived barriers to pain management, distress, and pain outcomes in a multiethnic sample of breast cancer patients. The extent to which ethnicity (Black, Latina, or White), language (English or Spanish), and level of education and income predicted these variables was also assessed. Methods Participants were breast cancer patients with persistent pain (N=87) who were recruited from oncology clinics in New York City. Patients completed an assessment battery that included measures of self-efficacy for coping with cancer, barriers to pain management, distress, and pain outcomes. Results Greater self-efficacy for coping with cancer was associated with older age, less time since diagnosis, and less distress. In addition, less self-efficacy for seeking and understanding medical information, Spanish language preference, and greater distress predicted greater barriers to pain management. Average pain severity was higher among Spanish-speaking individuals and those with lower incomes. Discussion Findings point to the potential importance of self-efficacy for seeking and understanding medical information and perceived barriers to pain management in understanding the psychologic well-being of breast cancer patients with pain, especially those who are Spanish-speaking.
Addiction to indoor tanning: Relation to anxiety, depression, and substance use
(AMA, 2010-04-01) Mosher, Catherine E.; Danoff-Burg, Sharon
To assess the prevalence of addiction to indoor tanning among college students and its association with substance use and symptoms of anxiety and depression.Two written measures, the CAGE (Cut down, Annoyed, Guilty, Eye-opener) Questionnaire, used to screen for alcoholism, and the Diagnostic and Statistical Manual of Mental Disorders(Fourth Edition, Text Revision) (DSM-IV-TR) criteria for substance-related disorders, were modified to evaluate study participants for addiction to indoor tanning. Standardized self-report measures of anxiety, depression, and substance use also were administered.A large university (approximately 18 000 students) in the northeastern United States.A total of 421 college students were recruited from September through December 2006.Self-reported addiction to indoor tanning, substance use, and symptoms of anxiety and depression.Among 229 study participants who had used indoor tanning facilities, 90 (39.3%) met DSM-IV-TR criteria and 70 (30.6%) met CAGE criteria for addiction to indoor tanning. Students who met DSM-IV-TR and CAGE criteria for addiction to indoor tanning reported greater symptoms of anxiety and greater use of alcohol, marijuana, and other substances than those who did not meet these criteria. Depressive symptoms did not significantly vary by indoor tanning addiction status.Findings suggest that interventions to reduce skin cancer risk should address the addictive qualities of indoor tanning for a minority of individuals and the relationship of this behavior to other addictions and affective disturbance.
Does narrative writing instruction enhance the benefits of expressive writing?
(Elsevier, 2010-05-01) Danoff-Burg, Sharon; Mosher, Catherine E.; Seawell, Asani H.; Agee, John D.
We examined whether instructing participants to write in a narrative fashion about stressful life events would produce superior physical and psychological health benefits relative to standard expressive writing instructions that do not specify the essay's structure. Undergraduates (N=101) were randomly assigned to engage in two, 20-minute narrative writing, standard expressive writing, or control writing tasks. Follow-up data were obtained one month later. The essays of the narrative writing group evidenced higher levels of narrative structure than did those of the expressive writing group. Greater narrative structure was associated with mental health gains, and self-rated emotionality of the essays was associated with lesser perceived stress at follow-up. In addition, the narrative and expressive writing groups reported lower levels of perceived stress and depressive symptoms relative to controls but did not differ from each other with regard to these outcomes. Health care utilization at follow-up did not vary by group assignment. Findings suggest that both emotional expression and narrative structure may be key factors underlying expressive writing's mental health benefits. Results also suggest that, among college students, instruction in narrative formation does not increase the positive effects of expressive writing relative to standard expressive writing instructions.

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